Uganda Cancer Institute, Kampala, Uganda.
Department of Medicine, School of Medicine, Makerere University, Kampala, Uganda; Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
Int J Infect Dis. 2021 Dec;113:355-358. doi: 10.1016/j.ijid.2021.10.038. Epub 2021 Oct 28.
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.
实时聚合酶链反应（RT-PCR）仍然是检测严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的金标准。本研究测试了 RT-PCR 混合检测策略的性能及其成本效益。总共对 2021 年 4 月 19 日至 5 月 6 日期间收集的 1280 份剩余呼吸道样本进行了 128 组每组 10 个样本的混合检测，其中 16 组为阳性。未混合样本的阳性率为 1.9%（24/1280）。使用个体和混合检测策略进行平行检测后，阳性符合率为 100%，阴性符合率为 99.8%。未混合样本的总体中位循环阈值（Ct）值为 29.8（四分位间距 22.3-34.3）。与个体样本检测结果相比仍为阳性的混合样本的中位 Ct 值低于结果为阴性的混合样本（28.8 与 34.8；P=0.035）。混合检测使成本降低了 4 倍以上。混合检测可能是一种更具成本效益的方法，可在资源有限的情况下诊断 SARS-CoV-2，而不会影响诊断性能。
