Feasibility, uptake, and performance of COVID-19 rapid antigen diagnostic tests among refugees and migrants: Finding from secondary analysis of data from a pilot project in Jordan

Abstract

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.