COVID-19 testing data across sites.

World Health Organization recommends antigen rapid diagnostic tests (RDT) as point of care tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in suspected outbreaks when polymerase-chain-reaction testing is not accessible; to trace the extent of outbreaks; and in areas with widespread community transmission. Annual economic costs were estimated for professional SARS-CoV-2 testing as part of several COVID-19 testing use cases in Malawi, Nigeria and Zimbabwe. Symptom screening and antigen-based RDT was implemented as part of a multi-country, Unitaid/STAR 3ACP (Africa, Asia, America COVID-19 Prevention) funded project (April 2022-June 2023). Testing services were provided through trained health providers in outpatient departments of primary care facilities (Malawi and Nigeria) and two primary non governmental organisation (NGO) use cases separately targeting key population (KP) and the general population in Zimbabwe. Combined financial expenditure analysis and on-site micro-costing took the provider/health system perspective in 2025 US$. Per test average costs were $9.73 (range across sites: $5.49-$29.90) in Malawi, $13.99 ($11.64-US$18) in Nigeria and $10.11 ($4.19-$209.09) and $19.98 ($10.76-$56.40) in Zimbabwe for general population and key population clinics respectively. Average costs per positive case identified were $521 ($61-$800) in Malawi; $1,118 ($202.66-$4,804.45) in Nigeria; and $1,125 ($336-$ 1,762) and $187 ($161-$ 1,272) in Zimbabwe. Major cost contributors were test kits in Malawi, test kits and building (consultation room space costs) and storage in Nigeria and personnel and training in Zimbabwe. Excluding above site level costs, the average cost per SARS-CoV-2 test was $9.73 in Malawi, $13.99 in Nigeria and $10.70 and $9.79 in Zimbabwe. Integrating COVID-19 testing into existing sites can reach people at high risk of severe illness at a reasonable cost. For resource-limited settings where programmes are threatened by low fiscal space, costs might be reduced when scaling up, through greater spreading of startup and capital costs.

世界卫生组织（World Health Organization）推荐抗原快速诊断检测（antigen rapid diagnostic tests, RDT）作为疑似暴发场景下严重急性呼吸综合征冠状病毒2型（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）的床旁检测手段，适用于无法开展聚合酶链式反应检测的情况、用于追踪疫情扩散范围，以及社区传播广泛的地区。本研究针对马拉维、尼日利亚和津巴布韦的多个新冠病毒检测应用场景，估算了专业新冠病毒检测的年度经济成本。症状筛查与基于抗原的快速诊断检测作为多国合作项目的一部分落地实施，该项目由Unitaid/STAR 3ACP（Africa, Asia, America COVID-19 Prevention，非洲、亚洲、美洲新冠预防项目）资助，实施周期为2022年4月至2023年6月。检测服务由经过培训的医护人员提供，服务地点包括马拉维和尼日利亚的基层医疗机构门诊部门，以及津巴布韦的两个非政府组织（non-governmental organisation, NGO）试点场景，分别针对关键人群（key population, KP）与普通人群开展检测。本研究以2025年美元计价，从提供者/卫生系统视角开展了综合财务支出分析与现场微观成本核算。马拉维的单份检测平均成本为9.73美元（各试点点区间：5.49美元至29.90美元）；尼日利亚为13.99美元（11.64美元至18.00美元）；津巴布韦针对普通人群门诊与关键人群门诊的单份检测平均成本分别为10.11美元（4.19美元至209.09美元）与19.98美元（10.76美元至56.40美元）。每检出1例阳性病例的平均成本，马拉维为521美元（61美元至800美元），尼日利亚为1118美元（202.66美元至4804.45美元）；津巴布韦普通人群门诊与关键人群门诊分别为1125美元（336美元至1762美元）与187美元（161美元至1272美元）。主要成本构成方面，马拉维为检测试剂盒，尼日利亚为检测试剂盒、建筑（诊室空间成本）与存储成本，津巴布韦为人员与培训成本。扣除上述试点点层面的成本后，马拉维的单份新冠病毒检测平均成本为9.73美元，尼日利亚为13.99美元，津巴布韦两个试点场景分别为10.70美元与9.79美元。将新冠病毒检测整合至现有医疗机构，能够以合理的成本覆盖重症高风险人群。对于受财政空间不足制约的资源受限地区，通过扩大初创与固定成本的分摊规模，可在检测规模扩大时进一步降低成本。