tetano
Editor, Senior Moderator
Med J Aust
. 2021 Jul 20.
doi: 10.5694/mja2.51188. Online ahead of print.
Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS-CoV-2 in primary care and children
Jane Oliver[SUP] 1 [/SUP], Shidan Tosif[SUP] 2 [/SUP], Lai-Yang Lee[SUP] 2 [/SUP], Anna-Maria Costa[SUP] 2 [/SUP], Chelsea Bartel[SUP] 2 [/SUP], Katherine Last[SUP] 2 [/SUP], Vanessa Clifford[SUP] 2 3 [/SUP], Andrew Daley[SUP] 2 4 [/SUP], Nicole Allard[SUP] 1 5 [/SUP], Catherine Orr[SUP] 5 [/SUP], Ashley Nind[SUP] 5 [/SUP], Karyn Alexander[SUP] 3 6 [/SUP], Niamh Meagher[SUP] 7 [/SUP], Michelle Sait[SUP] 8 [/SUP], Susan A Ballard[SUP] 8 [/SUP], Eloise Williams[SUP] 9 [/SUP], Katherine Bond[SUP] 10 [/SUP], Deborah A Williamson[SUP] 8 11 [/SUP], Nigel W Crawford[SUP] 12 [/SUP], Katherine B Gibney[SUP] 1 9 [/SUP]
Affiliations
Abstract
Objective: To compare the concordance and acceptability of saliva testing with standard-of-care oropharyngeal and bilateral deep nasal swab testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in children and in general practice.
Design: Prospective multicentre diagnostic validation study.
Setting: Royal Children's Hospital, and two general practices (cohealth, West Melbourne; Cirqit Health, Altona North) in Melbourne, July-October 2020.
Participants: 1050 people who provided paired saliva and oropharyngeal-nasal swabs for SARS-CoV-2 testing.
Main outcome measures: Numbers of cases in which SARS-CoV-2 was detected in either specimen type by real-time polymerase chain reaction; concordance of results for paired specimens; positive percent agreement (PPA) for virus detection, by specimen type.
Results: SARS-CoV-2 was detected in 54 of 1050 people with assessable specimens (5%), including 19 cases (35%) in which both specimens were positive. The overall PPA was 72% (95% CI, 58-84%) for saliva and 63% (95% CI, 49-76%) for oropharyngeal-nasal swabs. For the 35 positive specimens from people aged 10 years or more, PPA was 86% (95% CI, 70-95%) for saliva and 63% (95% CI, 45-79%) for oropharyngeal-nasal swabs. Adding saliva testing to standard-of-care oropharyngeal-nasal swab testing increased overall case detection by 59% (95% CI, 29-95%). Providing saliva was preferred to an oropharyngeal-nasal swab by most participants (75%), including 141 of 153 children under 10 years of age (92%).
Conclusion: In children over 10 years of age and adults, saliva testing alone may be suitable for SARS-CoV-2 detection, while for children under 10, saliva testing may be suitable as an adjunct to oropharyngeal-nasal swab testing for increasing case detection.
Keywords: COVID-19; Child health; Diagnosis; General practice; Infectious diseases; Public health; Respiratory tract infections.
. 2021 Jul 20.
doi: 10.5694/mja2.51188. Online ahead of print.
Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS-CoV-2 in primary care and children
Jane Oliver[SUP] 1 [/SUP], Shidan Tosif[SUP] 2 [/SUP], Lai-Yang Lee[SUP] 2 [/SUP], Anna-Maria Costa[SUP] 2 [/SUP], Chelsea Bartel[SUP] 2 [/SUP], Katherine Last[SUP] 2 [/SUP], Vanessa Clifford[SUP] 2 3 [/SUP], Andrew Daley[SUP] 2 4 [/SUP], Nicole Allard[SUP] 1 5 [/SUP], Catherine Orr[SUP] 5 [/SUP], Ashley Nind[SUP] 5 [/SUP], Karyn Alexander[SUP] 3 6 [/SUP], Niamh Meagher[SUP] 7 [/SUP], Michelle Sait[SUP] 8 [/SUP], Susan A Ballard[SUP] 8 [/SUP], Eloise Williams[SUP] 9 [/SUP], Katherine Bond[SUP] 10 [/SUP], Deborah A Williamson[SUP] 8 11 [/SUP], Nigel W Crawford[SUP] 12 [/SUP], Katherine B Gibney[SUP] 1 9 [/SUP]
Affiliations
- PMID: 34287935
- DOI: 10.5694/mja2.51188
Abstract
Objective: To compare the concordance and acceptability of saliva testing with standard-of-care oropharyngeal and bilateral deep nasal swab testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in children and in general practice.
Design: Prospective multicentre diagnostic validation study.
Setting: Royal Children's Hospital, and two general practices (cohealth, West Melbourne; Cirqit Health, Altona North) in Melbourne, July-October 2020.
Participants: 1050 people who provided paired saliva and oropharyngeal-nasal swabs for SARS-CoV-2 testing.
Main outcome measures: Numbers of cases in which SARS-CoV-2 was detected in either specimen type by real-time polymerase chain reaction; concordance of results for paired specimens; positive percent agreement (PPA) for virus detection, by specimen type.
Results: SARS-CoV-2 was detected in 54 of 1050 people with assessable specimens (5%), including 19 cases (35%) in which both specimens were positive. The overall PPA was 72% (95% CI, 58-84%) for saliva and 63% (95% CI, 49-76%) for oropharyngeal-nasal swabs. For the 35 positive specimens from people aged 10 years or more, PPA was 86% (95% CI, 70-95%) for saliva and 63% (95% CI, 45-79%) for oropharyngeal-nasal swabs. Adding saliva testing to standard-of-care oropharyngeal-nasal swab testing increased overall case detection by 59% (95% CI, 29-95%). Providing saliva was preferred to an oropharyngeal-nasal swab by most participants (75%), including 141 of 153 children under 10 years of age (92%).
Conclusion: In children over 10 years of age and adults, saliva testing alone may be suitable for SARS-CoV-2 detection, while for children under 10, saliva testing may be suitable as an adjunct to oropharyngeal-nasal swab testing for increasing case detection.
Keywords: COVID-19; Child health; Diagnosis; General practice; Infectious diseases; Public health; Respiratory tract infections.