Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe

Tobik, Emily R; Kitfield-Vernon, Lily B; Thomas, Russell J; Steel, Sydney A; Tan, Steph H; Allicock, Orchid M; Choate, Brittany L; Akbarzada, Sumaira; Wyllie, Anne L.

doi:10.1080/14737159.2022.2094250

Cited by 25 publications

(34 citation statements)

References 157 publications

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“…This strategy could prove useful to monitor both COVID-19 and In uenza outbreaks. And although saliva has many advantages as a sample type 47 , we have successfully used the MP4 assay with nasal swabs and non-invasive polyvinyl alcohol mask strips 48 . And depending on the needs of the assay, a wide variety of pooling strategies can be employed to balance sensitivity with e ciency.…”

Section: Discussionmentioning

confidence: 99%

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

Wagner

Fox

Gordon

et al. 2022

Preprint

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In response to the SARS-CoV-2 pandemic, we developed a multiplexed, paired-pool droplet digital PCR (MP4) screening assay. Key features of our assay are the use of minimally processed saliva, 8-sample paired pools, and reverse-transcription droplet digital PCR (RT-ddPCR) targeting the SARS-CoV-2 nucleocapsid gene. The limit of detection was determined to be 2 and 12 copies per µl for individual and pooled samples, respectively. Using the MP4 assay, we routinely processed over 1,000 samples a day with a 24-hour turnaround time and over the course of 17 months, screened over 250,000 saliva samples. Modeling studies showed that the efficiency of 8-sample pools was reduced with increased viral prevalence and that this could be mitigated by using 4-sample pools. We also present a strategy for, and modeling data supporting, the creation of a third paired pool as an additional strategy to employ under high viral prevalence.

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Section: Discussionmentioning

confidence: 99%

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

Wagner

Fox

Gordon

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…28 These efforts have enabled more affordable and, importantly, more sustainable testing programmes that have effectively controlled outbreaks. 11 , 29 …”

Section: Test Affordabilitymentioning

confidence: 99%

“…SARS-CoV-2 saliva testing studies and programmes have been implemented in most regions of the world, including low-cost and less technologically demanding methods that can be adapted to low-resource settings. 29 Low- and middle-income countries globally have demonstrated the feasibility of saliva-based diagnostics with PCR technology. 29 In South America, saliva collection has been recommended as a high-performing, non-invasive option.…”

Section: Current Applicationsmentioning

confidence: 99%

“… 29 Low- and middle-income countries globally have demonstrated the feasibility of saliva-based diagnostics with PCR technology. 29 In South America, saliva collection has been recommended as a high-performing, non-invasive option. The sensitivity of the method was found to be comparable to that of nasopharyngeal swabs in studies in Brazil, 30 Chile 31 and French Guiana.…”

Section: Current Applicationsmentioning

confidence: 99%

“… 33 In sub-Saharan Africa, saliva-based PCR testing is offered in several countries, including the Democratic Republic of the Congo and Sudan, while a self-collection programme is currently being piloted in South Africa. 29 …”

Section: Current Applicationsmentioning

confidence: 99%

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Saliva-based methods for SARS-CoV-2 testing in low- and middle-income countries

Tan¹,

Allicock²,

Katamba³

et al. 2022

Bull World Health Org

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As the coronavirus disease 2019 (COVID-19) continues to disproportionately affect low- and middle-income countries, the need for simple, accessible and frequent diagnostic testing grows. In lower-resource settings, case detection is often limited by a lack of available testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To address global inequities in testing, alternative sample types could be used to increase access to testing by reducing the associated costs. Saliva is a sensitive, minimally invasive and inexpensive diagnostic sample for SARS-CoV-2 detection that is appropriate for asymptomatic surveillance, symptomatic testing and at-home collection. Saliva testing can lessen two major challenges faced by lower- and middle-income countries: constrained resources and overburdened health workers. Saliva sampling enables convenient self-collection and requires fewer resources than swab-based methods. However, saliva testing for SARS-CoV-2 diagnostics has not been implemented on a large scale in low- and middle-income countries. While numerous studies based in these settings have demonstrated the usefulness of saliva sampling, there has been insufficient attention on optimizing its implementation in practice. We argue that implementation science research is needed to bridge this gap between evidence and practice. Low- and middle-income countries face many barriers as they continue their efforts to provide mass COVID-19 testing in the face of substantial inequities in global access to vaccines. Laboratories should look to replicate successful approaches for sensitive detection of SARS-CoV-2 in saliva, while governments should act to facilitate mass testing by lifting restrictions that limit implementation of saliva-based methods.

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Saliva-based detection of SARS-CoV-2: a bibliometric analysis of global research

et al. 2023

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Saliva has emerged as a promising noninvasive biofluid for the diagnosis of oral and systemic diseases, including viral infections. During the coronavirus disease 2019 (COVID-19) pandemic, a growing number of studies focused on saliva-based detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Taking advantage of the WoS core collection (WoSCC) and CiteSpace, we retrieved 1021 articles related to saliva-based detection of SARS-CoV-2 and conducted a comprehensive bibliometric analysis. We analyzed countries, institutions, authors, cited authors, and cited journals to summarize their contribution and influence and analyzed keywords to explore research hotspots and trends. From 2020 to 2021, research focused on viral transmission via saliva and verification of saliva as a reliable specimen, whereas from 2021 to the present, the focus of research has switched to saliva-based biosensors for SARS-CoV-2 detection. By far, saliva has been verified as a reliable specimen for SARS-CoV-2 detection, although a standardized procedure for saliva sampling and processing is needed. Studies on saliva-based detection of SARS-CoV-2 will promote the development of saliva-based diagnostics and biosensors for viral detection. Collectively, our findings could provide valuable information to help scientists perceive the basic knowledge landscapes on saliva-based detection of SARS-CoV-2, the past and current research hotspots, and future opportunities.

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Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe

Cited by 25 publications

References 157 publications

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

Saliva-based methods for SARS-CoV-2 testing in low- and middle-income countries

Saliva-based detection of SARS-CoV-2: a bibliometric analysis of global research

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