Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
Communicable Disease Control, Department of Health, Western Cape, South Africa.
Pan Afr Med J. 2020 Sep 15;37(Suppl 1):10. doi: 10.11604/pamj.supp.2020.37.10.25982. eCollection 2020.
the COVID-19 pandemic, which results from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents important diagnostic challenges. Diagnostic strategies available to identify or rule out current infection, or to identify people in need of care escalation, or to test for past infection and immune response have become available, to reduce household and community transmission. We highlight a Cochrane review, published in September 2020, on the assessment of diagnostic accuracy of point-of-care antigen and molecular-based tests to determine current SARS-CoV-2 infection.
the authors of the Cochrane review searched multiple electronic databases for studies, which assessed SARS-CoV-2 infection with a diagnostic test. Eligible participants for the review included people with suspected current SARS-CoV-2 infection, known to have, or not to have COVID-19 infection, or where tests were used to screen for infection.
the authors included 18 studies of point-of-care tests conducted in various parts of the world, with none from Africa. The review shows that there is considerable variability in sensitivity and specificity of the antigen tests. The review also shows that molecular tests had less variability in sensitivity and specificity.
the review suggests that the current evidence is not strong enough to determine the usefulness of point-of-care tests in all settings. However, the benefits are likely to be more noticeable in countries, like Africa where community transmission is high. An impact evaluation would be warranted when rapid point-of-care tests are implemented in African countries.
由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的 COVID-19 大流行带来了重要的诊断挑战。现已有多种诊断策略可用于识别或排除当前感染、识别需要升级护理的人群、或检测过去的感染和免疫反应，以减少家庭和社区传播。我们重点介绍了 2020 年 9 月发表的 Cochrane 综述，该综述评估了即时检测抗原和基于分子的检测对确定当前 SARS-CoV-2 感染的诊断准确性。
Cochrane 综述的作者在多个电子数据库中搜索了评估 SARS-CoV-2 感染的诊断测试的研究。该综述的纳入标准为疑似当前 SARS-CoV-2 感染的人群，已知患有 COVID-19 感染或未患有 COVID-19 感染的人群，或使用检测进行感染筛查的人群。
作者纳入了来自世界各地的 18 项即时检测的研究，没有来自非洲的研究。综述表明，抗原检测的敏感性和特异性存在很大差异。综述还表明，分子检测的敏感性和特异性差异较小。
综述表明，目前的证据不足以确定即时检测在所有环境中的有用性。然而，在社区传播率较高的国家，如非洲，其益处可能更为明显。当快速即时检测在非洲国家实施时，进行效果评估是合理的。
