Combining rapid antigen testing and syndromic surveillance improves community-based COVID-19 detection in a low-income country

Diagnostics for COVID-19 detection are limited in many settings. Syndromic surveillance is often the only means to identify cases but lacks specificity. Rapid antigen testing is inexpensive and easy-to-deploy but can lack sensitivity. We examine how combining these approaches can improve surveillanc...

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Vydáno v:Nature communications Ročník 13; číslo 1; s. 2877 - 9
Hlavní autoři: Chadwick, Fergus J., Clark, Jessica, Chowdhury, Shayan, Chowdhury, Tasnuva, Pascall, David J., Haddou, Yacob, Andrecka, Joanna, Kundegorski, Mikolaj, Wilkie, Craig, Brum, Eric, Shirin, Tahmina, Alamgir, A. S. M., Rahman, Mahbubur, Alam, Ahmed Nawsher, Khan, Farzana, Swallow, Ben, Mair, Frances S., Illian, Janine, Trotter, Caroline L., Hill, Davina L., Husmeier, Dirk, Matthiopoulos, Jason, Hampson, Katie, Sania, Ayesha
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Nature Publishing Group UK 26.05.2022
Nature Publishing Group
Nature Portfolio
Témata:
631/326/596/4130
692/1807
692/699/255/2514
692/700/139
692/700/478/174
Antigens
Bangladesh - epidemiology
Coronaviruses
COVID-19
COVID-19 - diagnosis
COVID-19 - epidemiology
Epidemics
Epidemiology
Health surveillance
Humanities and Social Sciences
Humans
Income
Low income areas
Mathematical models
Models, Statistical
multidisciplinary
Performance evaluation
Performance prediction
Science
Science (multidisciplinary)
Sensitivity
Sentinel Surveillance
Statistical analysis
Statistical models
Surveillance
Bangladesh
ISSN:2041-1723, 2041-1723
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Shrnutí:Diagnostics for COVID-19 detection are limited in many settings. Syndromic surveillance is often the only means to identify cases but lacks specificity. Rapid antigen testing is inexpensive and easy-to-deploy but can lack sensitivity. We examine how combining these approaches can improve surveillance for guiding interventions in low-income communities in Dhaka, Bangladesh. Rapid-antigen-testing with PCR validation was performed on 1172 symptomatically-identified individuals in their homes. Statistical models were fitted to predict PCR-status using rapid-antigen-test results, syndromic data, and their combination. Under contrasting epidemiological scenarios, the models’ predictive and classification performance was evaluated. Models combining rapid-antigen-testing and syndromic data yielded equal-to-better performance to rapid-antigen-test-only models across all scenarios with their best performance in the epidemic growth scenario. These results show that drawing on complementary strengths across rapid diagnostics, improves COVID-19 detection, and reduces false-positive and -negative diagnoses to match local requirements; improvements achievable without additional expense, or changes for patients or practitioners. Rapid antigen tests and syndromic surveillance for identification of COVID-19 cases are limited by low sensitivity and specificity, respectively. Here, the authors use data from Bangladesh and show that combining the two methods improves diagnostic accuracy in a range of epidemiological scenarios.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-022-30640-w