Diagnostic accuracy and acceptability of molecular diagnosis of COVID-19 on saliva samples relative to nasopharyngeal swabs in tropical hospital and extra-hospital contexts: The COVISAL study

Mergeay-Fabre, Mayka; Blanchet, Denis; Benois, Orelie; Pozl, Tristan; Mesphoule, Pauline; Sainte-Rose, Vincent; Vialette, Véronique; Toulet, Bruno; Moua, Aurélie; Saout, Mona; Simon, Stéphane; Guidarelli, Manon; Galindo, Muriel; Biche, Barbara; Faurous, William; Chaizemartin, Laurie; Fahrasmane, Aniza; Rochemont, Devi; Diop, Fatou; Niang, Moussa; Pujo, Jean Marc; Vignier, Nicolas; Dotou, Dominique; Vabret, Astrid; Demar, Magalie

doi:10.1371/journal.pone.0257169

Cited by 17 publications

(12 citation statements)

References 21 publications

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“…We chose saliva as the specimen type for detecting SARS-CoV-2 in this study. The analytical sensitivity and specificity of viral detection in saliva has been reported to be equivalent or even better than NP swabs in many studies [ 18 , 48 – 51 ]. Saliva is very advantageous over NP swabs because it can be self-collected in a non-invasive manner and transported to the lab without any collection medium.…”

Section: Discussionmentioning

confidence: 99%

Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago

Atsawasuwan

Campo

et al. 2022

PLoS ONE

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COVID-19 has impacted and increased risks for healthcare providers, including orthodontists. There is no information regarding the potential transmission risks in the orthodontic community. This study aims to compare the positivity rate of SARS-CoV-2 infection in orthodontic patients at the University of Illinois Chicago (UIC) orthodontic clinic to the positivity rate of the local population in Chicago. All orthodontic patients who sought treatment at the UIC orthodontic clinic from June 16 to October 31, 2021, were invited to participate in the study. Three milliliters of saliva from the participants were collected in the sample collection tubes and subjected to a polymerase chain reaction (PCR) based assay to detect SAR-CoV-2. All participants’ age, sex, history of COVID-19 infection, and vaccination status were recorded. The COVID-19 positivity rates of Chicago, Cook County of Illinois, and the orthodontic clinic at UIC were compared. One thousand four hundred and thirty-seven orthodontic patients aged 6 to 70 years old (41.8% males and 58.2% females) participated in the study. Among all participants, nine participants tested positive for SARS-CoV-2 (5 males and 4 females). During the study, the average COVID-19 positivity rate at the UIC orthodontic clinic was 0.626%. All of the positive participants were asymptomatic, and two of the participants had a history of COVID-19 infection. Among all positive participants, three participants had received complete COVID-19 vaccination. An increased frequency of positive cases at the orthodontic clinic was observed during the time of high positivity rate in Chicago and Cook County. A potential risk of COVID-19 transmission from patients to orthodontic providers remains, even with asymptomatic and vaccinated patients.

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Section: Discussionmentioning

confidence: 99%

Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago

Atsawasuwan

Campo

et al. 2022

PLoS ONE

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“…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. 32 In South-East Asia, saliva-based testing is considered to be suitable for low-resource areas and able to accurately detect asymptomatic infections through PCR screening, as demonstrated in Viet Nam. 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.…”

Section: Current Applicationsmentioning

confidence: 99%

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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“…Molecular tests for the detection of the SARS-CoV-2 virus genome have been generally more sensitive than antigen tests; however, molecular tests can be costly, can take days to result during outbreaks, and can be hard to scale for large population testing. Furthermore, for tests requiring a swab-based respiratory tract specimen, these can be uncomfortable and difficult to obtain, especially in the setting of weekly self-collected specimen protocols, deterring individuals from participating in testing 8 . Early in the pandemic response, saliva emerged as an alternative specimen for SARS-CoV-2 testing and by 2021 it became apparent that a self-collected specimen could obviate the disadvantages of respiratory tract swab specimens.…”

Section: Introductionmentioning

confidence: 99%

Pooled RNA-extraction-free testing of saliva for the detection of SARS-CoV-2

Allicock

Yolda-Carr

Todd³

et al. 2023

Sci Rep

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The key to limiting SARS-CoV-2 spread is to identify virus-infected individuals (both symptomatic and asymptomatic) and isolate them from the general population. Hence, routine weekly testing for SARS-CoV-2 in all asymptomatic (capturing both infected and non-infected) individuals is considered critical in situations where a large number of individuals co-congregate such as schools, prisons, aged care facilities and industrial workplaces. Such testing is hampered by operational issues such as cost, test availability, access to healthcare workers and throughput. We developed the SalivaDirect RT-qPCR assay to increase access to SARS-CoV-2 testing via a low-cost, streamlined protocol using self-collected saliva. To expand the single sample testing protocol, we explored multiple extraction-free pooled saliva testing workflows prior to testing with the SalivaDirect RT-qPCR assay. A pool size of five, with or without heat inactivation at 65 °C for 15 min prior to testing resulted in a positive agreement of 98% and 89%, respectively, and an increased Ct value shift of 1.37 and 1.99 as compared to individual testing of the positive clinical saliva specimens. Applying this shift in Ct value to 316 individual, sequentially collected, SARS-CoV-2 positive saliva specimen results reported from six clinical laboratories using the original SalivaDirect assay, 100% of the samples would have been detected (Ct value < 45) had they been tested in the 1:5 pool strategy. The availability of multiple pooled testing workflows for laboratories can increase test turnaround time, permitting results in a more actionable time frame while minimizing testing costs and changes to laboratory operational flow.

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Diagnostic accuracy and acceptability of molecular diagnosis of COVID-19 on saliva samples relative to nasopharyngeal swabs in tropical hospital and extra-hospital contexts: The COVISAL study

Cited by 17 publications

References 21 publications

Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago

Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago

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

Pooled RNA-extraction-free testing of saliva for the detection of SARS-CoV-2

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