Rapid SARS-CoV-2 Antigen Detection Self-Tests to Increase COVID-19 Case Detection in Peru: Qualitative Study (Preprint)

Abstract

BACKGROUND Background: The COVID-19 pandemic heavily impacted many low- and middle-income countries, such as Peru, overwhelming their health systems. Rapid antigen-detection self-tests for SARS-CoV-2, the virus that causes COVID-19, have been proposed as a portable, safe, affordable, and easy-to-perform approach to improve early detection and surveillance of SARS-CoV-2 in resource-constrained populations where there are gaps in access to healthcare. Methods: In 2021, a qualitative study was conducted in two areas of Peru (urban Lima and rural Valle del Mantaro), which aimed to explore decision-makers’ values and attitudes toward SARS-CoV-2 self-testing. Purposive sampling was used to identify representatives of various civil society communities, healthcare workers, and potential implementers, to act as informants whose voices would provide a proxy for the public’s attitudes around self-testing. The study received ethics approval from the Universidad Peruana Cayetano Heredia. Results: In total, 30 informants participated in individual semi-structured interviews (SSI), and 29 informants participated in five focus group discussions (FGD). Self-tests were considered to represent an approach to increase access to testing that both the rural and urban public in Peru would accept. The public would prefer saliva-based self-tests and would prefer to access them in their community pharmacies. Information about how to perform a self-test should be clear for each population subgroup in Peru. The tests should be of high quality and low cost. Health-informed communication strategies must accompany any introduction of self-testing. Conclusion: The Peruvian public would accept SARS-CoV-2 self-tests if they were accurate, safe to use, easily available, and affordable. Adequate information about the self-tests’ features and instructions, as well as about post-use access to counseling and care, must be made available through Ministry of Health personnel and Peru’s health system channels. OBJECTIVE With the aim of informing WHO policy guidance and Peru’s public health authorities, a qualitative study was conducted to investigate the public’s values and preferences around self-testing. METHODS With the aim of informing WHO policy guidance and Peru’s public health authorities, a qualitative study was conducted to investigate the public’s values and preferences around self-testing. RESULTS This study explored decision-makers’ values and preferences around SARS-CoV-2 self-testing in Peru. Most of the study informants did not know about self-testing; however, they appreciated its advantages and the benefits that it could bring, both to the general public and to the public health system in Peru. The majority of informants expressed a willingness to recommend its use. Regarding preferences, it was suggested that self-testing could be delivered in local pharmacies in coordination with public health services. In the informants’ opinion, if self-test devices had a price of between 5 and 10 USD, the public might find this cost acceptable. CONCLUSIONS This study explored decision-makers’ values and preferences around SARS-CoV-2 self-testing in Peru. Most of the study informants did not know about self-testing; however, they appreciated its advantages and the benefits that it could bring, both to the general public and to the public health system in Peru. The majority of informants expressed a willingness to recommend its use. Regarding preferences, it was suggested that self-testing could be delivered in local pharmacies in coordination with public health services. In the informants’ opinion, if self-test devices had a price of between 5 and 10 USD, the public might find this cost acceptable. CLINICALTRIAL This study received ethical approval from the Institutional Review Board of the Universidad Peruana Cayetano Heredia (ref. 205954).