{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:46:31Z","timestamp":1790401591340,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UNITAID","award":["KFW P09022-00"],"award-info":[{"award-number":["KFW P09022-00"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>COVID-19 testing is critical for identifying cases to prevent transmission. COVID-19 self-testing has the potential to increase diagnostic testing capacity and to expand access to hard-to-reach areas in low-and-middle-income countries. We investigated the feasibility and acceptability of COVID-19 self-sampling and self-testing using SARS-CoV-2 Antigen-Rapid Diagnostic Tests (Ag-RDTs).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>From July 2021 to February 2022, we conducted a mixed-methods cross-sectional study examining self-sampling and self-testing using Standard Q and Panbio COVID-19 Ag Rapid Test Device in Urban and rural Blantyre, Malawi. Health care workers and adults (18y+) in the general population were non-randomly sampled.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall, 1,330 participants were enrolled of whom 674 (56.0%) were female and 656 (54.0%) were male with 664 for self-sampling and 666 for self-testing. Mean age was 30.7y (standard deviation [SD] 9.6). Self-sampling usability threshold for Standard Q was 273\/333 (82.0%: 95% CI 77.4% to 86.0%) and 261\/331 (78.8%: 95% CI 74.1% to 83.1%) for Panbio. Self-testing threshold was 276\/335 (82.4%: 95% CI 77.9% to 86.3%) and 300\/332 (90.4%: 95% CI 86.7% to 93.3%) for Standard Q and Panbio, respectively. Agreement between self-sample results and professional test results was 325\/325 (100%) and 322\/322 (100%) for Standard Q and Panbio, respectively. For self-testing, agreement was 332\/333 (99.7%: 95% CI 98.3 to 100%) for Standard Q and 330\/330 (100%: 95% CI 99.8 to 100%) for Panbio. Odds of achieving self-sampling threshold increased if the participant was recruited from an urban site (odds ratio [OR] 2.15 95% CI 1.44 to 3.23, <jats:italic>P<\/jats:italic> &lt; .01. Compared to participants with primary school education those with secondary and tertiary achieved higher self-testing threshold OR 1.88 (95% CI 1.17 to 3.01), <jats:italic>P =<\/jats:italic> .01 and 4.05 (95% CI 1.20 to13.63), <jats:italic>P =<\/jats:italic> .02, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>One of the first studies to demonstrate high feasibility and acceptability of self-testing using SARS-CoV-2 Ag-RDTs among general and health-care worker populations in low- and middle-income countries potentially supporting large scale-up. Further research is warranted to provide optimal delivery strategies of self-testing.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0289291","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T17:29:13Z","timestamp":1690565353000},"page":"e0289291","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["COVID-19 self-testing using antigen rapid diagnostic tests: Feasibility evaluation among health-care workers and general population in Malawi"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9656-8255","authenticated-orcid":true,"given":"Madalo","family":"Mukoka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euphemia","family":"Sibanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constancia","family":"Watadzaushe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Kumwenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Abok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-3181","authenticated-orcid":true,"given":"Elizabeth L.","family":"Corbett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ivanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustine Talumba","family":"Choko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"pone.0289291.ref001","doi-asserted-by":"crossref","first-page":"100038","DOI":"10.1016\/j.puhip.2020.100038","article-title":"COVID-19: Unpacking the low number of cases in Africa.","volume":"1","author":"I Chitungo","year":"2020","journal-title":"Public Health in Practice"},{"key":"pone.0289291.ref002","first-page":"3035","article-title":"The COVID-19 pandemic as a scientific and social challenge in the 21st century","volume":"22","author":"V Zoumpourlis","year":"2020","journal-title":"Mol Med Rep"},{"key":"pone.0289291.ref003","author":"World Health Organization","year":"2021","journal-title":"WHO-convened global study of origins of SARS-CoV-2: China Part. 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