Feasibility of Specimen Self-collection in Young Children Undergoing SARS-CoV-2 Surveillance for In-Person Learning

Altamirano, Jonathan; Lopez, Marcela; Robinson, India; Chun, Leanne X; Tam, Grace K-Y; Shaikh, Nuzhat J; Hoyte, Elisabeth G.; Carrington, Yuan J; Jani, Shilpa G.; Toomarian, Elizabeth Y.; Hsing, Julianna C.; Ma, Jasmin; Pulendran, Uma Palam; Govindarajan, Prasanthi; Blomkalns, Andra L.; Pinsky, Benjamin A.; Wang, C Jason; Maldonado, Yvonne

doi:10.1001/jamanetworkopen.2021.48988

Cited by 7 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One prior study investigated the feasibility of nasal swab self-collection by school-aged children based on the rate of observed deviations from a standard collection protocol, but re-sults of molecular testing were not reported. 10 In contrast, the studies presented here characterized the ability of schoolaged children and adolescents to self-collect nasal samples based on the results of SARS-CoV-2 molecular testing and evaluated the usability of self-collection from both the child and HCW perspectives. There was no significant bias or improvement in performance based on collected demographic variables.…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcome was SARS-CoV-2 detection and relative quantitation by cycle threshold (Ct) in self-vs health care worker-collected nasal swabs when tested with a real-time reverse transcriptase-polymerase chain reaction test with Emergency Use Authorization. RESULTS Among the study participants, 108 of 194 (55.7%) were male and the median age was 9 years (IQR,(6)(7)(8)(9)(10)(11). Of the 196 participants, 87 (44.4%) tested positive for SARS-CoV-2 and 105 (53.6%) tested negative by both self-and health care worker-collected swabs.…”

Section: Main Outcomes and Measuresmentioning

confidence: 99%

See 1 more Smart Citation

Concordance of SARS-CoV-2 Results in Self-collected Nasal Swabs vs Swabs Collected by Health Care Workers in Children and Adolescents

Waggoner

Vos

Tyburski

et al. 2022

JAMA

View full text Add to dashboard Cite

IMPORTANCEDespite the expansion of SARS-CoV-2 testing, available tests have not received Emergency Use Authorization for performance with self-collected anterior nares (nasal) swabs from children younger than 14 years because the effect of pediatric self-swabbing on SARS-CoV-2 test sensitivity is unknown.OBJECTIVE To characterize the ability of school-aged children to self-collect nasal swabs for SARS-CoV-2 testing compared with collection by health care workers.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of 197 symptomatic children and adolescents aged 4 to 14 years old. Individuals were recruited based on results of testing in the Children's Healthcare of Atlanta system from July to August 2021.EXPOSURES Children and adolescents were given instructional material consisting of a short instructional video and a handout with written and visual steps for self-swab collection. Participants first provided a self-collected nasal swab. Health care workers then collected a second specimen. MAIN OUTCOMES AND MEASURESThe primary outcome was SARS-CoV-2 detection and relative quantitation by cycle threshold (Ct) in self-vs health care worker-collected nasal swabs when tested with a real-time reverse transcriptase-polymerase chain reaction test with Emergency Use Authorization. RESULTS Among the study participants, 108 of 194 (55.7%) were male and the median age was 9 years (IQR,(6)(7)(8)(9)(10)(11). Of the 196 participants, 87 (44.4%) tested positive for SARS-CoV-2 and 105 (53.6%) tested negative by both self-and health care worker-collected swabs. Two children tested positive by self-or health care worker-collected swab alone; 1 child had an invalid health care worker swab. Compared with health care worker-collected swabs, self-collected swabs had 97.8% (95% CI, 94.7%-100.0%) and 98.1% (95% CI, 95.6%-100.0%) positive and negative percent agreement, respectively, and SARS-CoV-2 Ct values did not differ significantly between groups (mean [SD] Ct, self-swab: 26.7 [5.4] vs health care worker swab: 26.3 [6.0]; P = .65). CONCLUSIONS AND RELEVANCEAfter hearing and seeing simple instructional materials, children and adolescents aged 4 to 14 years self-collected nasal swabs that closely agreed on SARS-CoV-2 detection with swabs collected by health care workers.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Main Outcomes and Measuresmentioning

confidence: 99%

Concordance of SARS-CoV-2 Results in Self-collected Nasal Swabs vs Swabs Collected by Health Care Workers in Children and Adolescents

Waggoner

Vos

Tyburski

et al. 2022

JAMA

View full text Add to dashboard Cite

show abstract

“…One prior study investigated the feasibility of AN swab self-collection by school-aged children based on the rate of observed deviations from a standard collection protocol, but results of molecular testing were not reported. 9 In contrast, the studies presented here characterized the ability of school-aged children to adequately self-collect AN samples based on the results of SARS-CoV-2 molecular testing and evaluated the useability of self-collection from both the child and HCW perspective.…”

Section: Discussionmentioning

confidence: 99%

Adequacy of Nasal Self-Swabbing for SARS-CoV-2 Testing in Children

Waggoner

Vos

Tyburski

et al. 2022

Preprint

View full text Add to dashboard Cite

BackgroundThe goal of this study was to characterize the ability of school-aged children to self-collect adequate anterior nares (AN) swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.MethodsFrom July to August 2021, 287 children, age 4-14 years-old, were prospectively enrolled in the Atlanta area. Symptomatic (n=197) and asymptomatic (n=90) children watched a short instructional video before providing a self-collected AN specimen. Health care workers (HCWs) then collected a second specimen, and useability was assessed by the child and HCW. Swabs were tested side-by-side for SARS-CoV-2. RNase P RNA detection was investigated as a measure of specimen adequacy.ResultsAmong symptomatic children, 87/196 (44.4%) tested positive for SARS-CoV-2 by both self- and HCW-swab. Two children each were positive by self- or HCW-swab; one child had an invalid HCW-swab. Compared to HCW-swabs, self-collected swabs had 97.8% and 98.1% positive and negative percent agreements, respectively, and SARS-CoV-2 Ct values did not differ significantly between groups. Participants ≤8 years-old were less likely than those >8 to be rated as correctly completing self-collection, but SARS-CoV-2 detection did not differ. Based on RNase P RNA detection, 270/287 children (94.1%) provided adequate self-swabs versus 277/287 (96.5%) HCW-swabs (p=0.24) with no difference when stratified by age.ConclusionsChildren, aged 4-14 years-old, can provide adequate AN specimens for SARS-CoV-2 detection when presented with age-appropriate instructional material, consisting of a video and a handout, at a single timepoint. These data support the use of self-collected AN swabs among school-age children for SARS-CoV-2 testing.

show abstract

“…Self-collected respiratory samples for SARS-CoV-2 improve access and reduce risk of onward exposure to others [12][13][14][15][16] . However, standardisation of anatomical site of collection, adequate sample collection and time taken for sample delivery to the laboratory are common challenges 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Anterior nasal swabs are acceptable alternatives to nasopharyngeal swabs 5 , and a novel flocked anterior nasal swab (ANS) with features to reduce discomfort has been designed for children 6 . In this study, we compared self-collected combined nose and throat (CTN), saliva and novel anterior nasal swabs for detection of SARS-CoV-2 by polymerase chain reaction (PCR) and investigated feasibility in children aged [5][6][7][8][9][10][11][12][13][14][15][16][17][18] years.…”

Section: Introductionmentioning

confidence: 99%

Less invasive SARS-CoV-2 testing for children: A comparison of saliva and a novel Anterior Nasal Swab

Tosif

Lee

Nguyen

et al. 2022

Preprint

View full text Add to dashboard Cite

Reducing procedural discomfort for children requiring respiratory testing for SARS-CoV-2 is important in supporting testing strategies for case identification. Alternative sampling methods to nose and throat swabs, which can be self-collected, may reduce laboratory-based testing requirements and provide rapid results for clearance to attend school or hospital settings. The aim of this study was to compare preference and diagnostic sensitivity of a novel anterior nasal swab (ANS), and saliva, with a standard combined nose and throat (CTN) swab. The three samples were self-collected by children aged 5-18 years who had COVID-19 or were a household close contact. Samples were analysed by reverse transcription polymerase chain reaction (RT-PCR) on the Allplex SARS-CoV-2 Assay. Most children and parents preferred the ANS and saliva swab over the CTN swab for future testing. The ANS was highly sensitive (sensitivity 1.000 (95% Confidence Interval (CI) 0.920, 1.000)) for SARS-CoV-2 detection, compared to saliva (sensitivity 0.886, 95% CI 0.754, 0.962). We conclude the novel ANS is a highly sensitive and more comfortable method for SARS-CoV-2 detection when compared to CTN swab.

show abstract

Feasibility of Specimen Self-collection in Young Children Undergoing SARS-CoV-2 Surveillance for In-Person Learning

Abstract: IMPORTANCEThere is an urgent need to assess the feasibility of COVID-19 surveillance measures in educational settings. OBJECTIVETo assess whether young children can feasibly self-collect SARS-CoV-2 samples for surveillance testing over the course of an academic year.

Cited by 7 publications

References 12 publications

Concordance of SARS-CoV-2 Results in Self-collected Nasal Swabs vs Swabs Collected by Health Care Workers in Children and Adolescents

Concordance of SARS-CoV-2 Results in Self-collected Nasal Swabs vs Swabs Collected by Health Care Workers in Children and Adolescents

Adequacy of Nasal Self-Swabbing for SARS-CoV-2 Testing in Children

Less invasive SARS-CoV-2 testing for children: A comparison of saliva and a novel Anterior Nasal Swab

Contact Info

Product

Resources

About