Single-Session Filariasis Rapid Diagnostic Test Training for Primary Health Care Workers in a Brugia malayi-Endemic Area of Indonesia: Ceiling Effects and Non-Independent Responses

Background: Post-mass drug administration (MDA) surveillance of lymphatic filariasis (LF) in Brugia malayi-endemic areas relies on the Brugia Rapid IgG4 antibody test, yet most primary health care workers have never been trained to use it. To evaluate the effect of a single-session LF rapid diagnostic test (RDT) training on health workers’ knowledge and attitude. Method: A one-group pretest–post-test study was conducted among health workers of two primary health care centres in Batanghari District, Jambi. The training comprised a lecture and a live demonstration with limited supervised practice. Knowledge (20 items) and attitude (8 Likert items) were compared with the Wilcoxon signed-rank test and Hodges–Lehmann estimates, with sensitivity, response-pattern, baseline-stratified and item-level analyses. Result: Result of 46 registrants, 40 were analysed. Baseline scores were high (knowledge median 17/20; 37.5% at the attitude maximum). Neither knowledge (median 17 to 18; p = 0.837; r = 0.03) nor attitude (median 35.5 to 36.5; p = 0.896) changed. Twenty-two participants (55.0%) submitted post-tests identical to another participant’s, accounting for 22 of the 25 post-test scores ≥18, and 25 (62.5%) gave the same response to all attitude items. Among the 18 participants with unique post-tests, knowledge declined (median 16.5 to 13; p = 0.017), and the apparent gain among participants with low baseline knowledge was no longer observed. Conclusion: The training produced no measurable group-level change, but ceiling effects and non-independent responding prevented a valid estimate of its effect. LF RDT training should be hands-on and evaluated with individually supervised written and skills-based assessments.