People's willingness to use COVID-19 self-testing in Nigeria: a cross-sectional survey

Abstract

Objectives: Nigeria has been badly affected by the COVID-19 pandemic, and the poor testing coverage in the country may make controlling the spread of COVID-19 challenging. The aim of this study was to assess the general public's acceptability of SARS-CoV-2 self-testing as an approach which could help to address this gap.

Setting: A household-based survey was conducted in five urban and five rural local government areas in the states of Akwa Ibom, Anambra, Benue, Kaduna and Lagos, in mid-2021.

Participants: 2126 respondents (969 were female) participated. A five-pronged, probabilistic sampling approach was used to recruit individuals older than 17 years and available to participate when randomly approached in their households by the surveyors. A 35-item questionnaire was used to collect data on their values towards SARS-CoV-2 self-testing. Primary outcomes were: likelihood to use a self-test; willingness to pay for a self-test; and likely actions following a reactive self-test result.

Results: Of the total 2126 respondents, 14 (0.66%) were aware of COVID-19 self-testing, 1738 (81.80%) agreed with the idea of people being able to self-test for COVID-19, 1786 (84.05%) were likely/very likely to use self-tests if available, 1931 (90.87%) would report a positive result and 1875 (88.28%) would isolate if they self-tested positive. Factors significantly associated with the use of a self-test were having a college education or higher (adjusted Odds Ratio (AOR): 1.55; 95% CI: 1.03 to 2.33), full-time employment (AOR: 1.67; 95% CI: 1.06 to 2.63), feeling at moderate/high risk of COVID-19 (AOR: 2.43; 95% CI: 1.70 to 3.47) and presence of individuals at risk of COVID-19 within the household (AOR: 1.38; 95% CI: 1.06 to 1.78).

Conclusion: A majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health on self-testing positive. Self-test implementation research is necessary to frame how acceptability impacts uptake of preventive behaviours following a positive and a negative self-test result.

Keywords: COVID-19; Health policy; Public health.

Figure 1

Multivariate logistic regression analysis to assess factors associated with the willingness of adults in Nigeria to use a COVID-19 self-test (N=2126.) ST, Self-testing; aOR, Adjusted Odds Ratio; 95%CI, 95% Confidence Interval; Ref., Reference.

Figure 2

Multivariate logistic regression analysis to assess factors associated with the willingness of adults in Nigeria to pay for a COVID-19 self-test (N=2126). ST, Self-testing; aOR, Adjusted Odds Ratio; 95%CI, 95% Confidence Interval; Ref., Reference.

Figure 3

Ordinary least squares (OLS) analysis to assess factors associated with the compliance of adults in Nigeria with recommended hygiene and preventive measures post-COVID-19 self-testing (N=2126). ST, Self-testing; OLS, Ordinary Least Square; Coeff., Coefficient; 95%CI, 95% Confidence Interval; Ref, Reference.