Implementation of Antibody Rapid Diagnostic Testing versus Real-Time Reverse Transcription-PCR Sample Pooling in the Screening of COVID-19: a Case of Different Testing Strategies in Africa

Abstract

Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe; although the number of cases in Africa remains lower than in other regions, it is on a gradual upward trajectory. To date, COVID-19 cases have been reported in 54 out of 55 African countries. However, due to limited severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacity and scarcity of testing reagents, it is probable that the total number of cases could far exceed published statistics. In this viewpoint, using Ghana, Malawi, South Africa, and Zimbabwe as examples of countries that have implemented different testing strategies, we argue that the implementation of sample pooling for rRT-PCR over antibody rapid diagnostic testing could have a greater impact in assessing disease burden. Sample pooling offers huge advantages compared to single test rRT-PCR, as it reduces diagnostic costs, personnel time, burnout, and analytical run times. Africa is already strained in terms of testing resources for COVID-19; hence, cheaper alternative ways need to be implemented to conserve resources, maximize mass testing, and reduce transmission in the wider population.

Does the data tell the true story? A modelling assessment of early COVID-19 pandemic suppression and mitigation strategies in Ghana

“…Ghana's initial reproduction number is very close to that reported for South Africa and Morocco and relatively close to Kenya, Algeria but further afield to figures from some Chinese provinces and South Korea [55][56][57][58][59][60][61][62][63][64]. This result is also note-worthy for one key reason: during the early days of the pandemic, Ghana was testing relatively larger numbers than several African countries at a good rate by adopting a pooled sampling testing approach, which allowed a lot more COVID-19 tests to be conducted [53,54]. Ghana, for example, is reported as having conducted over 370,000 tests between March and mid-July 2020, putting the country among the highest in Africa with regard to number of tests when standardised by the population size [53].…”

Does the Data Tell the True Story? A Modelling Study of Early COVID-19 Pandemic Suppression and Mitigation Strategies in Ghana

“…Ghana’s initial reproduction number is very close to that reported for South Africa and Morocco, and also relatively close to Kenya, Algeria but further afield to figures from some Chinese provinces and South Korea. This result is also note-worthy for one key reason: during the early days of the pandemic, Ghana was testing relatively larger numbers than several African countries at a good rate by adopting a pooled sampling testing approach, which allowed a lot more COVID-19 tests to be conducted (WHO, 2020b; Nyazika et al, 2020). Ghana, for example, is reported as having conducted over 370,000 tests between March and mid-July 2020, putting the country among the highest in Africa with regard to number of tests when standardised by the population size (WHO, 2020b).…”

Nanotechnology enabled management approaches against the Covid-19 pandemic

“…The Food and Drug Administration issued an emergency-use authorization to Quest Diagnostics that would allow the lab testing company to pool samples from up to four patients to test for the COVID-19. Tinashe, et al have analyzed the validity of pooled resting in screening COVID 19 [50]. In pooled testing technique, individual samples from a group are mixed or pooled into one and tested.…”