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

Waggoner, Jesse J.; Tyburski, Erika A.; Lam, Wilbur A.

doi:10.1001/jama.2022.21599

Cited by 4 publications

(15 citation statements)

References 9 publications

(5 reference statements)

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“…Among the 17 included studies, six were published in 2021 [29–34], and the remaining 11 studies [35–45] were published in 2022. The study design of the included studies were randomized controlled trials [32, 34, 41], nonrandomized experimental studies [31, 33, 36], cohort studies [35, 42, 43], cross‐sectional studies [38–40, 44], self‐controlled case series (SCCS) [30], and economic evaluations [29, 37, 45]. Among the randomized controlled trials, two were cluster randomized controlled trials [32, 34].…”

Section: Resultsmentioning

confidence: 99%

“…Six of the studies considered symptomatic and asymptomatic individuals [29, 31, 33, 38, 39, 42], of which three studies also considered asymptomatic contacts [33, 39, 42]. Two studies focused on asymptomatic contacts only [32, 41], four studies focused on symptomatic individuals only [35, 36, 40, 43], one study focused on both symptomatic individuals and asymptomatic contacts [44], two studies focused on asymptomatic individuals only [34, 45], and two studies did not specify symptom status [30, 37]. Only one study specifically mentioned healthcare workers as participants, in addition to the general community [38].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

Saif‐Ur‐Rahman,

Movsisyan,

Kothari

et al. 2023

Cochrane Evidence Synthesis and Methods

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IntroductionRapid identification of severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) infections by testing potentially reduced coronavirus disease‐19 (COVID‐19) cases. Testing strategies varied across countries and during different stages of the pandemic. This scoping review aims to map the available evidence on the effectiveness of SARS‐CoV‐2 testing strategies for suspected cases and asymptomatic populations to inform the development of World Health Organization recommendations for SARS‐CoV‐2 testing strategies.MethodsWe followed the standard methods for scoping reviews. We searched Medline (OVID), EMBASE (Elsevier), and Europe PMC using a comprehensive search strategy. The search was conducted in January 2023 and covered the period from January 2020 to January 2023. Two review authors independently screened the titles and abstracts, and full texts. Data were extracted onto a pilot‐tested form by a review author and cross‐checked by another review author. We provided a descriptive report summarizing the extracted data around the outcomes and created an interactive map of the available evidence using the evidence for policy and practice mapper.ResultsWe identified 34,550 citations from the databases. After the screening, we included 17 studies from 11 countries for data extraction. The study designs were randomized controlled trials (n = 3), nonrandomized experimental studies (n = 3), cohort studies (n = 3), cross‐sectional studies (n = 4), self‐controlled case series (n = 1), and economic evaluations (n = 3). Among the included studies, 14 used reverse transcription‐polymerase chain reaction and 10 studies used antigen‐detecting rapid diagnostic test. The settings of the studies were healthcare facilities (n = 8), communities (n = 4), schools, and workplaces (n = 3). Included studies considered symptomatic and asymptomatic individuals, or both, or asymptomatic contacts. Most of the studies (n = 14) reported the COVID‐19 positivity rate as the primary outcome. Other reported outcomes are the number of COVID‐19 cases (n = 11), number of hospitalizations and deaths (n = 3), and cost (n = 3).ConclusionWe identified evidence gaps in the effectiveness of SARS‐CoV‐2 testing strategies, particularly in specific settings such as schools and long‐term care facilities. This scoping review provides a foundation for further research, allowing researchers and stakeholders to focus on addressing the identified gaps.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

Saif‐Ur‐Rahman,

Movsisyan,

Kothari

et al. 2023

Cochrane Evidence Synthesis and Methods

View full text Add to dashboard Cite

show abstract

“…Among the many measures that have been devised in response to this challenge, self‐testing for SARS CoV2 – using both laboratory‐based polymerase chain reaction and home‐administered rapid antigen testing technologies – has potentially opened the way to a more co‐operative approach 4 . It is now known that children as young as eight are capable of collecting naso‐pharyngeal samples that only two years ago were considered only possible to be taken effectively (sometimes with the exercise of naked force) by a doctor or nurse 5 …”

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confidence: 99%

Changing times in public health: The new wave of self‐collection of invasive samples

Komesaroff

2023

Aust NZ J Obst Gynaeco

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Testing in public health programs has long been recognised as beneficial but has often been experienced by community members as intrusive and paternalistic. Cervical screening has been seen as even more threatening by women who have experienced sexual violence or come from culturally and linguistically diverse communities. A simple and natural solution to these formidable barriers, increasingly recognised in recent years, has been presented by the advent of self‐testing. This article recounts the struggle to encourage medical practitioners to accept patient self‐testing. It emphasises the importance of scrutinising our own personal prejudices, listening to the community, and being open to novel strategies that ensure inclusiveness and respect for those whose interests we are seeking to serve.

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“…To address this barrier, several studies in adults have evaluated the use of self-collected samples for SARS-CoV-2 molecular testing and have demonstrated 93% to 97% concordance rates with standard swabs obtained by HCWs . In this issue of JAMA , the study by Waggoner et al further expands this knowledge by showing that school-aged children are capable of reliable self-sampling using nasal swabs.…”

mentioning

confidence: 99%

“…The study by Waggoner and colleagues in this issue of JAMA is a first step toward development of policies based on convenient school-based self-sampling. However, further validation in broader populations is needed before pediatric self-sampling can be implemented, including asymptomatic children and patients with the newer circulating SARS-CoV-2 variants.…”

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confidence: 99%

Self-sampling for SARS-CoV-2 Detection in Children

Youngster

2022

JAMA

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the Centers for Disease Control and Prevention (CDC) reported the first confirmed case of COVID-19 in the US. 1 Since then, in only 2.5 years, the global pandemic has resulted in 588 757 628 confirmed cases of and 6 433 794 deaths (as of August 8, 2022). 2 While the world is (once again) gradually reopening, the lingering social and economic effects of the pandemic are clearly felt, with national lockdowns and school closures still ongoing in 23 countries. Furthermore, the World Health Organization (WHO) recently forecasted a new wave of COVID-19, predicted to peak in the autumn and winter months, suggesting the potential need to reinstate disruptive measures in the northern hemisphere.Preparing for the future, the WHO released its autumn/ winter strategy for COVID-19, emphasizing the central role of diagnostics in counteracting the pandemic. Specifically, the organization recommended that countries should strengthen "laboratory capacities to ensure reliable rapid diagnostic SARS-CoV-2 detection and tracking of variants, complemented by continued population use of rapid diagnostic testing; [integrate] population-based surveillance systems for influenza, SARS-CoV-2 and other respiratory viruses to monitor the spread and intensity of respiratory viruses; [and prioritize] contact tracing and quarantining based on WHO recommendations for individuals, high-risk settings and situations of concern." 3 While reliable innovative diagnostic tests to detect SARS-CoV-2 were rapidly developed in the past 2 years, sampling has remained a major limiting factor, especially in settings where large-scale testing of symptomatic and asymptomatic populations are needed. The need for dedicated health care workers (HCWs), fitted with personal protective equipment, some of which has to be discarded between patients, has hampered implementation of mass screening. Sampling is time consuming, expensive, and exposes the HCW to potential transmission from patients. To address this barrier, several studies in adults have evaluated the use of self-collected samples for SARS-CoV-2 molecular testing and have demonstrated 93% to 97% concordance rates with standard swabs obtained by HCWs. [4][5][6][7] In this issue of JAMA, the study by Waggoner et al 8 further expands this knowledge by showing that school-aged children are capable of reliable selfsampling using nasal swabs.The authors enrolled children from kindergarten through eighth grade who were referred for SARS-CoV-2 testing due to symptoms compatible with COVID-19. The participants were shown a short instructional video demonstrating how to selfswab and were provided with an instructional pictorial hand-

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

Abstract: Conflict of Interest Disclosures: Dr Vest reported being a founder and equity holder in Uppstroms, a health technology company. No other disclosures were reported.

Cited by 4 publications

References 9 publications

Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

Changing times in public health: The new wave of self‐collection of invasive samples

Self-sampling for SARS-CoV-2 Detection in Children

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