Thind Priyam, Vargas Celibell Y, Reed Carrie, Wang Liqun, Alba Luis R, Larson Elaine L, Saiman Lisa, Stockwell Melissa S
Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infect Dis. 2023 Feb 16;10(3):ofad068. doi: 10.1093/ofid/ofad068. eCollection 2023 Mar.
Community surveillance for acute respiratory illness (ARI) can include unsupervised participant-collected nasal swabs. Little is known about use of self-swabs in low-income populations or among households including extended family members and the validity of self-collected swabs. We assessed the acceptability, feasibility, and validity of unsupervised participant-collected nasal swabs in a low-income, community sample.
This was a substudy of a larger prospective community-based ARI surveillance study in 405 households in New York City. Participating household members self-collected swabs on the day of a research home visit for an index case, and for 3-6 subsequent days. Demographics associated with agreement to participate and swab collection were assessed, and index case self-collected versus research staff-collected swab results were compared.
Most households (n = 292 [89.6%]) agreed to participate, including 1310 members. Being <18 years old, female, and the household reporter or member of the nuclear family (parents and children) were associated with both agreement to participate and self-swab collection. Being born in the United States or immigrating ≥10 years ago was associated with participation, and being Spanish-speaking and having less than a high school education were associated with swab collection. In all, 84.4% collected at least 1 self-swabbed specimen; self-swabbing rates were highest during the first 4 collection days. Concordance between research staff-collected swabs and self-swabs was 88.4% for negative swabs, 75.0% for influenza, and 69.4% for noninfluenza pathogens.
Self-swabbing was acceptable, feasible, and valid in this low-income, minoritized population. Some differences in participation and swab collection were identified that could be noted by future researchers and modelers.
对急性呼吸道疾病（ARI）进行社区监测可包括由参与者自行采集且无人监督的鼻拭子样本。对于低收入人群或包括大家庭成员在内的家庭中自行采集鼻拭子的使用情况以及自行采集拭子的有效性，人们了解甚少。我们评估了在低收入社区样本中由参与者自行采集且无人监督的鼻拭子样本的可接受性、可行性和有效性。
这是一项在纽约市405户家庭中开展的较大规模前瞻性社区ARI监测研究的子研究。参与研究的家庭成员在针对首例病例进行研究性家庭访视当天自行采集拭子样本，并在随后3至6天内每天进行采集。评估了与同意参与和拭子采集相关的人口统计学特征，并比较了首例病例自行采集的拭子与研究人员采集的拭子的检测结果。
大多数家庭（n = 292 [89.6%]）同意参与，包括1310名成员。年龄小于18岁、女性、家庭报告人或核心家庭（父母和子女）成员与同意参与和自行采集拭子均相关。在美国出生或10年前及更早移民与参与相关，说西班牙语且受教育程度低于高中与拭子采集相关。总体而言，84.4%的人至少采集了1份自行采集的样本；自行采集率在前4个采集日最高。研究人员采集的拭子与自行采集的拭子之间，阴性拭子的一致性为88.4%，流感检测的一致性为75.0%，非流感病原体检测的一致性为69.4%。
在这个低收入、少数族裔人群中，自行采集拭子是可接受的、可行的且有效的。研究人员和建模人员在未来研究中可留意到在参与和拭子采集方面存在的一些差异。
