Biomedicines (Sep 2022)

Clinical Performance of Self-Collected Nasal Swabs and Antigen Rapid Tests for SARS-CoV-2 Detection in Resource-Poor Settings

  • Nádia Sitoe,
  • Júlia Sambo,
  • Nédio Mabunda,
  • Neuza Nguenha,
  • Jorfélia Chilaúle,
  • Júlio Rafael,
  • Anésio Macicame,
  • Imelda Chelene,
  • Chishamiso Mudenyanga,
  • Jillian Sacks,
  • Sofia Viegas,
  • Osvaldo Loquiha,
  • Ilesh Jani

DOI
https://doi.org/10.3390/biomedicines10092327
Journal volume & issue
Vol. 10, no. 9
p. 2327

Abstract

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Background: In resource-poor countries, antigen-based rapid tests (Ag-RDTs) performed at primary healthcare and community settings improved access to SARS-CoV-2 diagnostics. However, the technical skills and biosafety requirements inherent to nasopharyngeal and oropharyngeal (OP) specimens limit the scale-up of SARS-CoV-2 testing. The collection of nasal-swabs is programmatically viable, but its performance has not been evaluated in resource-poor settings. Methods: We first evaluated the performance of SteriPack self-collected nasal swabs for the detection of SARS-CoV-2 by real-time PCR in 1498 consecutively enrolled patients with suspected infection. Next, we evaluated the clinical performance of three nasal swab-based Ag-RDTs against real-time PCR on OP specimens. Results: The sensitivity of nasal swabs was 80.6% [95% CI: 75.3–85.2%] compared to OP specimens. There was a good correlation (r = 0.58; p Conclusions: In our setting, the COVIOS Ag-RDT did not meet WHO requirements. Nasal swab-based Ag-RDTs for SARS-CoV-2 detection constitute a viable and accurate diagnostic option in resource-poor settings.

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