Harwood, Rachel 
ORCID: 0000-0003-3440-3142, Rad, Laura, Kelly, Christopher, Shelton, Cliff, Shepherd, Elizabeth, Roderick, Marion, Whittaker, Elizabeth, Dyke, Steven, Patel, Sanjay Vallabh, Gent, Nick et al (show 1 more authors)
(2023)
Lateral flow test performance in children for SARS-CoV-2 using anterior nasal and buccal swabbing: sensitivity, specificity, negative and positive predictive values.
ARCHIVES OF DISEASE IN CHILDHOOD, 108 (2).
pp. 137-140.
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Lateral flow test performance in children for SARS-CoV-2 using anterior nasal and buccal swabbing sensitivity, specificity, .pdf - Published version Download (356kB) | Preview |
Abstract
<h4>Objective</h4>To determine if the sensitivity of the lateral flow test is dependent on the viral load and on the location of swabbing in the respiratory tract in children.<h4>Design</h4>Phase 1: Routinely performed reverse transcriptase PCR (RT-PCR) using nose and throat (NT) swabs or endotracheal (ET) aspirates were compared with Innova lateral flow tests (LFTs) using anterior nasal (AN) swabs. Phase 2: RT-PCR-positive children underwent paired AN RT-PCR and LFT and/or paired AN RT-PCR and buccal LFT.<h4>Setting</h4>Tertiary paediatric hospitals.<h4>Patients</h4>Children under the age of 18 years. Phase 1: undergoing routine testing, phase 2: known SARS-CoV-2 positive.<h4>Results</h4>Phase 1: 435 paired swabs taken in 431 asymptomatic patients resulted in 8 positive RT-PCRs, 9 PCR test failures and 418 negative RT-PCRs from NT or ET swabs. The test performance of AN LFT demonstrated sensitivity: 25% (4%-59%), specificity: 100% (99%-100%), positive predictive value (PPV): 100% (18%-100%) and negative predictive value (NPV): 99% (97%-99%).Phase 2: 14 AN RT-PCR-positive results demonstrated a sensitivity of 77% (50%-92%) of LFTs performed on AN swabs. 15/16 paired buccal LFT swabs were negative.<h4>Conclusion</h4>The NPV, PPV and specificity of LFTs are excellent. The sensitivity of LFTs compared with RT-PCR is good when the samples are colocated but may be reduced when the LFT swab is taken from the AN. Buccal swabs are not appropriate for LFT testing. Careful consideration of the swabbing reason, the tolerance of the child and the requirements for test processing (eg, rapidity of results) should be undertaken within hospital settings.<h4>Trial registration number</h4>NCT04629157.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | infectious disease medicine, paediatrics, epidemiology |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 24 Mar 2023 16:34 |
| Last Modified: | 04 May 2023 05:52 |
| DOI: | 10.1136/archdischild-2022-324353 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3169244 |
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