SARS-CoV-2 testing uptake and its determinants in six ethnic groups living in Amsterdam, the Netherlands: a registry-based study within the HELIUS cohort.

Diagnostic testing was key in preventing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pre-vaccination era of the coronavirus disease 2019 pandemic. This study compared SARS-CoV-2 polymerase chain reaction (PCR) testing uptake and its determinants across six ethnic groups in Amsterdam, the Netherlands. We analyzed data from the population-based Healthy Life in an Urban Setting cohort linked to SARS-CoV-2 testing registry data from the Public Health Service of Amsterdam. Testing uptake was defined as completing at least one SARS-CoV-2 PCR test before 6 September 2021. We examined the association between ethnicity and testing uptake, and assessed determinants of testing uptake per ethnic group, using logistic regression while correcting for ethnic-specific age and sex distributions in Amsterdam. We included 19 006 participants (median age 53 years; 57% female). Testing uptake ranged from 25.3% (95% confidence interval (CI) = 23.1%-27.5%) in the Ghanaian to 52.2% (95% CI = 50.3%-54.1%) in the Turkish group. Individuals of Turkish origin [adjusted odds ratio (aOR) = 1.12, 95% CI = 1.01-1.23] were more likely, while those of African Surinamese (aOR = 0.88, 95% CI = 0.79-0.97) and particularly Ghanaian (aOR = 0.35, 95% CI = 0.30-0.40) origin less likely to be tested compared to those of Dutch origin. Younger age and perceived work or home-related stress were associated with testing uptake across most ethnic groups. Other determinants were specific to certain groups. SARS-CoV-2 testing uptake varied slightly across most ethnic groups in Amsterdam with the highest uptake among individuals of Turkish origin but was remarkably lower among individuals of Ghanaian origin. Given the diversity of identified determinants, testing strategies should be tailored to the needs of specific groups.