Article Category:
Research Article

Acceptability, Feasibility, and Uptake of COVID-19 Antigen Rapid Diagnostic Self-Testing at the Community Level in Tanzania

Grace W. Mwangoka Ifakara Health Institute, Dar es Salaam, Tanzania;

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Ali M. Ali Ifakara Health Institute, Dar es Salaam, Tanzania;

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Mwifadhi Mrisho Ifakara Health Institute, Dar es Salaam, Tanzania;

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Abdallah Mkopi Ifakara Health Institute, Dar es Salaam, Tanzania;

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Muhidin Mahende Ifakara Health Institute, Dar es Salaam, Tanzania;

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Hajirani M. Msuya Ifakara Health Institute, Dar es Salaam, Tanzania;

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Silas G. Temu Ifakara Health Institute, Dar es Salaam, Tanzania;

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Paul Kazyoba National Institute for Medical Research, Dar es Salaam, Tanzania;

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Michael G. Mihayo Ifakara Health Institute, Dar es Salaam, Tanzania;

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Omar Juma Ifakara Health Institute, Dar es Salaam, Tanzania;

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Ali Hamad Ifakara Health Institute, Dar es Salaam, Tanzania;

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Said A. Jongo Ifakara Health Institute, Dar es Salaam, Tanzania;

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Omar Lweno Ifakara Health Institute, Dar es Salaam, Tanzania;

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Anneth Tumbo Ifakara Health Institute, Dar es Salaam, Tanzania;

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Sara S. Mswata Ifakara Health Institute, Dar es Salaam, Tanzania;

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Anne Hoppe Foundation for Innovation and New Diagnostics, Campus Biotech, Geneva, Switzerland;
Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), Geneva, Switzerland

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Pallavi Dani Foundation for Innovation and New Diagnostics, Campus Biotech, Geneva, Switzerland;

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Salim Abdulla Ifakara Health Institute, Dar es Salaam, Tanzania;

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DOI:
https://doi.org/10.4269/ajtmh.23-0732
Volume/Issue:
Ahead of Print
Open access
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The rapid diagnosis of coronavirus disease 2019 (COVID-19) is critical for comprehensive public health response strategies, and self-testing with antigen rapid diagnostic tests (Ag-RDTs) presents opportunities to test in hard-to-reach communities. Therefore, we evaluated the acceptability, feasibility, and uptake of Ag-RDT self-testing at the community level in Tanzania. From June to October 2022, symptomatic individuals or those with recent contact with a known or suspected COVID-19 patient were offered assisted testing and self-testing within mining communities and at transport hubs. This study included a cross-sectional survey before and after implementation. Participants were assessed for their acceptability and uptake of the nasal Ag-RDT self-test and their preference for nasal Ag-RDT self-testing. The survey data were collected in Open Data Kit, whereas the Ag-RDT results in the community were recorded by using the COVISUSPECT Mobile Application. Data analysis was performed by using STATA and R Statistical Software. A total of 538 individuals were screened, and 454 (84.4%) consented to be tested. The preference for self-testing was relatively low (33%), and the majority of participants (67%) opted to be assisted by a healthcare professional. Of the participants who opted for testing, 149 (32.8%) were able to self-test. Generally, there was no major difference in the various assessed parameters between the baseline and end-line surveys. The results from fitting multiple logistic regression indicated that after controlling for age, participants living in Dodoma were significantly less likely to opt for self-testing (odds ratio = 0.54; P-value = 0.023) compared with those living in Dar es Salaam. There was no significant difference in self-testing between participants living in Mara and those living in Dar es Salaam (odds ratio = 0.7; P-value = 0.179). After controlling for region, older (≥40 years) participants were significantly less likely to self-test compared with participants aged 18 to <40 years (odds ratio = 0.47; P-value = 0.002). The intervention was well-accepted in all areas in which Ag-RDTs were deployed. Our findings can therefore support the Ministry of Health by increasing accessibility to severe acute respiratory syndrome coronavirus 2 testing in the hard-to-reach communities in response to the next COVID-19 wave.

Author Notes

Financial support: This project was supported through FIND, through a grant FIND received from the German Federal Ministry for Economic Cooperation and Development (BMZ).

Disclosures: Data collection tools and the data generated are available by emailing the corresponding author (gmwangoka@ihi.or.tz). Verbal consent was sought from all study participants who agreed to test or be tested using Ag-RDTs in the implementation program. Additionally, written informed consent was sought for those individuals who participated in the quantitative assessment. The protocol was approved by the Ifakara Health Institute Institutional Review Board, with the approval IHI/IRB/No: 07–2022, and the national ethics committee (NatHREC, NIMR/HQ/R.8a/Vol. IX/3982).

Current contact information: Grace W. Mwangoka, Ali M. Ali, Mwifadhi Mrisho, Abdallah Mkopi, Muhidin Mahende, Hajirani M. Msuya, Silas G. Temu, Michael G. Mihayo, Omar Juma, Ali Hamad, Said A. Jongo, Omar Lweno, Anneth Tumbo, Sara S. Mswata, and Salim Abdulla, Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania, E-mails: gmwangoka@ihi.or.tz, aali@ihi.or.tz, mmrisho@ihi.or.tz, amkopi@ihi.or.tz, mmahende@ihi.or.tz, hmsuya@ihi.or.tz, stemu@ihi.or.tz, mmihayo@ihi.or.tz, ojuma@ihi.or.tz, ahamad@ihi.or.tz, sjongo@ihi.or.tz, olweno@ihi.or.tz, atumbo@ihi.or.tz, smswata@ihi.or.tz, and sabdulla@ihi.or.tz. Paul Kazyoba, National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, 11101 Dar es Salaam, Tanzania, E-mail: pkazyoba@nimr.or.tz. Anne Hoppe, Foundation for Innovation and New Diagnostics, Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland, and Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, E-mail: ahoppe@pedaids.org. Pallavi Dani, Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), P.O. Box 2100, CH-1211 Geneva 2, Switzerland. E-mail: pallavi.dani@finddx.org.

Address correspondence to Grace W. Mwangoka, Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. E-mail: gmwangoka@ihi.or.tz
Copyright:
© The author(s) 2024
Received:
23 Oct 2023
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Accepted:
08 Sep 2024
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Published Online:
26 Nov 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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