Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
Infectious Diseases Service, Penitentiary Health System, ASST-Santi Paolo e Carlo, Milan, Italy.
Front Public Health. 2022 Aug 11;10:808030. doi: 10.3389/fpubh.2022.808030. eCollection 2022.
Saliva molecular tests have shown a similar sensitivity and specificity compared to nasopharyngeal test for SARS-CoV-2 diagnosis in both symptomatic and asymptomatic individuals. The SARS-CoV-2 pandemic affected Lombardy prisons, generating the need for extensive contact tracing activities and for detecting asymptomatic carriers. The availability of a less invasive test in a setting that hosts a high-risk and often hard-to-reach population, suggests its possible use in prisons.
The study was carried out on a population of new incomers in Milan San Vittore pre-trial prison. All the new incomers were submitted to quarantine and to saliva test and nasopharyngeal swab (NPS) for SARS-CoV-2 detection at the entry and at the end of quarantine before their admission in community (Protocol 1-February 2 to March 5, 2021). Starting from March 8 to July 30, 2021, the screening protocol was adjusted to avoid biases in sample collection (Protocol II), and saliva testing was performed at entrance.
12/1,120 enrolled subjects were excluded from the study. Among the 1,080 processed samples, 1 tested positive, 5 weakly positive, 1,069 negative, 3 were invalid, and 2 samples tested positive for the viral gene N2 only, with Ct value above 38. During Protocol I, 6/156 coupled saliva/NPS tests were discordant due to food ingestion prior saliva collection, prompting us to establishing Protocol II.
Saliva molecular testing is feasible in prison setting, being less invasive and easier to use, and reliable. Acceptability was very high even in a complex context as that of newly incarcerated persons.
唾液分子检测在有症状和无症状个体中与鼻咽拭子检测 SARS-CoV-2 相比，具有相似的灵敏度和特异性。SARS-CoV-2 大流行影响了伦巴第监狱，导致需要广泛开展接触者追踪活动，并检测无症状携带者。在一个有高危人群且难以接触到的人群的环境中，提供一种侵入性更小的检测方法，表明其在监狱中可能具有应用前景。
该研究在米兰圣维托审前监狱的新入狱人群中进行。所有新入狱者都在进入监狱时和隔离结束时接受了隔离，并进行了唾液检测和鼻咽拭子（NPS）检测，以检测 SARS-CoV-2（方案 1：2021 年 2 月 2 日至 3 月 5 日）。从 2021 年 3 月 8 日至 7 月 30 日，筛查方案进行了调整，以避免采样偏倚（方案 2），并在入口处进行唾液检测。
12/1120 名入组受试者被排除在研究之外。在处理的 1080 个样本中，1 个样本检测为阳性，5 个样本弱阳性，1069 个样本阴性，3 个样本无效，2 个样本仅病毒基因 N2 检测为阳性，Ct 值大于 38。在方案 1 中，由于唾液采集前进食，有 6/156 对唾液/NPS 检测结果不一致，促使我们建立了方案 2。
唾液分子检测在监狱环境中是可行的，具有侵入性更小、更易于使用和可靠的特点。即使在新入狱者这样复杂的情况下，接受度也非常高。
