Factors Influencing COVID-19 Testing: A Qualitative Study in Bhutan

Yangchen, Sonam; Ha, Solip; Assan, Abraham; Tobgay, Tashi

doi:10.21203/rs.3.rs-885659/v1

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…Saliva collection is less invasive and more acceptable to the general population ( 8 , 19 ). One of the barriers hindering COVID-19 testing is people’s fear of nasal swabs due to misinformation ( 20 ). In addition, the discomfort brought by nasal swabs may reduce people’s willingness to get tested regularly, especially among children ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

et al. 2022

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The findings of this manuscript are increasingly important with new variants that appear to have shorter incubation periods emerging, which may be more prone to detection in saliva before detection in nasal swabs. Therefore, there is an urgent need to provide the science to support the use of a detection method that is highly sensitive and widely acceptable to the public to improve screening rates and early detection.

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Section: Discussionmentioning

confidence: 99%

Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

et al. 2022

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“…Saliva collection is less invasive and more acceptable to the general population 7,18 . One of the barriers hindering COVID-19 testing is people’s fear of nasal swabs due to misinformation 19 . Also, the discomfort brought by nasal swabs may also reduce people’s willingness to get tested regularly, especially among children 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Saliva and Mid-Turbinate Swabs for Detection of COVID-19

Lai

German

Hong

et al. 2021

Preprint

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BackgroundSaliva is an attractive sample for detecting SARS-CoV-2 because it is easy to collect and minimally invasive. However, contradictory reports exist concerning the sensitivity of saliva versus nasal swabs.MethodsWe recruited and followed close contacts of COVID-19 cases for up to 14 days from their last exposure and collected self-reported symptoms, mid-turbinate swabs (MTS) and saliva every two or three days. Ct values and frequency of viral detection by MTS and saliva were compared. Logistic regression was used to estimate the probability of detection by days since symptom onset for the two sample types.ResultsWe enrolled 58 contacts who provided a total of 200 saliva and MTS sample pairs; 14 contacts (13 with symptoms) had one or more positive samples. Overall, saliva and MTS had similar rates of viral detection (p=0.78). Although Ct values for saliva were significantly greater than for MTS (p=0.014), Cohen’s Kappa demonstrated substantial agreement (κ=0.83). However, sensitivity varied significantly with time relative to symptom onset. Early in the course of infection (days -3 to 2), saliva had 12 times (95%CI: 1.2, 130) greater likelihood of detecting viral RNA compared to MTS. After day 2, there was a non-significant trend to greater sensitivity using MTS samples.ConclusionSaliva and MTS specimens demonstrated high agreement, making saliva a suitable alternative to MTS nasal swabs for COVID-19 detection. Furthermore, saliva was more sensitive than MTS early in the course of infection, suggesting that it may be a superior and cost-effective screening tool for COVID-19.Key PointsSaliva is more sensitive in detecting symptomatic cases of COVID-19 than MTS early in the course of infection.Saliva performs best in the pre-symptomatic period.Saliva and MTS demonstrated high agreement making saliva a suitable and cost-effective COVID-19 screening tool.

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“…This study is part of a two-country study that sought to identify factors in uencing COVID-19 testing in Bhutan and Ghana. For ndings on Bhutan's case study [11], this current study illuminates the facilitators and barriers to COVID-19 testing in Ghana. In that paper, six enablers and ve barriers were identi ed.…”

Section: Discussionmentioning

confidence: 82%

“…We envision ndings could serve as a roadmap scale-up COVID-19 testing and improve future responses to the pandemic, especially in low-middle income countries. This study is part of a two-country study on identifying facilitators and barriers to scale-up COVID-19 testing in Bhutan [11] and Ghana.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 testing: A qualitative study exploring enablers and barriers in the Greater Accra Region, Ghana

Yangchen

Assan³

2022

Preprint

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Introduction: Despite the rolling out of vaccines, the importance of extensive testing along with effective tracing and treatment is still crucial to slowing transmission of the COVID-19 virus. However, testing barriers can be significant impediments to effective COVID-19 response. This study explored enablers and barriers to COVID-19 testing in the Greater Accra region of Ghana. We envision lessons learned from this study could serve as a roadmap to strengthen the current response to COVID-19 and preparedness for future outbreaks, particularly in low- and middle-income countries. Methods: A qualitative design was undertaken to explore the phenomenon. Data collection methods included in-depth interviews with key informants with a purposively selected sample of 20 participants. Interviews were conducted using flexible semi-structured interview guides. Depending on the participant's position and involvement in COVID-19 testing, the guides were modified, and key elements were drawn from a tailored version of the WHO Health System Framework incorporating the Essential Public Health Functions (EPHF). The interview findings were augmented by reviewing published literature. Results: Better health governance and political leadership, community participation, multisectoral collaboration, effective resource management and information systems were key enablers of COVID-19 testing. Findings also revealed a strong political willingness to committing financial resources to enhance testing. The primary barriers to testing were mainly COVID-19 infodemic, inadequacy of material resources to meet growing health needs, and lack of opportunities to have equal and easy access to testing services. Further, although human resources were adequate, they were unevenly distributed across settings. Conclusion: To effectively be prepared for COVID-19 testing and respond to future outbreaks, the following are recommended: there should be improved political commitments to ensure even distribution of all resources across the country; financial supports should be provided for the poor to protect them from the financial burden of paying for expensive testing services; improving community participation should be encouraged to address socio-cultural barriers to testing hesitancy. However, multilateral cooperation with diverse stakeholders beyond the scope of health will be essential in facilitating pandemic responses such as scaling up testing strategies

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Factors Influencing COVID-19 Testing: A Qualitative Study in Bhutan

Cited by 4 publications

References 3 publications

Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

Comparison of Saliva and Mid-Turbinate Swabs for Detection of COVID-19

COVID-19 testing: A qualitative study exploring enablers and barriers in the Greater Accra Region, Ghana

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