Side-by-side comparison of parent vs. technician-collected respiratory swabs in low-income, multilingual, urban communities in the United States

Home-based swabbing has not been widely used. The objective of this analysis was to compare respiratory swabs collected by mothers of 7-12-year-olds living in low-income, multilingual communities in the United States with technician collected swabs. Retrospective data analysis of respiratory samples...

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Bibliographic Details
Published in:	BMC public health Vol. 22; no. 1; p. 103
Main Authors:	Chaves, Sandra S, Park, Ju-Hyeong, Prill, Mila M, Whitaker, Brett, Park, Reena, Chew, Ginger L
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 15-01-2022 BioMed Central BMC
Subjects:	Asthma Asymptomatic Bacteria Child Children Children & youth Chinese languages Coefficients Comparative analysis Confidence intervals Correlation analysis COVID-19 Data analysis Demographic aspects Diagnosis Diagnostic specimens Dry tube for specimen transport Enrollments Enteroviruses Home-swabbing Households Humans Income Influenza Low income areas Low income groups Medical laboratories Mothers Nose - microbiology Pandemics Parental swabbing Parents Pathogen detection Pathogens Public health Quality assessment Rank tests Respiratory diseases Respiratory tract infections Respiratory Tract Infections - diagnosis Respiratory Tract Infections - epidemiology Retrospective Studies Rhinovirus Ribonuclease P Secondary schools Sexually transmitted diseases Specimen Handling - methods STD Technicians Tubes United States Upper respiratory tract samples Urban areas Viruses Viruses - genetics Yield United States United States > US Upper respiratory tract samples Pathogen detection Parental swabbing Home-swabbing Dry tube for specimen transport
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Summary:	Home-based swabbing has not been widely used. The objective of this analysis was to compare respiratory swabs collected by mothers of 7-12-year-olds living in low-income, multilingual communities in the United States with technician collected swabs. Retrospective data analysis of respiratory samples collected at home by mothers compared to technicians. Anterior nasal and throat specimens collected using flocked swabs were combined in dry tubes. Test was done using TaqMan array cards for viral and bacterial pathogens. Cycle threshold (Ct) values of ribonuclease P (RNP) gene were used to assess specimen quality. Ct < 40 was interpreted as a positive result. Concordance of pathogen yield from mother versus technician collected swabs were analyzed using Cohen's Kappa coefficients. Correlation analysis, paired t-test, and Wilcoxon signed-rank test for paired samples were used for RNP Ct values. We enrolled 36 households in Cincinnati (African American) and 44 (predominately Chinese or Latino) in Boston. In Cincinnati, eight of 32 (25%) mothers did not finish high school, and 11 (34%) had finished high school only. In Boston, 13 of 44 (30%) mothers had less than a high school diploma, 23 (52%) had finished high school only. Mother versus technician paired swabs (n = 62) had similar pathogen yield (paired t-test and Wilcoxon signed rank test p-values = 0.62 and 0.63, respectively; 95% confidence interval of the difference between the two measurements = - 0.45-0.75). Median Ct value for RNP was 22.6 (interquartile range, IQR = 2.04) for mother-collected and 22.4 (IQR = 2.39) for technician-collected swabs (p = 0.62). Agreement on pathogen yield between samples collected by mothers vs. technicians was higher for viruses than for bacterial pathogens, with high concordance for rhinovirus/enterovirus, human metapneumovirus, and adenovirus (Cohen's kappa coefficients ≥80%, p < 0.0001). For bacterial pathogens, concordance was lower to moderate, except for Chlamydia pneumoniae, for which kappa coefficient indicated perfect agreement. Mothers with a range of education levels from low-income communities were able to swab their children equally well as technicians. Home-swabbing using dry tubes, and less invasive collection procedures, could enhance respiratory disease surveillance.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2458 1471-2458
DOI:	10.1186/s12889-022-12523-3