Diagnostic accuracy of the Panbio COVID-19 antigen rapid test device for SARS-CoV-2 detection in Kenya, 2021: A field evaluation.
PLoS One
; 18(1): e0277657, 2023.
Article
in English
| MEDLINE | ID: covidwho-2214773
ABSTRACT
BACKGROUND:
Accurate and timely diagnosis is essential in limiting the spread of SARS-CoV-2 infection. The reference standard, rRT-PCR, requires specialized laboratories, costly reagents, and a long turnaround time. Antigen RDTs provide a feasible alternative to rRT-PCR since they are quick, relatively inexpensive, and do not require a laboratory. The WHO requires that Ag RDTs have a sensitivity ≥80% and specificity ≥97%.METHODS:
This evaluation was conducted at 11 health facilities in Kenya between March and July 2021. We enrolled persons of any age with respiratory symptoms and asymptomatic contacts of confirmed COVID-19 cases. We collected demographic and clinical information and two nasopharyngeal specimens from each participant for Ag RDT testing and rRT-PCR. We calculated the diagnostic performance of the Panbio™ Ag RDT against the US Centers for Disease Control and Prevention's (CDC) rRT-PCR test.RESULTS:
We evaluated the Ag RDT in 2,245 individuals where 551 (24.5%, 95% CI 22.8-26.3%) tested positive by rRT-PCR. Overall sensitivity of the Ag RDT was 46.6% (95% CI 42.4-50.9%), specificity 98.5% (95% CI 97.8-99.0%), PPV 90.8% (95% CI 86.8-93.9%) and NPV 85.0% (95% CI 83.4-86.6%). Among symptomatic individuals, sensitivity was 60.6% (95% CI 54.3-66.7%) and specificity was 98.1% (95% CI 96.7-99.0%). Among asymptomatic individuals, sensitivity was 34.7% (95% CI 29.3-40.4%) and specificity was 98.7% (95% CI 97.8-99.3%). In persons with onset of symptoms <5 days (594/876, 67.8%), sensitivity was 67.1% (95% CI 59.2-74.3%), and 53.3% (95% CI 40.0-66.3%) among those with onset of symptoms >7 days (157/876, 17.9%). The highest sensitivity was 87.0% (95% CI 80.9-91.8%) in symptomatic individuals with cycle threshold (Ct) values ≤30.CONCLUSION:
The overall sensitivity and NPV of the Panbio™ Ag RDT were much lower than expected. The specificity of the Ag RDT was high and satisfactory; therefore, a positive result may not require confirmation by rRT-PCR. The kit may be useful as a rapid screening tool only for symptomatic patients in high-risk settings with limited access to rRT-PCR. A negative result should be interpreted based on clinical and epidemiological information and may require retesting by rRT-PCR.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
SARS-CoV-2
/
COVID-19
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Country/Region as subject:
Africa
Language:
English
Journal:
PLoS One
Journal subject:
Science
/
Medicine
Year:
2023
Document Type:
Article
Affiliation country:
Journal.pone.0277657
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