Evaluating the feasibility and attitudes towards SARS-CoV-2 self-testing in a rural population in Zimbabwe: a cross-sectional survey

Objectives The widespread adoption of self-testing for SARS-CoV-2 has proven effective in curbing the virus’ spread, particularly in Western countries. However, significant knowledge gaps persist regarding the feasibility, acceptance and factors influencing the uptake of self-testing in low-resource areas, notably rural Africa. Our aim was to assess the willingness and capability of rural Zimbabwean participants to self-diagnose COVID-19 using rapid lateral flow tests (LFTs) and adhere to post-positive test guidelines. Additionally, we aimed to identify barriers to self-testing uptake and reasons for non-compliance with follow-up actions.Design and setting We conducted a cross-sectional survey in Shamva District, Zimbabwe.Participants A total of 120 villagers aged 18 years and above participated. We employed a questionnaire to gather data on participants' attitudes towards self-testing for SARS-CoV-2 using LFTs, along with their knowledge, attitudes and practices regarding COVID-19. Primary outcomes included the likelihood of self-testing, the ability and accuracy of self-testing, adherence to post-test guidelines and socio-demographic factors influencing these responses.Results Among the 120 participants, 108 (90%) expressed willingness to use LFTs for self-testing. The subset unwilling to self-test belonged to a religious sect historically opposed to Western medicine. All self-tests yielded valid results, as confirmed by the appearance of control lines on the LFT. Participants demonstrated the ability to interpret their results accurately without assistance and expressed willingness to adhere to post-test guidelines. Questionnaire responses indicated a preference for self-testing due to its ease, lack of pain, convenience and confidentiality. Moreover, participants exhibited a high level of knowledge about COVID-19.Conclusion This study underscores the acceptability and feasibility of SARS-CoV-2 LFT self-testing in rural settings, suggesting its potential as an additional public health measure for epidemics and pandemics in low-resource areas.