Performance and cost-effectiveness of a pooled testing strategy for SARS-CoV-2 using real-time polymerase chain reaction in Uganda. (December 2021)

• Record Type: Journal Article
• Authors: Bogere, Naghib; Bongomin, Felix; Katende, Andrew; Ssebambulidde, Kenneth; Ssengooba, Willy; Ssenfuka, Henry; Kigozi, Edgar; Biraro, Samuel; Kateete, David P.; Andia-Biraro, Irene
• Is Part Of: International journal of infectious diseases. Volume 113(2021)
• Page Start: 355
• Page End: 358
• Publication Date: 2021-12
• Subjects: COVID-19 -- Pooled testing -- RT-PCR -- SARS-CoV-2 -- LMIC; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.10.038
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: A pooled-testing strategy for real-time polymerase chain reaction was feasible in Uganda. The pooled-testing strategy was cost-saving without compromising diagnostic performance compared with individual testing. A few positive samples may be missed by using a pooled-testing strategy ABSTRACT: Real-time polymerase chain reaction (RT-PCR) remains the gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study tested the performance of a pooled testing strategy for RT-PCR and its cost-effectiveness. In total, 1280 leftover respiratory samples collected between 19 April and 6 May 2021 were tested in 128 pools of 10 samples each, out of which 16 pools were positive. The positivity rate of the unpooled samples was 1.9% (24/1280). After parallel testing using the individual and pooled testing strategies, positive agreement was 100% and negative agreement was 99.8%. The overall median cycle threshold (Ct) value of the unpooled samples was 29.8 (interquartile range 22.3–34.3). Pools that remained positive when compared with the results of individual samples had lower median Ct values compared with those that turned out to be negative (28.8 versus 34.8; P =0.0.035). Pooled testing reduced the cost >4-fold. Pooled testing may be a more cost-effective approach to diagnose SARS-CoV-2 in resource-limited settings without compromising diagnostic performance.