Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
Department of Tropical Medicine and Infectious Diseases, University Medical Center Rostock, Rostock, Germany.
PLoS One. 2022 Sep 13;17(9):e0274545. doi: 10.1371/journal.pone.0274545. eCollection 2022.
Since the onset of the COVID-19 pandemic, children have been mentally and physically burdened, particularly due to school closures, with an associated loss of learning. Therefore, efficient testing strategies with high sensitivity are necessary to keep schools open. Apart from individual rapid antigen testing, various methods have been investigated, such as PCR-based pool-testing of nasopharyngeal swabs, gargle, or saliva samples. To date, previous validation studies have found the PCR-based saliva swab pool testing method to be an effective screening method, however, the acceptability and feasibility of a widespread implementation in the school-setting among stakeholders has not been comprehensively evaluated.
In this pilot study, SARS-CoV-2 saliva swab pool testing of up to 15 swabs per pool was conducted in ten primary and special schools in Mecklenburg-Western Pomerania, Germany, over a period of one month. Thereafter, parents, teachers and school principals of the participating schools as well as the participating laboratories were surveyed about the feasibility and acceptability of this method, its large-scale implementation and challenges. Data were analyzed quantitatively and qualitatively.
During the study period, 1,630 saliva swab pools were analyzed, of which 22 tested SARS-CoV-2 positive (1.3%). A total of N = 315 participants took part in the survey. Across all groups, the saliva swab pool testing method was perceived as more child-friendly (>87%), convenient (>82%), and easier (>81%) compared to rapid antigen testing by an anterior nasal swab. Over 80% of all participants favored widespread, regular use of the saliva swab method.
In school settings in particular, a high acceptability of the test method is crucial for a successful SARS-CoV-2 surveillance strategy. All respondents clearly preferred the saliva swab method, which can be used safely without complications in children six years of age and older. Hurdles and suggestions for improvement of an area-wide implementation were outlined.
自 COVID-19 大流行以来，儿童身心负担沉重，尤其是由于学校关闭，导致学习机会丧失。因此，需要使用高灵敏度的高效检测策略来保持学校开放。除了个体的快速抗原检测外，还研究了各种方法，例如基于聚合酶链反应（PCR）的鼻咽拭子、漱口液或唾液样本混合检测。迄今为止，之前的验证研究发现，基于 PCR 的唾液拭子混合检测方法是一种有效的筛查方法，但是，利益相关者尚未全面评估在学校环境中广泛实施的可接受性和可行性。
在这项初步研究中，对德国梅克伦堡-前波美拉尼亚州的十所小学和特殊学校中的最多 15 人一组的 SARS-CoV-2 唾液拭子混合样本进行了为期一个月的检测。此后，对参与学校的家长、教师和校长以及参与实验室就该方法的可行性和可接受性、大规模实施以及挑战进行了调查。对数据进行了定量和定性分析。
在研究期间，共分析了 1630 个唾液拭子混合样本，其中 22 个检测出 SARS-CoV-2 阳性（1.3%）。共有 315 名参与者参与了调查。在所有组中，与快速抗原检测相比，唾液拭子混合检测方法被认为对儿童更友好（>87%）、更方便（>82%）、更容易（>81%）。所有参与者中有超过 80%的人赞成广泛、定期使用唾液拭子方法。
在学校环境中，测试方法的高可接受性对于成功的 SARS-CoV-2 监测策略至关重要。所有受访者明显更喜欢唾液拭子方法，该方法可在 6 岁及以上儿童中安全使用，不会引起并发症。概述了全面实施面临的障碍和改进建议。
