Assessment of the Quality of COVID-19 Antigen Rapid Diagnostic Testing in the Testing Sites of Ekiti State, Nigeria: A Quality Improvement Cross-Sectional Study.

Background Antigen rapid diagnostic testing (Ag-RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important testing technique used for the control and containment of COVID-19. This study aims to assess the quality of COVID-19 Ag-RDT in the testing sites in Ekiti State, Nigeria. Methods A validated World Health Organization (WHO) questionnaire was used to collect data from 138 testing sites located in 138 health facilities in Ekiti State. The assessment was based on the activities carried out in the last three months before the study. Results A total of 138 testing sites participated in the study out of which 121 (87.7%) were primary health facility testing sites. The mean number of samples tested in these sites was 26 samples, and 97 (70.3%) testing sites were tested below this. The average quality performance of the secondary/tertiary health facility testing sites (64.46 ± 10.47) was significantly higher than that of the primary health facility testing sites (53.13 ± 13.54) (p = 0.002). Additionally, the average quality performance of testing sites that tested 26 samples or more (61.61 ± 9.84) was significantly higher than that of the testing sites that tested below this mean cut-off (51.53 ± 13.97) (p < 0.001). Conclusion The majority of the testing sites that tested below the mean 26 samples, secondary/tertiary health facility testing sites, and sites that tested above the mean cut-off had higher average quality performance scores. Therefore, encouraging clinicians to refer for more testing of suspected cases and supportive supervision of COVID-19 Ag-RDT, especially in primary health facilities, is recommended.