ABSTRACT
The COVID-19 pandemic has accelerated the growth of digital health tools. Although a number of different tools exist to support field data collection in the context of outbreak response, they have not been sufficient. This prompted the World Health Organization (WHO) to collaborate with the Global Outbreak Alert and Response Network (GOARN) and GOARN partners to develop a comprehensive system, Go.Data. Go.Data, a digital tool for outbreak response has simplified how countries operationalize and monitor case and contact data. Since the start of the pandemic, WHO and GOARN partners have provided support to Go.Data projects in 65 countries and territories, yet the demand by countries to have documented success cases of Go.Data implementations continues to grow. This viewpoint documents the successful Go.Data implementation frameworks in two countries, Argentina and Guatemala and an academic institution, the University of Texas at Austin.
ABSTRACT
[ABSTRACT]. Objectives. To measure protocol adherence and antigen-based detection tests (AgDT) negative predictive value after 3 months of massive use as a diagnostic tool for COVID-19 in Guatemala. Methods. The study period included nasopharyngeal swabs taken between March 12 and August 31, 2020, which results were entered in the national COVID-19 information system. Proportional increase in testing between one month before and one month after the introduction of AgDT (May 9–June 8 vs. June 9–July 8) was measured. Results. After AgDT introduction, there was a 139% increase in SARS-CoV-2 testing. Between June 9 and August 31, 7.8% of 110 657 AgDT-negative patients had follow-up RT-PCR testing. Of them, 30% were RT-PCR positive. Conclusions. While introducing AgDT improved access to diagnostics, ensuring the availability of timely RT-PCR capacities to confirm diagnosis is also key.
[RESUMEN]. Objetivos. Evaluar la adherencia al protocolo y el valor predictivo negativo de las pruebas de detección basadas en antígeno (AgDT) después de 3 meses de uso masivo como método diagnóstico para la COVID-19 en Guatemala. Métodos. Se estudiaron hisopados nasofaríngeos tomados entre el 12 de marzo y el 31 de agosto de 2020, cuyos resultados constaban en el sistema de información nacional de COVID-19. Se midió el aumento proporcional del número de pruebas entre un mes antes y un mes después de la introducción de las AgDT (9 de mayo a 8 de junio, frente a 9 de junio a 8 de julio). Resultados. Después de la introducción de AgDT hubo un aumento del 139% en el número de pruebas de SARS-CoV-2. Entre el 9 de junio y el 31 de agosto, el 7,8% de 110 657 pacientes negativos según una AgDT se sometieron a una prueba de seguimiento con RT-PCR. De ellos, el 30% presentó una RT-PCR positiva. Conclusiones. Aunque la introducción de AgDT mejoró el acceso al diagnóstico, también es clave asegurar la disponibilidad oportuna de RT-PCR para confirmar el diagnóstico.
Subject(s)
Laboratory Test , Clinical Laboratory Techniques , Reverse Transcriptase Polymerase Chain Reaction , Coronavirus Infections , Guatemala , COVID-19 , Laboratory Test , Clinical Laboratory Techniques , Reverse Transcriptase Polymerase Chain Reaction , Coronavirus InfectionsABSTRACT
Brucellosis is a zoonosis mainly present in developing countries. The WHO reports 500,000 new cases every year. From 2012 to 2016, 13,677 cases were reported in Mexico, with 2.00 to 2.64 rate per 100,000 inhabitants. To analyze the diagnostic algorithm of brucellosis in Mexico, we compared the commercial laboratory tests ELISA, Brucellacapt®, and lateral flow test (LFT) in a study of 473 individuals from two endemic Mexican populations. All patients were treated in first-level medical units for presenting brucellosis compatible symptoms and without a history of the disease. Clinical-epidemiological information was gathered and initial serum samples were obtained to react with anti-Brucella antibodies; subsequent samples were collected at follow-up treatment visits. Using the Rose Bengal screening, we found 165 negative samples and 308 positive reactive samples, of which 222 cases were confirmed and 234 were positive on at least one marker (IgG or IgM) or LFT. When Brucellacapt® was used, similar results to those observed with the conventional algorithm were found as judged by the Cohen's kappa coefficient (κ) (0.813, 95% CI 0.7788-0.8472). Similar κ indices between conventional algorithm and ELISA pair were found, 0.7038 (95% CI 0.6555-0.7521), representing high similarity between both groups of diagnosis. We conclude that conventional serodiagnoses, Brucellacapt® and LFT, presented inconclusive results and poor correlation between them. By contrast, ELISA test pair (IgG + IgM) presented high correlation with the conventional algorithm and greater capacity for correct positive and negative classification.
Subject(s)
Brucella/classification , Brucellosis/diagnosis , Brucellosis/prevention & control , Serologic Tests , Adult , Algorithms , Brucellosis/epidemiology , Brucellosis/microbiology , Disease Management , Female , Follow-Up Studies , Humans , Male , Mexico/epidemiology , Middle Aged , Public Health Surveillance , Reproducibility of Results , Risk Factors , Sensitivity and Specificity , Serologic Tests/methods , Serologic Tests/standards , Young AdultABSTRACT
Objectives: To measure protocol adherence and antigen-based detection tests (AgDT) negative predictive value after 3 months of massive use as a diagnostic tool for COVID-19 in Guatemala. Methods: The study period included nasopharyngeal swabs taken between March 12 and August 31, 2020, which results were entered in the national COVID-19 information system. Proportional increase in testing between one month before and one month after the introduction of AgDT (May 9-June 8 vs. June 9-July 8) was measured. Results: After AgDT introduction, there was a 139% increase in SARS-CoV-2 testing. Between June 9 and August 31, 7.8% of 110 657 AgDT-negative patients had follow-up RT-PCR testing. Of them, 30% were RT-PCR positive. Conclusions: While introducing AgDT improved access to diagnostics, ensuring the availability of timely RT-PCR capacities to confirm diagnosis is also key.
Objetivos: Evaluar la adherencia al protocolo y el valor predictivo negativo de las pruebas de detección basadas en antígeno (AgDT) después de 3 meses de uso masivo como método diagnóstico para la COVID-19 en Guatemala. Métodos: Se estudiaron hisopados nasofaríngeos tomados entre el 12 de marzo y el 31 de agosto de 2020, cuyos resultados constaban en el sistema de información nacional de COVID-19. Se midió el aumento proporcional del número de pruebas entre un mes antes y un mes después de la introducción de las AgDT (9 de mayo a 8 de junio, frente a 9 de junio a 8 de julio). Resultados: Después de la introducción de AgDT hubo un aumento del 139% en el número de pruebas de SARS-CoV-2. Entre el 9 de junio y el 31 de agosto, el 7,8% de 110 657 pacientes negativos según una AgDT se sometieron a una prueba de seguimiento con RT-PCR. De ellos, el 30% presentó una RT-PCR positiva. Conclusiones: Aunque la introducción de AgDT mejoró el acceso al diagnóstico, también es clave asegurar la disponibilidad oportuna de RT-PCR para confirmar el diagnóstico.
