Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is currently finally determined in laboratory settings by real-time reverse-transcription polymerase-chain-reaction (rt-PCR). However, simple testing with immediately available results are crucial to gain control over COVID-19. The aim was to evaluate such a point-of-care antigen rapid test (AG-rt) device in its performance compared to laboratory-based rt-PCR testing in COVID-19 suspected, symptomatic patients. METHODS: For this prospective study, two specimens each of 541 symptomatic female (54.7%) and male (45.3%) patients aged between 18 and 95 years tested at five emergency departments (ED, n = 296) and four primary healthcare centres (PHC, n = 245), were compared, using AG-rt (positive/negative/invalid) and rt-PCR (positive/negative and cycle threshold, Ct) to diagnose SARS-CoV-2. Diagnostic accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), and likelihood ratios (LR+/-) of the AG-rt were assessed. RESULTS: Differences between ED and PHC were detected regarding gender, age, symptoms, disease prevalence, and diagnostic performance. Overall, 174 (32.2%) were tested positive on AG-rt and 213 (39.4%) on rt-PCR. AG correctly classified 91.7% of all rt-PCR positive cases with a sensitivity of 80.3%, specificity of 99.1%, PPV of 98.3, NPV of 88.6%, LR(+) of 87.8, and LR(-) of 0.20. The highest sensitivities and specificities of AG-rt were detected in PHC (sensitivity: 84.4%, specificity: 100.0%), when using Ct of 30 as cut-off (sensitivity: 92.5%, specificity: 97.8%), and when symptom onset was within the first three days (sensitivity: 82.9%, specificity: 99.6%). CONCLUSIONS: The highest sensitivity was detected with a high viral load. Our findings suggest that AG-rt are comparable to rt-PCR to diagnose SARS-CoV-2 in COVID-19 suspected symptomatic patients presenting both at emergency departments and primary health care centres.

Oral contraceptives and antibiotics. A cross-sectional study about patients' knowledge in general practice.

BACKGROUND: The evidence regarding oral contraceptives and its effectiveness with concomitant ingestion of antibiotics is conflicting. Until evidence becomes clearer, patients should be aware of this possible interaction. The aim of this study was to assess the knowledge and the source of information about this interaction in GP patients in Austria. METHODS: Within the framework of the APRES study, 20 Austrian GPs were purposefully selected from among a GP research network and were asked to recruit 200 patients each. The patient cohort was asked to complete a questionnaire. Subsequent analysis included descriptive statistics, statistical tests and logistic regression models. FINDINGS: Overall, 3280 questionnaires could be used for analysis. Of these, 29.7 % (n = 974) of patients acknowledged an awareness of the interaction of antibiotics with OCPs. Women under the age of 46 years acknowledged this interaction in 52.3 % of cases. Positive associations for the belief in an existing interaction in women were identified with age (OR 2.2) and having read the package inserts (OR 1.6). Further, belief was recognized in males based on age (OR 2.5) and tertiary education (OR 2.0). The main source of information regarding antibiotics was the GP (55.9 %). CONCLUSIONS: Less than one-third of all participants and half of the women in the reproductive age acknowledged an interaction between antibiotics and OCPs. Since the GP is the main source of information, this finding depicts a large potential for knowledge transfer within the primary health care setting. A multifaceted strategy is needed at both the population and the GP level to improve awareness and to address these educational gaps.

Antibiotics and their effects: what do patients know and what is their source of information?

BACKGROUND: The Eurobarometer 2010 report on antimicrobial resistance included a survey on the knowledge of Europeans about antibiotics. Austria was ranked at the bottom of the EU27 countries. Based on these alarming results, it was the aim of this study to analyse demographic characteristics of patients and general practitioners in Austria to assess possible predictors for this outcome as well as to assess the main source of information related to antibiotics. METHODS: This cross-sectional study was conducted within the context of the European APRES project. An additional 12-item questionnaire was developed asking for the knowledge about antibiotics, demographic data and the source of information. Statistical analyses included subgroup analyses and linear mixed regression models. RESULTS: Overall, 3280 questionnaires were analysed. On average, 2.78 (standard deviation 1.69) out of the six knowledge questions were answered correctly. The main predictors for a low knowledge score were low educational level, age, speaking another language than German and male sex. In all, 55.6% of the participants marked the general practitioner as main source of information. However, the source was less important for the knowledge score than their highest educational level. CONCLUSION: The Eurobarometer report result for Austrians could be confirmed and important associations and predictors could be identified: a multifaceted and evidence informed strategy is needed to improve the situation, which should both focus on target-group-specific interventions at the individual level to increase the knowledge of people with the highest needs as well as on strengthening the primary health care and educational sector at the system level.