COVID-19 Testing: Perceived Barriers Among the Urban Slum Dwellers of Dhaka, Bangladesh

Background: Urban slum dwellers are unduly affected by COVID-19, and low testing rates among them are worsening their situation. This study aimed to explore the perceived barriers to COVID-19 testing in the slums, which is crucial to its surveillance, tracking, and allocating resources to combat the pandemic. Methods: A quantitative study with a cross-sectional design was conducted among 149 urban slum dwellers (≥11 years of age), who had previously experienced COVID-19 like symptoms. They were identified from an existing slum cohort at Bauniabadh, Dhaka. Information related to their testing status and perceived barriers was acquired by a telephone survey from October to November 2020. Results: The mean age of the respondents was 34.4±15.6 years, and 58.4% of them were female. Fever (79.2%) and cough (74.5%) were the most common symptoms mentioned. Only 6.7% of the respondents had undergone COVID-19 testing. Fast relief (within 1-3 days) from symptoms (87.6%) was the most prevailing barrier to testing, seen across all age and education groups. Negative advocacy regarding the testing from family and friends (46.7%), participants uncertainty about the guidelines, site, cost, and schedule of testing (15.3%), and a general belief that ‘COVID-19 is not a disease of slum people instead, it is an affliction of the rich folk' (20.4%), were the other cited barriers. Conclusions: The COVID-19 testing rate remained very low among the urban slum dwellers. To remove the barriers to testing, tailored behavioral change communication and augmenting the resources for testing are necessary to curb the spread in the slums.