Validation of a PrCr Dipstick Diagnostic Test in Ghana

This cross-sectional diagnostic accuracy evaluation will employ mixed methods to assess the performance of the PrCr dipstick test and to explore the operational feasibility of using this test as an alternative to the current protein-only test. These methods include: Assess the accuracy of the PrCr test for detection of proteinuria in a representative ANC setting in Ghana. • Detection of proteinuria using the PrCr dipstick test compared to the current standard of care and laboratory reference assay used for confirming proteinuria. Patient samples will be tested with multiple assays. The PrCr test and a protein-only dipstick (The Mission® Urinalysis Reagent Strips (Urine), will be used at the point of care. Patient samples will be transferred to KHRC laboratory using cold boxes (conditioned at 2oC - 8oC) and will be tested using a laboratory reference assay. Understand the feasibility of integrating the use of the PrCr test into ANC services. * Pre- and post-evaluation of ANC staff training on use of the PrCr test * Interviews with ANC staff * Consultations with key district and national stakeholders. Explore the potential for improved ANC management of PE/E using the PrCr test in the intended ANC setting. * Analysis of pregnancy outcomes (live or stillbirth) and review of referral records. Actual outcomes along with referral practices and linkage to care based on the current diagnostics will be compared to any potential changes in referral practices and linkage to care based on prospective PrCr test results. * Assessment of use of PrCr test with other clinical indicators and integration into diagnostic algorithms. Prospective PrCr test results will be integrated into an existing diagnostic algorithm to assess any potential changes in referral practices and linkage to care.