BDBV Diagnostic Procurement Brief

In a new CEID report, Drs. Brooke Nichols, Alexandra de Nooy, Megan A. Hansen, Nahid Bhadelia, share results of modelling which estimates diagnostic test needs in the Bundibugyo virus outbreak in Democratic Republic of Congo in two scenarios where either just nucleic acid amplification tests (such as PCR tests) are deployed or they are deployed with rapid tests. The model provides demand forecasting and makes case for why investment in rapid tests is important for multiple use cases.

The current Bundibugyo virus outbreak in the Democratic Republic of Congo has set in motion the familiar machinery of outbreak response: treatment units, contact tracing, and public awareness efforts. But one constraint quietly shapes everything else—the ability to test. Bundibugyo virus, a species of Ebolavirus, begins with fever, headache, and weakness, symptoms that are indistinguishable in their early stages from malaria, typhoid, and the many other febrile illnesses common across the region. Without a fast, reliable way to tell these apart, health workers are forced to make high-stakes decisions blind: true cases can be missed and placed in general wards where the virus spreads, while patients who simply have malaria may be isolated alongside the infected. The gold-standard test, PCR, is highly accurate but depends on centralized laboratories and currently takes around four days to return a result—an eternity during an outbreak, and a workload that quickly outstrips available lab capacity as cases climb.

This brief models what happens to diagnostic demand under two scenarios: relying on PCR alone, versus pairing it with rapid, point-of-care tests for Bundibugyo and other common fevers. The case for rapid tests is operational as much as clinical. Although individually less sensitive than PCR, they allow health workers to triage patients at the door, give staff the confidence that non-Bundibugyo patients can be safely treated, and keep facilities open for the routine care—malaria, pneumonia, childbirth—that people still need and might otherwise avoid out of fear. Notably, the modeling shows that the need for rapid tests holds remarkably steady, at roughly 20,000 per week, whether case counts rise or fall, which makes them a predictable procurement target rather than a moving one. PCR remains indispensable for confirming cases and clearing recovered patients for discharge, but it is rapid testing that lets the health system function rather than operate blind. The conclusion is direct: developing and deploying rapid Bundibugyo tests must be an immediate priority.