Factors influencing uptake of diagnostic test interventions for SARS-CoV-2: A qualitative review.

Background: Diagnostic tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be performed based on symptomatic presentation or for screening of asymptomatic persons. Testing can limit spread by enabling rapid identification of cases leading to containment measures. However, views regarding diagnostic test as a containment intervention vary across different settings.

Aim: To synthesise the findings of qualitative studies on the perceptions and factors influencing the uptake of diagnostic test interventions for SARS-CoV-2.

Setting: Healthcare facilities, care homes, communities including households.

Method: We searched MEDLINE database and the (WHO) SARS-CoV-2 Research database from 01 January 2020 to 06 September 2022. Qualitative data were synthesised thematically while data for barriers and facilitators were synthesised using the SURE framework. The GRADE-CERQual approach was used to assess the confidence in each review finding, while the ENTREQ checklist was used to report the QES. The quality of included studies was assessed with the CASP tool.

Results: Twenty two studies were included for QES. Two were conducted in the health facility setting, 2 in care homes, and 18 in the community. Twenty of the studies came from high-income countries, 2 from low- and middle-income countries. In all, 13 analytical and 31 descriptive themes of low to moderate quality evidence emerged; mainly around fear of contracting COVID-19, test procedure and socio-economic implications of a positive test result.

Conclusion: Low to moderate quality evidence of barriers to uptake of diagnostic test were largely due to misconceptions about the interventions.

Contribution: Sensitising and engaging communities and stakeholders in the healthcare system, will help mitigate the fear barrier and enhance policy coordination.