Head-to-head comparison of nasal and nasopharyngeal sampling using SARS-CoV-2 rapid antigen testing in Lesotho

Labhardt, Niklaus Daniel; Fernández, Lucía; Katende, Bulemba; Muhairwe, Josephine; Bresser, Moniek; Amstutz, Alain; Glass, Tracy R.; Rühwald, Morten; Sacks, Jilian A.; Escadafal, Camille; Mareka, Mathabo; Mooko, Sekhele Matabo; Vos, Margaretha de; Reither, Klaus

doi:10.1371/journal.pone.0278653

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…To interpret these findings, it is also important to consider broader contextual factors that played a role. One of them is related to the variation of circulating SARS-CoV-2 virus (Omicron variant) and the lower diagnostic sensitivity observed using RDTs [ 44 – 46 ]. In our setting, this could have led to a lower detection of cases in symptomatic people seeking services.…”

Section: Discussionmentioning

confidence: 99%

Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho

Katende¹,

Bresser

Kamele³

et al. 2023

PLOS Glob Public Health

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The surge of the COVID-19 pandemic challenged health services globally, and in Lesotho, the HIV and tuberculosis (TB) services were similarly affected. Integrated, multi-disease diagnostic services were proposed solutions to mitigate these disruptions. We describe and evaluate the effect of an integrated, hospital-based COVID-19, TB and HIV screening and diagnostic model in two rural districts in Lesotho, during the period between December 2020 and August 2022. Adults, hospital staff, and children above 5 years attending two hospitals were pre-screened for COVID-19 and TB symptoms. After a positive pre-screening, participants were offered to enroll in a service model that included clinical evaluation, chest radiography, SARS-CoV-2, TB, and HIV testing. Participants diagnosed with COVID-19, TB, or HIV were contacted after 28 days to evaluate their health status and linkage to HIV and/or TB care services. Of the 179160 participants pre-screened, 6623(3.7%) pre-screened positive, and 4371(66%) were enrolled in this service model. Of the total 458 diagnoses, only 17 happened in children. One positive rapid antigen test for SARS-CoV-2 was found per 11 participants enrolled, one Xpert-positive TB case was diagnosed per 85 people enrolled, and 1 new HIV diagnosis was done per 182 people enrolled. Of the 321(82.9%) participants contacted after 28 days of diagnosis, 304(94.7%) reported to be healthy. Of the individuals that were newly diagnosed with HIV or TB, 18/24(75.0%) and 46/51(90.1%) started treatment within 28 days of the diagnosis. This screening and diagnostic model successfully maintained same-day, integrated COVID-19, TB, and HIV testing services, despite frequent disruptions caused by the surge of COVID-19 waves, healthcare seeking patterns, and the volatile context (social measures, travel restrictions, population lockdowns). There were positive effects in avoiding diagnostic delays and ensuring linkage to services, however, diagnostic yields for adults and children were low. To inform future preparedness plans, research will need to identify essential health interventions and how to optimize them along each phase of the emergency response.

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Section: Discussionmentioning

confidence: 99%

Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho

Katende¹,

Bresser

Kamele³

et al. 2023

PLOS Glob Public Health

Self Cite

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Effectiveness of Frequent Point-of-Care Molecular COVID-19 Surveillance in a Rural Workplace: A Non-Randomized Controlled Clinical Trial Among Miners (Preprint)

Sood,

Jarrell,

Shore

et al. 2024

Preprint

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BACKGROUND Numerous studies have assessed the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and infection among healthcare workers during the pandemic. However, far fewer studies have investigated the impact of SARS-CoV-2 on essential workers in other sectors. Moreover, guidance for maintaining a safely operating workplace in sectors outside of healthcare remains limited. Workplace surveillance has been recommended by the Centers for Disease Control and Prevention, but few studies have examined the feasibility or effectiveness of this approach. OBJECTIVE The objective of this study was to investigate the feasibility and effectiveness of using frequent point-of-care molecular workplace surveillance as an intervention strategy to prevent the spread of SARS-CoV-2 at essential rural workplaces (mining sites) where physical distancing, remote work, and flexible schedules are not possible. METHODS In this non-randomized controlled clinical trial conducted from February 2021–March 2022, 169 miners in New Mexico (intervention cohort) and 61 miners in Wyoming (control cohort) were enrolled. Investigators performed point-of-care rapid antigen testing on midnasal swabs (NS) self-collected by intervention miners. Rates of seropositivity to SARS-CoV-2 nucleocapsid protein were analyzed in the intervention cohort compared to the control cohort at baseline and 3, 6, and 12 months. The diagnostic accuracy of detecting SARS-CoV-2 using rapid antigen testing on NS was compared to laboratory-based RT-PCR on nasopharyngeal swabs (NPS) in a subset of 68 samples. RESULTS Our intervention had a mean acceptance rate of 96.7% and intervention miners exibited lower cumulative seropositivity (p=0.025) demonstrating frequent point-of-care testing is a feasible, effective way to lower the rate of infection. Analysis of SARS-CoV-2 antigen detection in self-administered NS revealed 100% sensitivity and specificity compared to laboratory-based RT-PCR testing on NPS. CONCLUSIONS Our findings establish frequent point-of-care molecular workplace COVID-19 surveillance as a feasible option for keeping essential rural workplaces open and preventing SARS-CoV-2 spread. These findings extend beyond this study, providing valuable insights for designing interventions to maintain employees’ safety at other essential workplaces during an infectious disease outbreak. CLINICALTRIAL ClinicalTrials.gov NCT04977050

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Head-to-head comparison of nasal and nasopharyngeal sampling using SARS-CoV-2 rapid antigen testing in Lesotho

Cited by 2 publications

References 22 publications

Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho

Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho

Effectiveness of Frequent Point-of-Care Molecular COVID-19 Surveillance in a Rural Workplace: A Non-Randomized Controlled Clinical Trial Among Miners (Preprint)

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