Feasibility and acceptability of self-testing for COVID-19 in Ethiopia: a mixed-methods study

COVID-19 self-testing can enhance early detection to prevent disease transmission. We assessed the feasibility and acceptability of COVID-19 self-testing in Ethiopia to inform the development of national self-testing guidelines.

We conducted a mixed-methods study and invited clients presenting to health facilities with COVID-19 symptoms or considered high risk for infection for rapid antigen detection (Ag-RDT) self-testing, using nasal swabs. We described client characteristics, self-test, and survey results and used logistic regression to determine predictors for the likeliness of future self-test use. We conducted semi-structured interviews with 13 clients, 8 health workers, and 8 decision makers and used a thematic analysis approach.

Of 359 invited clients, 338 (94.2%) accepted and performed COVID-19 self-testing. 79.9% clients experienced self-testing as very easy and 73.7% reported likeliness of future self-test use, which was predicted by higher perceived risk of infection (adjusted odds ratio [AOR]: 2.75; 95% confidence interval [CI]: 1.02-7.45) and higher educational level (AOR: 5.45; 95% CI: 1.94-15.28). Interviewees perceived self-testing acceptable and feasible if it is available, affordable, and supported by culturally and linguistically sensitive video and written instruction materials.

COVID-19 self-testing is acceptable and feasible if implementation is accompanied by educational campaigns to empower clients to conduct self-testing.