ABSTRACT
INTRODUCTION: Mass testing is essential in the surveillance strategy for fighting the COVID-19 pandemic. It allows early detection of suspected cases and subsequently early isolation to mitigate spread. However, the high cost and limited consumables and reagents hinder the mass testing strategy in developing countries such as Indonesia. The specimen pooling strategy is an option to perform mass screening with limited resources. This study aims to determine the positivity rate cut-off and to evaluate the efficiency of pooling strategy for the laboratory diagnosis of COVID-19. METHODOLOGY: Between August 4th, 2020, and November 11th, 2020, a four-sample pooling strategy testing to detect SARS-CoV-2 was carried out at the Microbiology Diagnostic Laboratory of Diponegoro National Hospital, Semarang, Indonesia. Pools with positive results were subjected to individual specimen retesting. Spearman's correlation and linear regression analysis were used to determine the best positivity rate cut-off to apply pooling strategy. RESULTS: A total of 15,216 individual specimens were pooled into 3,804 four-sample pools. Among these pools, 1,007 (26.47%) were positive. Five hundred and ten (50.64%) were 1/4 positive. A maximum positivity rate of 22% is needed to save at least 50% extraction and qRT-PCR reactions in a four-sample pooling strategy. CT values between individual specimens and pools showed a good interval agreement. CONCLUSIONS: Pooling strategy could reduce personnel workload and reagent cost, and increase laboratory capacity by up to 50% when the positivity rate is less than 22%.
Subject(s)
COVID-19 , COVID-19/diagnosis , COVID-19 Testing , Humans , Pandemics , SARS-CoV-2 , Sensitivity and Specificity , Specimen Handling/methodsABSTRACT
COVID-19 has become a global pandemic in 2020. As of May, 25 2020 there were 22750 confirmed cases of COVID-19 in Indonesia. Prevention and control of COVID-19 needs to be carried out by the village government which is in direct contact with the community. Supported by the issuance of Permendes No. 6 of 2020 concerning the Implementation Regulations for the COVID-19 Response Village Program. Meteseh Village is one of the villages in Kendal Regency that has a risk of spreading COVID-19. This research is a qualitative descriptive study using in-depth interviews using purposive technique with informants selected based on criteria and literature study. The results show that the implementation of the COVID-19 Response Village Program in Meteseh Village has not been running optimally due to unclear implementation standards in related policies limited human resource capacity in program planning and resource management especially in the aspect of controlling COVID-19 and the community attitudes that do not apply health protocols influenced by social economic political conditions. Therefore, Meteseh Village is advised to increase the role of village midwives to provide education about the handling of COVID-19 to program implementers increase the participation of health workers religious leaders and community leaders in Meteseh Village to assist in handling COVID-19 continue to provide information’s of COVID-19 and conduct evaluation activities of program implementation including make a complete written report about program implementation.