Rapid antigen testing by community health workers for detection of SARS-CoV-2 in Dhaka, Bangladesh: a cross-sectional study

Autor: Ayesha Sania, Ahmed Nawsher Alam, A S M Alamgir, Joanna Andrecka, Eric Brum, Fergus Chadwick, Tasnuva Chowdhury, Zakiul Hasan, Davina L Hill, Farzana Khan, Mikolaj Kundegorski, Seonjoo Lee, Mahbubur Rahman, Yael K Rayport, Tahmina Shirin, Motahara Tasneem, Katie Hampson
Jazyk: angličtina
Rok vydání: 2022
Předmět:
ISSN: 2044-6055
Popis: ObjectiveTo evaluate the diagnostic performance and feasibility of rapid antigen testing for SARS-CoV-2 detection in low-income communities.DesignWe conducted a cross-sectional community-based diagnostic accuracy study. Community health workers, who were trained and supervised by medical technicians, performed rapid antigen tests on symptomatic individuals, and up to two additional household members in their households and diagnostic results were calibrated against the gold standard RT-PCR.SettingLow-income communities in Dhaka, Bangladesh.ParticipantsBetween 19 May 2021 and 11 July 2021, 1240 nasal and saliva samples were collected from symptomatic individuals and 993 samples from additional household members (up to two from one household).ResultsThe sensitivity of rapid antigen tests was 0.68 on nasal samples (95% CI 0.62 to 0.73) and 0.41 on saliva (95% CI 0.35 to 0.46), with specificity also higher on nasal samples (0.98, 95% CI 0.97 to 0.99) than saliva (0.87, 95% CI 0.85 to 0.90). Testing up to two additional household members increased sensitivity to 0.71 on nasal samples (95% CI 0.65 to 0.76), but reduced specificity (0.96, 95% CI 0.94 to 0.97). Sensitivity on saliva rose to 0.48 (95% CI 0.42 to 0.54) with two additional household members tested but remained lower than sensitivity on nasal samples. During the study period, testing in these low-income communities increased fourfold through the mobilisation of community health workers for sample collection.ConclusionsRapid antigen testing on nasal swabs can be effectively performed by community health workers yielding equivalent sensitivity and specificity to the literature. Household testing by community health workers in low-resource settings is an inexpensive approach that can increase testing capacity, accessibility and the effectiveness of control measures through immediately actionable results.
Databáze: OpenAIRE