Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People's Democratic Republic
Iem, Vibol (Liverpool School of Tropical Medicine)
Xangsayarath, Phonepadith (National Center for Laboratory and Epidemiology)
Chittamany, Phonenaly (National Tuberculosis Control Center)
Suthepmany, Sakhone (National Tuberculosis Control Center)
Siphanthong, Souvimone (National Tuberculosis Control Center)
Paboriboune, Phimpha (Center of Infectiology Lao Christophe Mérieux)
Somphavong, Silaphet (Lao Association for Medical Laboratory Sciences)
Konstantina, Kontogianni (Liverpool School of Tropical Medicine)
Khan, Jahangir A. M. (University of Gothenburg)
Edwards, Thomas (Liverpool School of Tropical Medicine)
Wingfield, Tom (Liverpool University Hospital NHS Foundation Trust)
Creswell, Jacob (Stop TB Partnership)
Domínguez, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cuevas, Luis E. (Liverpool School of Tropical Medicine)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	The COVID-19 pandemic created the need for large-scale testing of populations. However, most laboratories do not have sufficient testing capacity for mass screening. We evaluated pooled testing of samples, as a strategy to increase testing capacity in Lao PDR. Samples of consecutive patients were tested in pools of four using the Xpert Xpress SARS CoV-2 assay. Positive pools were confirmed by individual testing, and we describe the performance of the test and savings achieved. We also diluted selected positive samples to describe its effect on the assays CT values. 1,568 patients were tested in 392 pools of four. 361 (92. 1%) pools were negative and 31 (7. 9%) positive. 29/31 (93. 5% (95%CI 77-99%) positive pools were confirmed by individual testing of the samples but, in 2/31 (6. 5%) the four individual samples were negative, suggesting contamination. Pools with only one positive sample had higher CT values (lower RNA concentrations) than the respective individual samples, indicating a dilution effect, which suggested an increased risk of false negative results with dilutions >1:10. However, this risk may be low if the prevalence of infection is high, when pools are more likely to contain more than one positive sample. Pooling saved 67% of cartridges and substantially increased testing capacity. Pooling samples increased SARS-CoV-2 testing capacity and resulted in considerable cartridge savings. Given the need for high-volume testing, countries may consider implementation of pooling for SARS-CoV-2 screening.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 17 (september 2022) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0275294
PMID: 36173954

12 p, 984.3 KB

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