Combining rapid antigen testing and syndromic surveillance improves community-based COVID-19 detection in a low-income country.
Mair, Frances S
Springer Science and Business Media LLC
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Chadwick, F. J., Clark, J., Chowdhury, S., Chowdhury, T., Pascall, D., Haddou, Y., Andrecka, J., et al. (2022). Combining rapid antigen testing and syndromic surveillance improves community-based COVID-19 detection in a low-income country.. Nat Commun, 13 (1) https://doi.org/10.1038/s41467-022-30640-w
Funder: Juniper Consortium MR/V038613/1
Funder: Bill and Melinda Gates Foundation (Bill & Melinda Gates Foundation)
Diagnostics for COVID-19 detection are limited in many settings. Syndromic surveillance is often the only means to identify cases but lacks specificity. Rapid antigen testing is inexpensive and easy-to-deploy but can lack sensitivity. We examine how combining these approaches can improve surveillance for guiding interventions in low-income communities in Dhaka, Bangladesh. Rapid-antigen-testing with PCR validation was performed on 1172 symptomatically-identified individuals in their homes. Statistical models were fitted to predict PCR-status using rapid-antigen-test results, syndromic data, and their combination. Under contrasting epidemiological scenarios, the models' predictive and classification performance was evaluated. Models combining rapid-antigen-testing and syndromic data yielded equal-to-better performance to rapid-antigen-test-only models across all scenarios with their best performance in the epidemic growth scenario. These results show that drawing on complementary strengths across rapid diagnostics, improves COVID-19 detection, and reduces false-positive and -negative diagnoses to match local requirements; improvements achievable without additional expense, or changes for patients or practitioners.
Article, /692/699/255/2514, /692/700/478/174, /692/700/139, /692/1807, /631/326/596/4130, article
Bill and Melinda Gates Foundation (Bill & Melinda Gates Foundation) (INV-022851, INV-022851)
RCUK | Engineering and Physical Sciences Research Council (EPSRC) (EP/R513222/1)
Wellcome Trust (Wellcome) (207569/Z/17/Z)
External DOI: https://doi.org/10.1038/s41467-022-30640-w
This record's URL: https://www.repository.cam.ac.uk/handle/1810/337511