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. 2023 Apr:32:102114.
doi: 10.1016/j.pmedr.2023.102114. Epub 2023 Jan 18.

Values of COVID-19 Self-Testing among Urban and Rural South Africans: A Cross-Sectional Survey

Amanda N Brumwell  1 , Gbotemi B Babatunde  1 , Michael W Wilson  1   2 , Karl le Roux  3 , Monique M Marks  4 , Jamila K Adam  4 , Elena Ivanova  5 , Deepshikha Batheja  6 , Srishti Goel  6 , Sonjelle Shilton  5 , Guillermo Z Martínez-Pérez  5
Affiliations

Values of COVID-19 Self-Testing among Urban and Rural South Africans: A Cross-Sectional Survey

Amanda N Brumwell et al. Prev Med Rep. 2023 Apr.

Abstract

Self-testing for COVID-19 may be a preferable strategy for identifying SARS-CoV-2 infection among populations in low- and middle-income settings. To determine South Africans' values related to COVID-19 self-testing should it become widely available, a cross-sectional survey was administered in Durban, KwaZulu-Natal Province and the King Sabata Dalindyebo sub-district of the Eastern Cape. A 35-question survey was administered to 531 participants (268 female) in one urban and one rural setting of South Africa. Survey participants were randomly selected by household in the rural setting, while in the urban setting participants were approached in randomly selected public places. The survey assessed participants' likelihood of using and willingness to pay for a COVID-19 self-test and actions they would take following a COVID-19 self-test. The results were analysed using descriptive statistics and bivariate and multivariate regression. Overall, 93.03% of participants supported COVID-19 self-testing, 61.62% of participants were willing to pay for self-testing, and 90.15% indicated they would communicate their results if they tested positive. Rural participants were more positively associated with each of these outcomes compared with urban-based participants. Should they test positive, most participants said they would: go in-person to a health facility for counselling (76.45%), self-isolate (95.85%), notify close contacts (97.74%), and inform their employer (95.14%). COVID-19 self-testing was a preferable option for most participants, although this varied with setting and demographic characteristics. Self-testing may overcome barriers to care for South Africans, but to achieve this, policies for self-testing and delivery methods must not exacerbate individuals' underlying economic vulnerabilities.

Keywords: COVID-19; Home diagnostics; SARS-CoV-2 testing; Self-testing; South Africa; Survey.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
(a) Results of bivariate analysis of the associations between respondents’ characteristics with the likelihood of using a COVID-19 self-test. (b) Results of multivariate analysis of the associations between respondents’ characteristics and the likelihood of using a COVID-19 self-test.
Fig. 2
Fig. 2
(a) Results of bivariate analysis of the associations of respondents’ characteristics with willingness to pay for COVID-19 self-testing. (b) Results of multivariate analysis of the associations of respondents’ characteristics with willingness to pay for COVID-19 self-testing.
Fig. 3
Fig. 3
(a) Results of bivariate analysis of the associations of respondents’ characteristics with likelihood to adhere to recommended actions after receiving a positive COVID-19 self-test. (b) Results of multivariate analysis of the associations of respondents’ characteristics with likelihood to adhere to recommended actions after receiving a positive COVID-19 self-test.
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