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Anand A, Vialard F, Esmail A, Ahmad Khan F, O’Byrne P, Routy JP, Dheda K, Pant Pai N. Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020-2023). PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002336. [PMID: 38324519 PMCID: PMC10849237 DOI: 10.1371/journal.pgph.0002336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
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 and DOR 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) use of digital interventions (70.15%, 95%CI: 50.18-84.63%; n = 14). Lower sensitivity was attributed to absence of symptoms, 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%). Overall 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. These data will guide COVIDST policy. Our review demonstrates that COVIDST has paved the way for self-testing in pandemics worldwide.
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Affiliation(s)
- Apoorva Anand
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Fiorella Vialard
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Aliasgar Esmail
- Centre for Lung Infection and Immunity, Division of Pulmonology, UCT Lung Institute and Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Faiz Ahmad Khan
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Patrick O’Byrne
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean-Pierre Routy
- Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, UCT Lung Institute and Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Nitika Pant Pai
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Folayan M, Shilton S, Undelikwo V, Alaba O, Amusan R, Ibrahim M, Ogbozor PA, Mojisola O, Batheja D, Banerji A, Ivanova Reipold E, Martínez-Pérez GZ. People's willingness to use COVID-19 self-testing in Nigeria: a cross-sectional survey. BMJ Open 2023; 13:e063323. [PMID: 36717135 PMCID: PMC9887470 DOI: 10.1136/bmjopen-2022-063323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Nigeria has been badly affected by the COVID-19 pandemic, and the poor testing coverage in the country may make controlling the spread of COVID-19 challenging. The aim of this study was to assess the general public's acceptability of SARS-CoV-2 self-testing as an approach which could help to address this gap. SETTING A household-based survey was conducted in five urban and five rural local government areas in the states of Akwa Ibom, Anambra, Benue, Kaduna and Lagos, in mid-2021. PARTICIPANTS 2126 respondents (969 were female) participated. A five-pronged, probabilistic sampling approach was used to recruit individuals older than 17 years and available to participate when randomly approached in their households by the surveyors. A 35-item questionnaire was used to collect data on their values towards SARS-CoV-2 self-testing. Primary outcomes were: likelihood to use a self-test; willingness to pay for a self-test; and likely actions following a reactive self-test result. RESULTS Of the total 2126 respondents, 14 (0.66%) were aware of COVID-19 self-testing, 1738 (81.80%) agreed with the idea of people being able to self-test for COVID-19, 1786 (84.05%) were likely/very likely to use self-tests if available, 1931 (90.87%) would report a positive result and 1875 (88.28%) would isolate if they self-tested positive. Factors significantly associated with the use of a self-test were having a college education or higher (adjusted Odds Ratio (AOR): 1.55; 95% CI: 1.03 to 2.33), full-time employment (AOR: 1.67; 95% CI: 1.06 to 2.63), feeling at moderate/high risk of COVID-19 (AOR: 2.43; 95% CI: 1.70 to 3.47) and presence of individuals at risk of COVID-19 within the household (AOR: 1.38; 95% CI: 1.06 to 1.78). CONCLUSION A majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health on self-testing positive. Self-test implementation research is necessary to frame how acceptability impacts uptake of preventive behaviours following a positive and a negative self-test result.
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Affiliation(s)
- Morenike Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | | | - Oluwatoyin Alaba
- Institute of Public Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Ranmilowo Amusan
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Pamela Adaobi Ogbozor
- Department of Psychology, Enugu State University of Science and Technology, Enugu, Anambra State, Nigeria
| | - Oluyide Mojisola
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Abhik Banerji
- Center for Disease Dynamics Economics & Policy, Delhi, India
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Meyer JC, MacBride-Stewart S, Fadare JO, Abdulrahman Jairoun A, Haque M, Massele A, Kumar S, Sefah IA, P Skosana P, Godman B. Key Considerations From a Health Authority Perspective When Proton Pump Inhibitors Are Used to Treat Gastroesophageal Reflux Disease (GERD) and Their Implications. Cureus 2022; 14:e31918. [DOI: 10.7759/cureus.31918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 11/28/2022] Open
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