1) Background: Antigen Rapid Diagnostic Tests (Ag-RDTs) supplements health system’s capacities for COVID-19 testing. Minimal data are available on their use for refugees and migrants. The study aims to describe the feasibility, uptake, and performance of Ag-RDTs among refugees and migrants in Jordan while describing the encountered facilitators and barriers. 2) Methods: A cross-sectional study using data collected from an Ag-RDTs pilot project comprising 17,000 Ag-RDTs in Jordan. 3) Results: About 17,060 people were eligible, of which 99.5% consented. Exactly 99 (0.6%) people were positive. Higher positivity was observed among those with severe COVID-19 symptoms (4.2%) and a history of COVID-19 contact (4.1%). A non-random sample of 209 people underwent confirmatory rt-PCR tests. Observed sensitivity, specificity, positive and negative predictive values of Ag-RDTs were 72%, 97%, 57% and 98.5%, respectively. Key challenges included facing initial hesitancy to undergo Ag-RDTs due to perceived fear of pain, stigma, and isolation, and in getting confirmatory rt-PCR testing. 4) Conclusion: Good feasibility and uptake of Ag-RDTs were demonstrated among refugees and migrants in Jordan. Despite low positivity, certain characteristics were associated with higher rates. Higher specificity and negative predictive values indicate Ag-RDTs can be incorporated within national COVID-19 testingstrategies for ruling out COVID-19.
North-west Syria (NWS) is a conflict-affected and unstable area. Due to its limited health infrastructure, accessing advanced COVID-19 testing services is challenging. COVID-19 antigen rapid diagnostic tests (Ag-RDTs) have the potential to overcome this barrier. A pilot project was implemented to introduce Ag-RDTs in NWS, aiming to determine the feasibility, uptake, and results of Ag-RDTs and identify facilitators and barriers to testing with Ag-RDTs. A cross-sectional study design involving secondary analysis of data collected during the project was employed. A local non-governmental organization implemented 25,000 Ag-RDTs that were conducted cross-border by trained community health workers. In total, 27,888 eligible individuals were enrolled, 24,956 (89.5%) consented to test, and 121 (0.5%) were COVID-19-positive. The highest positivity was observed among those with severe COVID-19 symptoms (12.7%), with respiratory illnesses (2.5%), enrolled at hospitals in Afrin (2.5%), and healthcare workers (1.9%). A non-random sample of 236 individuals underwent confirmatory RT-PCR testing. Observed sensitivity, specificity, and positive and negative predictive values were 80.0%, 96.1%, 91.4%, and 90.3%, respectively. Challenges included obtaining informed consent and conducting confirmatory testing. Ag-RDTs represent a feasible screening/diagnostic tool for COVID-19 infections in NWS, with nearly 90% uptake. Embedding Ag-RDTs into COVID-19 testing and screening strategies would be highly beneficial.
1) Background: Northwest Syria (NWS), is a conflict-affected and unstable area. Due to its limited health infrastructure, accessing advanced COVID-19 testing services is challenging. COVID-19 antigen rapid diagnostic tests (Ag-RDTs) have the potential to overcome this barrier. Therefore, a pilot project was implemented to introduce Ag-RDTs in this setting aiming to a) describe the feasibility, uptake, and results of Ag-RDTs; and b) identify facilitators and barriers to Ag-RDTs testing. 2) Methods: A cross-sectional study design involving secondary analysis of data collected during the project’s monitoring was developed. A local NGO implemented 25,000 Ag-RDTs cross boarder through trained community health workers. 3) Results: A total of 27,888 persons were found eligible and enrolled, of which 24,956 (89.5%) consented to test and 121 (0.5%) were found positive. Highest positivity was observed among those with severe COVID-19 symptoms (12.7%), those with respiratory illnesses (2.5%), persons enrolled at Afrin Hospitals (2.5%), and healthcare workers (1.9%). A non-random sample of 236 people underwent confirmatory rt-PCR test. Accordingly, observed sensitivity, specificity, positive and negative predictive values, were 80.0%, 96.1%, 91.4% and 90.3%, respectively. Key encountered challenges included obtaining informed consent and conducting confirmatory rt-PCR testing. 4) Conclusion: This project demonstrated great feasibility utilizing Ag-RDTs as a screening/diagnostic tool for COVID-19 infections with nearly 90% uptake. Considering the high specificity and negative predictive values and the higher positivity rates among severe COVID-19 symptomatic, embedding Ag-RDTs into COVID-19 testing strategies for ruling out and in COVID-19 infections would hold a great advantage.
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