The acceptability and validity of self‐collected nasal swabs for detection of influenza virus infection among older adults in Thailand

Abstract

BackgroundSelf‐collection of nasal swabs could improve the timeliness of influenza virus detection in older adults.ObjectivesMeasure the acceptability, adequacy, timeliness, and validity of self‐collected nasal swabs among adults >65 years in Thailand.MethodsOur evaluation consisted of two parts: a one‐month study among randomly selected, community‐dwelling older adults to simulate community‐based surveillance for acute respiratory infections (ARI); and a clinic study of older adults with ARI to evaluate the sensitivity and specificity of self‐collected nasal swabs for influenza virus infection compared with healthcare worker (HCW)‐collected nasal and nasopharyngeal swabs.ResultsIn the community study, 24% of participants experienced an ARI during the observation period. All (100%) participants with an ARI self‐collected nasal swabs within 72 hours of symptom onset of which 92% were considered adequate samples. In the clinic study, 45% of patients with ARI presented within 72 hours of symptom onset. The sensitivity of self‐collected nasal swabs for detection of influenza virus infection was 78% (95% CI 40‐97) compared to nasopharyngeal and 88% (95% CI 47‐100) compared to nasal swabs collected by HCWs. Specificity was 100% (95% CI 97‐100) compared to both methods. Self‐collection of nasal swabs was found acceptable by 99% of participants in both studies.ConclusionsSelf‐collection of nasal swabs was acceptable to older adults in Thailand who were able to take adequate samples. Self‐collection of nasal swabs may improve the timeliness of sample collection but lower sensitivity will need to be considered.

Understanding user requirements to improve adoption of influenza diagnostics in clinical care within Metro Manila

“…Current evidence suggests that trade‐offs exist between collection methods . Test developers looking to improve the usability of their tests may consider prioritizing innovations and features that simplify sample collection and preparation such as allowing for patient self‐swabbing, which has been demonstrated to be both effective and acceptable among patients …”

Effect of acute respiratory illness on short‐term frailty status of older adults in Nakhon Phanom, Thailand—June 2015 to June 2016: A prospective matched cohort study

“…Swabs were transported on ice for processing, stored at −70°C, and tested at the Thailand National Institute of Health national reference laboratory using real‐time reverse transcription polymerase chain reaction (rRT‐PCR) for influenza and respiratory syncytial viruses . The participant self‐swab method was previously validated in this population; sensitivity for detection of influenza virus was 88% and specificity was 100% compared to nasal swabs collected by trained healthcare workers . To confirm specimen quality, each was tested by rRT‐PCR for the presence of Rnase P …”

“…The participant self‐swab method was previously validated in this population; sensitivity for detection of influenza virus was 88% and specificity was 100% compared to nasal swabs collected by trained healthcare workers . To confirm specimen quality, each was tested by rRT‐PCR for the presence of Rnase P …”

“…12,13 The participant self-swab method was previously validated in this population; sensitivity for detection of influenza virus was 88% and specificity was 100% compared to nasal swabs collected by trained healthcare workers. 14 Vulnerable Elders Survey-13 is a questionnaire developed to screen people ≥65 years in the community to determine their risk for death or functional decline. 11,15 The questionnaire asks older adults to self-report their age, health, limitations in physical function, and functional disabilities.…”

“…To confirm specimen quality, each was tested by rRT-PCR for the presence of Rnase P 14. To measure the effect of an ARI episode on frailty status, a subset of participants who experienced their first ARI after enrollment were matched with cohort participants who had not yet experienced an ARI on age (±5 years), sex, influenza vaccination status, and most recent pre-ARI episode VES-13 measurement (±1 point).…”