A rapid review of equity considerations in large-scale testing campaigns during infectious disease epidemics

Ost, K.; Duquesne, L.; Duguay, C.; Traverson, L.; Mathevet, I.; Ridde, V.; Zinszer, K.

Context: Large-scale testing is an intervention that is instrumental for infectious disease control and a central tool for the COVID-19 pandemic. Our rapid review aimed to identify if and how equity has been considered in large-scale testing initiatives. Methods: We searched Web of Science and PubMed in November 2020 and followed PRISMA recommendations for scoping reviews. Articles were analyzed using descriptive and thematic analysis. Results: Our search resulted in 291 studies of which 41 were included for data extraction after full article screening. Most of the included articles (83%) reported on HIV-related screening programs, while the remaining programs focused on other sexually transmitted infections (n=3) or COVID-19 (n=4). None of the studies presented a formal definition of (in)equity in testing, however, 23 articles did indirectly include elements of equity in the program or intervention design, largely through the justification of their target population. Conclusion: The studies included in our rapid review did not explicitly consider equity in their design or evaluation. It is imperative that equity is incorporated into the design of infectious disease testing programs and serves as an important reminder of how equity considerations are needed for SARS-CoV-2 testing and vaccination programs.