ABSTRACT
Underserved communities in low-resource countries are disproportionately impacted by communicable diseases when compared to those in developed countries. These communities have limited access to life saving diagnostic laboratory tests making it difficult to treat communicable diseases like SARS-CoV-2 and Human Immunodeficiency Virus (HIV). Rapid diagnostic tests, like the COVID-19 antigen (Ag) test, play a crucial role in underserved communities by enabling fast and inexpensive diagnosis in low-resource settings. Unfortunately, these rapid test platforms often lack the accuracy and precision of their laboratory-based analogs, resulting in a need for improved rapid diagnostics. The World Health Organization’s (WHO) ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free, and Deliverable to end-users) criteria are often referenced in the development of diagnostic tests. In this work, we aim to provide guidance to the “user-friendly” component of ASSURED through end-user surveys taken in rural Kenya. In these surveys, we examine the user-friendliness of two of the most commonly used rapid diagnostic tests, the COVID-19 Ag test and pregnancy test, by assessing participants’ familiarity with the tests, their opinion of test appearance, and the perceived complexity of the operator’s workflow. We also examine community acceptance and desire for a self-test for the highly stigmatized HIV. We intend these results to help guide developers of future rapid diagnostic tests intended for low-resource communities.
Subject(s)
COVID-19 , HIV InfectionsABSTRACT
This report describes the aggregation and anonymization process applied to the COVID-19 Vaccination Search Insights (published at http://goo.gle/covid19vaccinationinsights), a publicly available dataset showing aggregated and anonymized trends in Google searches related to COVID-19 vaccination. The applied anonymization techniques protect every user's daily search activity related to COVID-19 vaccinations with $(\varepsilon, \delta)$-differential privacy for $\varepsilon = 2.19$ and $\delta = 10^{-5}$.
Subject(s)
COVID-19ABSTRACT
The COVID-19 pandemic has challenged testing capacity worldwide. The mass testing needed to stop the spread of the virus requires new molecular diagnostic tests that are faster and with reduced equipment requirement, but as sensitive as the current gold standard protocols based on polymerase chain reaction. We developed a fast (25-35 minutes) molecular test using reverse transcription recombinase polymerase amplification for simultaneous detection of two conserved regions of the virus, targeting the E and RdRP genes. The diagnostic platform offers two complementary detection methods: real-time fluorescence or visual dipstick. The analytical sensitivity of the test by real-time fluorescence was 9.5 (95% CI: 7.0-18) RNA copies per reaction for the E gene and 17 (95% CI: 11-93) RNA copies per reaction for the RdRP gene. The analytical sensitivity for the dipstick readout was 130 (95% CI: 82-500) RNA copies per reaction. The assay showed high specificity with both detection methods when tested against common seasonal coronaviruses, SARS-CoV and MERS-CoV model samples. The dipstick readout demonstrated potential for point-of-care testing, with simple or equipment-free incubation methods and a user-friendly prototype smartphone application was proposed with data capture and connectivity. This ultrasensitive molecular test offers valuable advantages with a swift time-to-result and it requires minimal laboratory equipment compared to current gold standard assays. These features render this diagnostic platform more suitable for decentralised molecular testing.
Subject(s)
COVID-19ABSTRACT
This report describes the aggregation and anonymization process applied to the initial version of COVID-19 Search Trends symptoms dataset (published at https://goo.gle/covid19symptomdataset on September 2, 2020), a publicly available dataset that shows aggregated, anonymized trends in Google searches for symptoms (and some related topics). The anonymization process is designed to protect the daily symptom search activity of every user with $\varepsilon$-differential privacy for $\varepsilon$ = 1.68.
Subject(s)
COVID-19ABSTRACT
Introduction: The coronavirus pandemic has resulted in unprecedented rates of patients requiring intubation and ventilation over a short period of time. The authors present 3-month data on airway, voice and swallow outcomes for this cohort to better understand the impact of COVID-19 critical illness on laryngotracheal morbidity. Methods: An observational cohort study was performed on all patients discharged following critical illness at our tertiary institution over a 2-month period (1st March 2020 - 30th April 2020). Patients were stratified on the basis of primary diagnosis: COVID-19 pneumonitis, Non-COVID-19 respiratory failure and non-respiratory. Our primary outcome measure was reported airway, voice, and swallow dysfunction during inpatient admission and on 6-12 week Critical Illness Recovery Clinic follow up. Endoscopic findings of patients referred onward to our Multidisciplinary Laryngology-Speech Therapy Clinic were recorded.Results: 141 patients were included in our study. During inpatient admission there were no statistically significant differences in reported rates of airway, voice, or swallow dysfunction. In Critical Illness Recovery Clinic, there were markedly higher rates of reported airway, voice and swallow dysfunction in the COVID-19 pneumonitis cohort, although these rates only reached statistical significance in respect to airway outcomes (airway p=0.038, voice p=0.064, swallow p=0.240). 100% of patients reviewed to date in the Laryngology-Speech Therapy Clinic following COVID-19 critical illness had clinically significant laryngeal pathology.Conclusion: Our data highlights an impending surge in COVID-19 related laryngotracheal morbidity. Robust, prospective screening and clear referral pathways for all patients following COVID-19 critical illness are essential to identifying and managing this cohort.