Volta

Epidemic Mitigation and Marginal Mortality Gains Using Self-Testing as a Diagnostic Intervention for Epidemic-Prone Diseases in Africa

Background/Objectives: African Union (AU) guidance identifies decentralized diagnostics as central to epidemic preparedness. However, the epidemiological role of self-testing across epidemic-prone diseases remains underexplored. Drivers for the potential impact of self-testing were examined conceptually using a transmission model. Methods: A deterministic SEIR model compared standard-of-care testing with additional self-testing. Global sensitivity analysis using Latin Hypercube sampling and partial rank correlation coefficients (PRCCs) examined parameters influencing reductions in peak disease prevalence (mitigation). Dynamics were illustrated using AU pathogen archetypes (Ebola, Influenza A, Cholera, Coronavirus, and Mpox), estimating the number needed to self-test (NNST) to avert one death. Results: Epidemic mitigation was minimal (median 1.9%; IQR: 0.4–5.8%); this correlated with isolation adherence (PRCC = 0.784), self-testing intensity (PRCC = 0.617), lower R0 …

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