RT-PCR Screening Tests for SARS-CoV-2 with Saliva Samples in Asymptomatic          People: Strategy to Maintain Social and Economic Activities while Reducing the Risk of          Spreading the Virus

Oba, Junna; Taniguchi, Hiroaki; Sato, Masae; Takamatsu, Reika; Morikawa, Satoru; Nakagawa, Taneaki; Takaishi, Hiromasa; Saya, Hideyuki; Matsuo, Koichi; Nishihara, Hiroshi

doi:10.2302/kjm.2021-0003-oa

Cited by 23 publications

(19 citation statements)

References 45 publications

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“…On the contrary, it was very useful to quickly and accurately detect individuals who were capable of transmitting the infection to others [22,23,25,26] Another relevant issue is the high proportion of PCR-confirmed negative cases in antigen-negative participants, and the fact that three non-confirmed cases were found in subjects with very a high Ct, above 35. Even in the case of low sensitivity, it could be assumed that false negatives, infected subjects not detected by RADT, are cases with low viral loads that are therefore limited as potential sources of infection, at least in population screening and outside enclosed places, where there is a high potential for transmission (i.e., health facilities, COVID-19 testing centers/sites, care homes, prisons or schools) [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Role of Rapid Antigen Testing in Population-Based SARS-CoV-2 Screening

Martín-Sánchez

Fernández‐Villa

Carvajal

et al. 2021

JCM

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This study evaluates a population-based screening of asymptomatic people, using a rapid antigen diagnostic test (RADT), in areas of high transmission. To detect sources of SARS-CoV-2 infection, nasopharyngeal samples were taken and were tested using RADT. Confirmatory RT-qPCR tests were performed in both positive and negative cases. The internal validity of the RADT, the prevalence of infection, and the positive and negative predictive values (PPV and NPV) were estimated, based on the percentages of confirmed cases with 95% confidence interval. Of the 157,920 people registered, 50,492 participated in the screening; 50,052 were negative, and 440 were positive on the RADT (0.87%). A total of 221 positive RADT samples were reanalysed using RT-qPCR and 214 were confirmed as positive (96.8%; 95% CI: 93.5–98.7%), while 657 out of 660 negative RADT samples were confirmed as RT-qPCR negative (99.5%; 95% CI 98.7–99.9%). The sensitivity obtained was 65.1% (38.4–90.2%) and the specificity was 99.97% (99.94–99.99%). The prevalence of infection was 1.30% (0.95–2.13%). The PPVs were 95.4% (85.9–98.9%) and 97.9% (93.3–99.5%), respectively, while the NPVs were 99.7% (99.4–100%) and 99.2% (98.7–100%), respectively. The high specificity found allow us to report a high screening performance in asymptomatic patients, even in areas where the prevalence of infection was less than 2%.

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Section: Discussionmentioning

confidence: 99%

Role of Rapid Antigen Testing in Population-Based SARS-CoV-2 Screening

Martín-Sánchez

Fernández‐Villa

Carvajal

et al. 2021

JCM

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“…The nasopharyngeal or oropharyngeal swabs that are widely used for PCR assays can be difficult and uncomfortable to collect. Other more convenient specimen types, such as saliva 39 – 41 and nasal swabs, 42 are being investigated, with encouraging results. A systematic review of the diagnostic performance of different swabs found that saliva and nasal swabs had good performance and were acceptable alternatives to nasopharyngeal swabs.…”

Section: Practical Considerationsmentioning

confidence: 99%

“… 39 However, pooled results from saliva samples might still be useful for quickly identifying and isolating individuals with a high concentration of virus particles. 41 …”

Section: Practical Considerationsmentioning

confidence: 99%

Pooled testing for SARS-CoV-2, options for efficiency at scale

Reilly¹,

Chohan²

2021

Bull World Health Org

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Widescale testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is recognized as a key element of surveillance and outbreak control in the coronavirus disease 2019 (COVID-19) pandemic. The practical challenges, however, have often led to testing only symptomatic individuals and their close contacts. As many countries plan for a cautious relaxation of social restrictions, more effective approaches for widescale testing are increasingly important. Early in the COVID-19 pandemic, laboratories in several countries demonstrated the feasibility of detecting SARS-CoV-2 infection by pooled testing, which combines the specimens from several individuals. Since no further testing is needed for individuals in a negative pool, there is potential for greater efficiency of testing. Despite validations of the accuracy of the results and the efficiency in testing specific groups, the benefits of pooling are less acknowledged as a population surveillance strategy that can detect new disease outbreaks without posing restrictions on entire societies. Pooling specimens from natural clusters, such as school classes, sports teams, workplace colleagues and other social networks, would enable timely and cost-effective widescale testing for SARS-CoV-2. The initial result would be readily translatable into action in terms of quarantine and isolation policies. Clusters of uninfected individuals would be quickly identified and immediate local lockdown of positive clusters would be the appropriate and sufficient action while retesting those individuals. By adapting to the social networks of a population, pooled testing offers a cost-efficient surveillance system that is synchronized with quarantine policies that are rational, risk-based and equitable.

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“… 4–6 Many countries (eg, South Korea, Germany, and Japan) are already using routine saliva tests to control the spread of the virus while preserving social and economic activity. 7 …”

Section: Introductionmentioning

confidence: 99%

Acceptability of Community Saliva Testing in Controlling the COVID-19 Pandemic: Lessons Learned from Two Case Studies in Nursing Homes and Schools

Pétré¹,

Paridans²,

Gillain³

et al. 2022

PPA

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Current public health debate centers on COVID-19 testing methods and strategies. In some communities, high transmission risk may justify routine testing, and this requires test methods that are safe and efficient for both patients and the administrative or health-care workers administering them. Saliva testing appears to satisfy those criteria. There is, however, little documentation on the acceptability of this method among beneficiaries. This article presents the lessons learned from a pilot study on the use of saliva testing for routine screening of nursing home and secondary school personnel in Wallonia (the French-speaking part of Belgium), conducted in December 2020 to April 2021, respectively. Administrators at the facilities in question seemed to think highly of saliva testing and wished to continue it after the pilot study was over. This result reinforces the criteria (the noninvasive aspect, in particular) supporting a key role for saliva testing in monitoring community spread of the virus. Nevertheless, wider-scale deployment of this particular method will only be possible if the testing strategy as a whole takes a health promotion approach.

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RT-PCR Screening Tests for SARS-CoV-2 with Saliva Samples in Asymptomatic People: Strategy to Maintain Social and Economic Activities while Reducing the Risk of Spreading the Virus

Cited by 23 publications

References 45 publications

Role of Rapid Antigen Testing in Population-Based SARS-CoV-2 Screening

Role of Rapid Antigen Testing in Population-Based SARS-CoV-2 Screening

Pooled testing for SARS-CoV-2, options for efficiency at scale

Acceptability of Community Saliva Testing in Controlling the COVID-19 Pandemic: Lessons Learned from Two Case Studies in Nursing Homes and Schools

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