Sensitivity and specificity of the antigen-based anterior nasal self-testing programme for detecting SARS-CoV-2 infection in schools, Austria, March 2021

Willeit, Peter; Bernar, Benoît; Zurl, Christoph; Alrawi, M.; Berghold, Andrea; Bernhard, David; Borena, Wegene; Doppler, Christian; Kerbl, Reinhold; Köhler, Alwin; Krause, Robert; Lamprecht, Bernd; Pröll, Johannes; Schmidt, Hannes; Steinmetz, Ivo; Stelzl, Evelyn; Stoiber, Heribert; Laer, Dorothee von; Zuber, Johannes; Müller, Thomas; Strenger, Volker; Wagner, Michael

doi:10.2807/1560-7917.es.2021.26.34.2100797

Cited by 7 publications

(24 citation statements)

References 8 publications

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“…In 14 datasets (77.8% of all datasets) [15-17,27-29,31-34], C19ST was implemented as part of a routinely testing service, most often (4 datasets) [29,31,33,34] for testing twice weekly. C19ST was mainly performed at home (10 data sets; 58.8%), but also in school (4; 23.5% of all data sets) [27,31] or at work (1; 5.9% of all data sets) [34].…”

Section: Resultsmentioning

confidence: 99%

“…Reporting the test result following self-testing was required by study design in four data sets [27,31]. Participants included in two datasets were contacted by telephone if they did not submit a test result and the proportion of results reported was 90.7% [30].…”

Section: Resultsmentioning

confidence: 99%

“…The full text of 182 articles was read, with seven being found to be eligible for inclusion in the review. Experts Antigen Rapid Test Kit (Lepu Medical Technology, China) [31] were used in three data sets each (17.6% of all data sets). Of the remaining three data sets, one (5.9% of all data sets) used the BD Veritor At-Home COVID-19 Test (Becton, Dickinson and Company, United States…”

Section: Study Descriptionmentioning

confidence: 99%

“…[NJ]) [30], another the RIDA QUICK SARS-CoV-2 Antigen (R-Biopharm, German) [32] and for the third the Ag-RDT used was unclear [27]. In eleven data sets (64.7% of all data sets), the sample type was anterior nasal / mid-turbinate (AN/MT) [28][29][30][31][32][33]35 [29,31,33,34] for testing twice weekly.…”

Section: Study Descriptionmentioning

confidence: 99%

“…C19ST was mainly performed at home (10 data sets; 58.8%), but also in school (4; 23.5% of all data sets) [27,31] or at work (1; 5.9% of all data sets) [34]. In two data sets (11.7% of all data sets) from the same study, testing was performed at dedicated testing sites at the beginning of the study and at home towards end of the study [16].…”

Section: Study Descriptionmentioning

confidence: 99%

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The clinical utility and epidemiological impact of self-testing for SARS-CoV-2 using antigen detecting diagnostics: a systematic review and meta-analysis

Brümmer

Erdmann

Tolle

et al. 2022

Preprint

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IntroductionSelf-testing for COVID-19 (C19ST) based on antigen detecting diagnostics could significantly support controlling the SARS-CoV-2 pandemic. To inform the World Health Organization in developing a C19ST guideline, we performed a systematic review and meta-analysis of the available literature.MethodsWe electronically searched Medline and the Web of Science core collection, performed secondary reference screening, and contacted experts for further relevant publications. Any study published between December 1, 2020 and November 30, 2021 assessing the epidemiological impact and clinical utility of C19ST was included. Study quality was evaluated using the Newcastle Ottawa Scale (NOS). The review was registered on PROSPERO (CRD42022299977).Results11 studies only from high-income countries with an overall low quality (median of 3/9 stars on the NOS) were found. Pooled C19ST positivity was 0.2% (95% CI 0.1% to 0.4%; eight data sets) in populations where otherwise no dedicated testing would have occurred. The impact of self-testing on virus transmission was uncertain. Positive test results mainly resulted in people having to isolate without further confirmation of results (eight data sets). When testing was voluntary by study design, pooled testing uptake was 53.2% (95% CI 36.7% to 68.9%; five data sets. Outside direct health impacts, C19ST reduced quarantine duration and absenteeism from work, and made study participants feel safer. Study participants favored self-testing and were confident that they performed testing and sampling correctly.ConclusionsThe present data suggests that C19ST could be a valuable tool in reducing the spread of COVID-19, as it can achieve good uptake, may identify additional cases, and was generally perceived as positive by study participants. However, data was very limited and heterogenous, and further research especially in low- and middle-income countries is needed to assess the clinical utility and epidemiological impact of C19ST in more detail.CONTRIBUTIONS TO THE LITERATURE- COVID-19 self-testing (C19ST) using antigen detection could conceivably support pandemic control. A current PubMed search found no systematic evidence synthesis of studies assessing the epidemiological impact and clinical utility of C19ST implementation- We systematically reviewed and meta-analyzed 11 studies including more than 1.1 million persons tested- C19ST can achieve good uptake, may identify additional cases, and was general perceived as positive by study participants, suggesting it to be a valuable tool in reducing the spread of SARS-CoV-2- Further data especially from low- and middle-income countries is needed to understand the impact of C19ST in more detail

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Descriptionmentioning

confidence: 99%

Section: Study Descriptionmentioning

confidence: 99%

Section: Study Descriptionmentioning

confidence: 99%

See 3 more Smart Citations

The clinical utility and epidemiological impact of self-testing for SARS-CoV-2 using antigen detecting diagnostics: a systematic review and meta-analysis

Brümmer

Erdmann

Tolle

et al. 2022

Preprint

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Potential usage of anterior nasal sampling in clinical practice with three rapid antigen tests for SARS-CoV-2

Nomoto¹,

Yamamoto²,

Isaka³

et al. 2023

Journal of Infection and Chemotherapy

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Self-tests for COVID-19: what is the evidence? A living systematic review and meta-analysis (2020-2023)

Anand,

Vialard,

Esmail

et al. 2023

Preprint

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COVID-19 self-testing strategy (COVIDST) can rapidly identify symptomatic and asymptomatic SARS-CoV-2-infected individuals and their contacts, potentially reducing transmission. In this living systematic review, we evaluated the evidence for real-world COVIDST performance. Two independent reviewers searched six databases (PubMed, Embase, Web of Science, World Health Organization database, Cochrane COVID-19 registry, Europe PMC) for the period April 1st, 2020, to January 18th, 2023. Data on studies evaluating COVIDST against laboratory-based conventional testing and reported on diagnostic accuracy, feasibility, acceptability, impact, and qualitative outcomes were abstracted. Bivariate random effects meta-analyses of COVIDST accuracy were performed (n=14). Subgroup analyses (by sampling site, symptomatic/asymptomatic infection, supervised/unsupervised strategy, with/without digital supports) were conducted. Data from 70 included studies, conducted across 25 countries with a median sample size of 817 (range: 28-784,707) were pooled. Specificity was high overall, irrespective of subgroups (98.37-99.71%). Highest sensitivities were reported for: a) symptomatic individuals (73.91%, 95%CI: 68.41-78.75%; n=9), b) mid-turbinate nasal samples (77.79%, 95%CI: 56.03-90.59%; n=14), c) supervised strategy (86.67%, 95%CI: 59.64-96.62%; n=13), and d) presence of digital interventions (70.15%, 95%CI: 50.18-84.63%; n=14). Sensitivity was lower in asymptomatic populations (40.18%, 95% CI: 21.52-62.20%; n=4), due to errors in test conduct and absence of supervision or a digital support. We found no difference in COVIDST sensitivity between delta and omicron pre-dominant period. Digital supports increased confidence in COVIDST reporting and interpretation (n=16). Overall acceptability was 91.0-98.7% (n=2) with lower acceptability reported for daily self-testing (39.5-51.1%). Feasibility was 69.0-100.0% (n=5) with lower feasibility (35.9-64.6%) for serial self-testing. COVIDST decreased closures in school, workplace, and social events (n=4). COVIDST is an effective rapid screening strategy for home-, workplace- or school-based screening, for symptomatic persons, and for preventing transmission during outbreaks. This data is useful for updating COVIDST policy. Our review demonstrates that COVIDST has paved the way for the introduction of self-tests, worldwide.

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Sensitivity and specificity of the antigen-based anterior nasal self-testing programme for detecting SARS-CoV-2 infection in schools, Austria, March 2021

Cited by 7 publications

References 8 publications

The clinical utility and epidemiological impact of self-testing for SARS-CoV-2 using antigen detecting diagnostics: a systematic review and meta-analysis

The clinical utility and epidemiological impact of self-testing for SARS-CoV-2 using antigen detecting diagnostics: a systematic review and meta-analysis

Potential usage of anterior nasal sampling in clinical practice with three rapid antigen tests for SARS-CoV-2

Self-tests for COVID-19: what is the evidence? A living systematic review and meta-analysis (2020-2023)

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