The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings

Duma, Zamathombeni; Chuturgoon, Anil A.; Ramsuran, Veron; Edward, Vinodh; Naidoo, Pragalathan; Mpaka-Mbatha, Miranda N.; Bhengu, Khethiwe N.; Nembe, Nomzamo; Pillay, Roxanne; Singh, Ravesh; Mkhize‐Kwitshana, Zilungile L.

doi:10.1186/s12992-022-00796-7

Cited by 21 publications

(19 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Real-time reverse transcription-polymerase chain reaction (rRT-PCR) remains the reference standard for the diagnosis of SARS-CoV-2 infection [3]. However, rRT-PCR has limitations, including the need for specialized laboratories, equipment, and staff, longer turnaround time (TAT) for clinical decision making and prevention measures, high cost, and erratic supply of reagents to conduct SARS-CoV-2 rRT-PCR due to increased demand [3][4][5][6]. These limitations have increased the demand for more rapid, cheaper, and easy to perform testing methods [7].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of the Panbio COVID-19 antigen rapid test device for SARS-CoV-2 detection in Kenya, 2021: A field evaluation

et al. 2023

View full text Add to dashboard Cite

Background Accurate and timely diagnosis is essential in limiting the spread of SARS-CoV-2 infection. The reference standard, rRT-PCR, requires specialized laboratories, costly reagents, and a long turnaround time. Antigen RDTs provide a feasible alternative to rRT-PCR since they are quick, relatively inexpensive, and do not require a laboratory. The WHO requires that Ag RDTs have a sensitivity ≥80% and specificity ≥97%. Methods This evaluation was conducted at 11 health facilities in Kenya between March and July 2021. We enrolled persons of any age with respiratory symptoms and asymptomatic contacts of confirmed COVID-19 cases. We collected demographic and clinical information and two nasopharyngeal specimens from each participant for Ag RDT testing and rRT-PCR. We calculated the diagnostic performance of the Panbio™ Ag RDT against the US Centers for Disease Control and Prevention’s (CDC) rRT-PCR test. Results We evaluated the Ag RDT in 2,245 individuals where 551 (24.5%, 95% CI: 22.8–26.3%) tested positive by rRT-PCR. Overall sensitivity of the Ag RDT was 46.6% (95% CI: 42.4–50.9%), specificity 98.5% (95% CI: 97.8–99.0%), PPV 90.8% (95% CI: 86.8–93.9%) and NPV 85.0% (95% CI: 83.4–86.6%). Among symptomatic individuals, sensitivity was 60.6% (95% CI: 54.3–66.7%) and specificity was 98.1% (95% CI: 96.7–99.0%). Among asymptomatic individuals, sensitivity was 34.7% (95% CI 29.3–40.4%) and specificity was 98.7% (95% CI: 97.8–99.3%). In persons with onset of symptoms <5 days (594/876, 67.8%), sensitivity was 67.1% (95% CI: 59.2–74.3%), and 53.3% (95% CI: 40.0–66.3%) among those with onset of symptoms >7 days (157/876, 17.9%). The highest sensitivity was 87.0% (95% CI: 80.9–91.8%) in symptomatic individuals with cycle threshold (Ct) values ≤30. Conclusion The overall sensitivity and NPV of the Panbio™ Ag RDT were much lower than expected. The specificity of the Ag RDT was high and satisfactory; therefore, a positive result may not require confirmation by rRT-PCR. The kit may be useful as a rapid screening tool only for symptomatic patients in high-risk settings with limited access to rRT-PCR. A negative result should be interpreted based on clinical and epidemiological information and may require retesting by rRT-PCR.

show abstract

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of the Panbio COVID-19 antigen rapid test device for SARS-CoV-2 detection in Kenya, 2021: A field evaluation

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The implementation of simple, affordable diagnosis techniques and diagnostic facilities would greatly help low-resource endemic countries in Africa given that those areas are the most concerned by the Monkeypox disease ( 51 ). The recent epidemiology of MPXV shows how the disease is not exclusive to African countries ( 50 ).…”

Section: Discussionmentioning

confidence: 99%

Useful public health countermeasures to control the current multicountry outbreak of Monkeypox disease

Diatta

Faye

Sall

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

Monkeypox is a viral disease endemic to some countries in Central and Western Africa. However, sporadic human cases have also been reported outside of Africa. The first human case was reported in 1970 in the Democratic Republic of Congo. Very similar to the eradicated smallpox regarding its clinical representation, the Monkeypox disease is most common in children aged between 5 and 9 years with a fatality rate ranging from 1 to 11% in Africa. During the past decade, the number of countries that reported human cases of the disease grew significantly, while experts still sought knowledge on the characteristics of the virus. The recent increase in Monkeypox cases in many countries raises the concern about a possible global health threat. There is a need to subsequently provide insights into the incidence of Monkeypox disease and come up with mechanisms to prevent its emergence and contain its spread. Furthermore, it is crucial to have a better view of the global diagnostic capacity of the Monkeypox virus. This review aims to assess useful public health countermeasures to control the current multicountry outbreak of Monkeypox disease. Articles were searched in PubMed and Google Scholar electronic databases on 30 June 2022, using selected keywords, without language and date restriction. A total of 44 scientific records were published between 1 January 1962 and 30 June 2022. Herein, we discuss the epidemiological and public health situation at a global scale, provide an updated overview and data of utility for a better understanding of knowledge and research gaps in the epidemiology of the Monkeypox disease, and give useful measures for controlling the current multicountry outbreak.

show abstract

“…In addition, these continents had robust COVID-19 testing capacities and effective public surveillance systems, which are crucial to preventing a high infection rate. Approximately 3.4 billion tests were performed globally from December 2019 to August 2021, most of which were restricted to high-income countries, which conducted more SARS-CoV-2 testing (i.e., USA: 192%, Australia: 146%, Switzerland: 124%, and Canada: 113%) compared to that undertaken in low-income countries (LICs; i.e., Bangladesh: 6%, Uganda: 4% and Nigeria: 1%) ( 20 ). Furthermore, several other factors, such as the fragile healthcare system, relatively low population density, low obesity or diabetes burden, younger population, climate, genetics, and lessons from the public health response to other deadly infectious diseases (e.g., Ebola virus) are correlated with the lower case and death rates observed in Africa ( 21 – 23 ).…”

Section: Discussionmentioning

confidence: 99%

Evolving trend change during the COVID-19 pandemic

Gao¹,

Zheng

Shi³

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

Coronavirus disease (COVID-19) has caused unimaginable damage to public health and socio-economic structures worldwide; thus, an epidemiological depiction of the global evolving trends of this disease is necessary. As of March 31, 2022, the number of cases increased gradually over the four waves of the COVID-19 pandemic, indicating the need for continuous countermeasures. The highest total cases per million and total deaths per million were observed in Europe (240,656.542) and South America (2,912.229), despite these developed countries having higher vaccination rates than other continents, such as Africa. In contrast, the lowest of the above two indices were found in undeveloped African countries, which had the lowest number of vaccinations. These data indicate that the COVID-19 pandemic is positively related to the socio-economic development level; meanwhile, the data suggest that the vaccine currently used in these continents cannot completely prevent the spread of COVID-19. Thus, rethinking the feasibility of a single vaccine to control the disease is needed. Although the number of cases in the fourth wave increased exponentially compared to those of the first wave, ~43.1% of deaths were observed during the first wave. This was not only closely linked to multiple factors, including the inadequate preparation for the initial response to the COVID-19 pandemic, the gradual reduction in the severity of additional variants, and the protection conferred by prior infection and/or vaccination, but this also indicated the change in the main driving dynamic in the fourth wave. Moreover, at least 12 variants were observed globally, showing a clear spatiotemporal profile, which provides the best explanation for the presence of the four waves of the pandemic. Furthermore, there was a clear shift in the trend from multiple variants driving the spread of disease in the early stage of the pandemic to a single Omicron lineage predominating in the fourth wave. These data suggest that the Omicron variant has an advantage in transmissibility over other contemporary co-circulating variants, demonstrating that monitoring new variants is key to reducing further spread. We recommend that public health measures, along with vaccination and testing, are continually implemented to stop the COVID-19 pandemic.

show abstract

The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings

Cited by 21 publications

References 50 publications

Diagnostic accuracy of the Panbio COVID-19 antigen rapid test device for SARS-CoV-2 detection in Kenya, 2021: A field evaluation

Diagnostic accuracy of the Panbio COVID-19 antigen rapid test device for SARS-CoV-2 detection in Kenya, 2021: A field evaluation

Useful public health countermeasures to control the current multicountry outbreak of Monkeypox disease

Evolving trend change during the COVID-19 pandemic

Contact Info

Product

Resources

About