People's Willingness to Use COVID-19 Self-Testing in Nigeria: A Cross-Sectional Survey

Background: Nigeria has been badly affected by the COVID-19 pandemic, and the poor testing coverage in the country may make controlling the spread of COVID-19 challenging. Self-testing could help to address this gap. The aim of this study was to assess the acceptability of SARS-CoV-2 self-testing among the general population in Nigeria. Methods: A household-based survey was conducted in five Nigerian states in mid-2021. A five-pronged, probabilistic sampling approach was used to recruit respondents, and a 35-item questionnaire was used to collect data on key variables, such as willingness to use and to pay for a SARS-CoV-2 self-test and likely actions following a positive result. Bivariate and multivariate regression analyses were performed. Findings: Of 2126 respondents, (969 were female), 14 (0·66%) were aware of COVID-19 self-testing, 1738 (81·80%) agreed with the idea of people being able to self-test for COVID-19, 1786 (84·05%) were likely/very likely to use self-tests if available, 1931 (90·87%) would report a positive result, and 1875 (88·28%) would isolate if they self-tested positive. Factors significantly associated with the use of a self-test were having a college education or higher (AOR: 1·55;95%CI: 1·03–2·33), full-time employment (AOR: 1·67;95%CI: 1·06–2·63), feeling at moderate/high risk of COVID-19 (AOR: 2·43;95%CI: 1·70–3·47), and presence of individuals at risk of COVID-19 within the same household (AOR: 1·38;95%CI: 1·06–1·78). Interpretation: A majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health upon self-testing positive. Funding Information: This study was funded by the German government, who played no role in the study design implementation, analysis, or decision to publish. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: All respondents provided written informed consent to participate in the study. The study protocol received approval from the Health Research Ethics Committee of the Institute of Public Health, Obafemi Awolowo University (Ref: IPH/OAU/12/1730).