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Mass gathering event restrictions were part of mitigation measures during the COVID-19 pandemic that were lifted as prevalence decreased and after vaccination rollout. We explored SARS–CoV-2 antigen rapid diagnostic test acceptability and positivity in community settings in Cameroon. In August–October 2022, community workers sensitized and referred individuals for COVID-19 testing to nearby testing points in Douala and Yaoundé. Participants consented to SARS–CoV-2 antigen rapid diagnostic testing, a survey, or both components. We describe the positivity rate, COVID-19–related history, and Likert-scale testing perceptions. Factors associated with testing acceptance were analyzed using logistic regression. Overall, 20.5% (2,449/11,945) of sensitized individuals visited testing points, and 1,864 (76.1%) were enrolled; 50.6% accepted the survey and testing (46.0% accepted survey only). Seven (0.7%) of 1,006 individuals tested positive. Most (71.8%; 1,292/1,800) considered community testing more accessible than hospital-based testing. Individuals accepting versus refusing testing differed in perceived COVID-19 risk (67%, 49%; P <0.001), belief in accurate test results (79%, 47%; P <0.001), and ability to test easily (96%, 55%; P <0.001). Males (adjusted odds ratio [aOR]: 1.26 [1.04–1.53]) and those over 50 years (aOR: 1.9 [1.4–2.7]), with symptoms (aOR: 1.80 [1.30–2.50]), and at least partial vaccination (aOR: 0.76 [0.58–0.99]) were significantly associated with test acceptance. Refusal reasons included lack of perceived need for testing (33.8%) and testing discomfort (26.3%). Although community-based testing was generally perceived as important, actual testing uptake was low. In future pandemics, community testing should be optimized by addressing misinformation, offering alternative testing modalities for greater comfort, creating demand, and tailoring approaches to maximize testing uptake.
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: The views expressed are those of the author(s) and not necessarily those of the Elizabeth Glaser Pediatric AIDS Foundation or the Ministry of Public Health Cameroon. The protocol was approved by the Cameroon National Ethics Committee for Research in Human Health (CNERSH), reference number 2022/07/1478/CE/CNERSH/SP. Study staff were trained on ethics to ensure compliance with human subjects’ research requirements and signed a confidentiality agreement. Each participant in this study provided their informed consent prior to the start of their participation.
Authors’ contributions: T. K. Djikeussi, M. M. Gill, B. K. Tchounga, B. T. Youngui, and L. Guay designed the study. T. K. Djikeussi, L. Feuzeu, R. Kana, B. T. Youngui, P. Tchendjou, S. Viana, A. Mambo, C. Moussi, J. Fokam, E. Epée, A. Hoppe, and P. Dani provided technical oversight and monitored study implementation. R. Kana and H. J. Hoffman analyzed the data. T. K. Djikeussi and M. M. Gill co-wrote the first draft of the paper. All authors reviewed the manuscript and provided final approval of the version to be published.
Current contact information: Tatiana K. Djikeussi, Elizabeth Glaser Pediatric AIDS Foundation Cameroon, Bonanjo Douala office EGPAF/Douala, Cameroon, E-mail: tdjikeussi@pedaids.org. Boris Kevin Tchounga, Loic Feuzeu, Rogacien Kana, Boris Tchakounte Youngui, and Patrice Tchendjou, Elizabeth Glaser Pediatric AIDS Foundation Cameroon, Bastos Yaoundé office EGPAF/Yaoundé, Cameroon, E-mails: btchounga@pedaids.org, lfeuzeu@pedaids.org, rkana@pedaids.org, btchakounte@pedaids.org, and ptchendjou@pedaids.org. Shannon Viana, Laura Guay, and Michelle M. Gill, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, E-mails: shannonviana@gmail.com, lguay@pedaids.org, and mgill@pedaids.org. Heather J. Hoffman, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, E-mail: hhoffman@gwu.edu. Albert Mambo, Littoral Regional Delegation of Public Health, Ministry of Public Health, Douala, Cameroon, E-mail: mamal.albert@yahoo.fr. Charlotte Moussi, Centre Regional Delegation of Public Health, Ministry of Public Health, Yaounde, Cameroon, E-mail: lotyomgba73@gmail.com. Joseph Fokam, Virology Laboratory, Chantal BIYA International Reference Centre, Yaoundé, Cameroon, E-mail: josephfokam@gmail.com. Emilienne Epée, National Public Health Emergency Operations Coordination Centre, Ministry of Public Health, Yaounde, Cameroon, and Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon, E-mail: epeeemilienne@gmail.com. Anne Hoppe, Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland, E-mail: ahoppe@pedaids.org. Pallavi Dani, Foundation for Innovative New Diagnostics, Geneva, Switzerland, E-mail: pallavi.dani@finddx.org.
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