Schneitler, Sophie, Jung, Philipp, Bub, Florian, Alhussein, Farah, Benthien, Sophia, Berger, Fabian K., Berko-Gottel, Barbara, Eisenbeis, Janina, Hahn, Daphne, Halfmann, Alexander, Last, Katharina, Linxweiler, Maximilian, Lohse, Stefan ORCID: 0000-0003-2529-1900, Papan, Cihan, Pfuhl, Thorsten, Rissland, Jurgen, Roth, Sophie ORCID: 0000-0002-5334-2077, Schlotthauer, Uwe, Utzinger, Jurg, Smola, Sigrun, Gartner, Barbara C. and Becker, Soren L. (2020). Simple Questionnaires to Improve Pooling Strategies for SARS-CoV-2 Laboratory Testing. Ann. Glob. Health, 86 (1). LONDON: UBIQUITY PRESS LTD. ISSN 2214-9996

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Abstract

Background: Liberal PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is key to contain the coronavirus disease 2019 (COVID-19) pandemic. Combined multi-sample testing in pools instead of single tests might enhance laboratory capacity and reduce costs, especially in low- and middle-income countries. Objective: The purpose of our study was to assess the value of a simple questionnaire to guide and further improve pooling strategies for SARS-CoV-2 laboratory testing. Methods: Pharyngeal swabs for SARS-CoV-2 testing were obtained from healthcare and police staff, hospital inpatients, and nursing home residents in the southwestern part of Germany. We designed a simple questionnaire, which included questions pertaining to a suggestive clinical symptomatology, recent travel history, and contact with confirmed cases to stratify an individual's pre-test probability of having contracted COVID-19. The questionnaire was adapted repeatedly in face of the unfolding pandemic in response to the evolving epidemiology and observed clinical symptomatology. Based on the response patterns, samples were either tested individually or in multi-sample pools. We compared the pool positivity rate and the number of total PCR tests required to obtain individual results between this questionnaire-based pooling strategy and randomly assembled pools. Findings: Between March 11 and July 5, 2020, we processed 25,978 samples using random pooling (n = 6,012; 23.1%) or questionnaire-based pooling (n = 19,966; 76.9%). The overall prevalence of SARSCoV-2 was 0.9% (n = 238). Pool positivity (14.6% vs. 1.2%) and individual SARS-CoV-2 prevalence (3.4% vs. 0.1%) were higher in the random pooling group than in the questionnaire group. The average number of PCR tests needed to obtain the individual result for one participant was 0.27 tests in the random pooling group, as compared to 0.09 in the questionnaire-based pooling group, leading to a laboratory capacity increase of 73% and 91%, respectively, as compared to single PCR testing. Conclusions: Strategies that combine pool testing with a questionnaire-based risk stratification can increase laboratory testing capacities for COVID-19 and might be important tools, particularly in resource-constrained settings.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schneitler, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jung, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bub, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alhussein, FarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benthien, SophiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, Fabian K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berko-Gottel, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eisenbeis, JaninaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hahn, DaphneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Halfmann, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Last, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Linxweiler, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lohse, StefanUNSPECIFIEDorcid.org/0000-0003-2529-1900UNSPECIFIED
Papan, CihanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfuhl, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rissland, JurgenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roth, SophieUNSPECIFIEDorcid.org/0000-0002-5334-2077UNSPECIFIED
Schlotthauer, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Utzinger, JurgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smola, SigrunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gartner, Barbara C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becker, Soren L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-349573
DOI: 10.5334/aogh.3126
Journal or Publication Title: Ann. Glob. Health
Volume: 86
Number: 1
Date: 2020
Publisher: UBIQUITY PRESS LTD
Place of Publication: LONDON
ISSN: 2214-9996
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Public, Environmental & Occupational HealthMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34957

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