Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Feasibility, Uptake, and Results of COVID-19 Antigen Rapid Diagnostic Tests Among Refugees and Migrants in a Pilot Project in Northwest Syria

Hassan Ghawji
* ORCID logo ,
Mohamad Nihad ALYOUSFI
,
Srinath Satyanarayana
,
Nevin Wilson
ORCID logo ,
Laila Tomeh
,
Hussam Alkhellov
,
Sali Hasan
,
Sanjay Sarin
,
Kekeletso Kao
Version 1 : Received: 27 April 2023 / Approved: 28 April 2023 / Online: 28 April 2023 (10:33:29 CEST)

A peer-reviewed article of this Preprint also exists.

Ghawji, H.; AlYousfi, M.N.; Satyanarayana, S.; Wilson, N.; Tomeh, L.; Alkhellov, H.; Hasan, S.; Sarin, S.; Kao, K. Feasibility, Uptake, and Results of COVID-19 Antigen Rapid Diagnostic Tests among Refugees and Migrants in a Pilot Project in North-West Syria. Trop. Med. Infect. Dis. 2023, 8, 281. Ghawji, H.; AlYousfi, M.N.; Satyanarayana, S.; Wilson, N.; Tomeh, L.; Alkhellov, H.; Hasan, S.; Sarin, S.; Kao, K. Feasibility, Uptake, and Results of COVID-19 Antigen Rapid Diagnostic Tests among Refugees and Migrants in a Pilot Project in North-West Syria. Trop. Med. Infect. Dis. 2023, 8, 281.

Abstract

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.

Keywords

COVID-19; rapid diagnostic tests; refugees; prevention; Ag-RDTs; PCR

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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