在学校卫生室进行快速抗原检测以监测 SARS-CoV-2 和甲型流感。

IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Annals of Family Medicine Pub Date : 2024-11-01 DOI:10.1370/afm.22.s1.4841
Jonathan Temte, Shari Barlow, Emily Temte, Maureen Goss
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引用次数: 0

摘要

背景:SARS-CoV-2 (SC2) 大流行扰乱了对急性呼吸道感染 (ARI) 的评估,限制了对临床环境中呼吸道病原体的全面监测。除了利用医疗机构的 ARI 进行公共卫生监测外,还需要其他方法。一种可能的方法是评估学校卫生室 (SHO) 中的儿童和学校工作人员,作为与大流行相关的应对措施,加强在新环境中进行 SC2 检测的创新方法。目标:评估基于学校卫生室快速抗原检测的 SC2 和甲型流感(FLuA)检测与传统监测系统的可比性。研究设计:采用交叉相关分析法,对郊区/农村学区自助卫生室的 SC2 和甲型流感快速抗原检测结果进行前瞻性评估,并与大规模、全县范围的 SC2 检测和基于诊所的甲型流感监测结果进行比较。环境:戴恩县(DC:威斯康星州中南部)的俄勒冈学区(OSD),为期两个学年(2021 年 9 月至 2023 年 4 月)。研究人群:学龄儿童(4-18 岁)和学校教职员工/教师向 SHO 报告急性呼吸道感染症状。比较数据包括向麦迪逊和戴恩郡公共卫生局报告的所有 SC2 PCR 检测,以及华盛顿特区五家家庭医学诊所的流感 PCR 检测。干预措施/仪器:Quidel Sofia SARS/流感荧光免疫分析仪,可将匿名结果无线传输到云服务器,供研究小组使用。结果测量:比较学校和社区的 SC2 和 FLuA 病例每周计数的交叉相关性和滞后估计值。结果7 所可持续发展教育学校的卫生保健干事共进行了 1,508 次测试,无效测试次数很少(7 次;0.46%)。参与者年龄跨度较大[1-71 岁],中位年龄为 13 岁,包括 1 145 名学生(76%)。SC2:在 OSD 和 DC 中分别发现了 118 和 119,630 个病例。交叉相关性最大(r=0.82),且无时间差。流感 A:在体育部和区议会分别发现 61 和 75 个病例。最大的交叉相关性(r=0.69)出现在区委会滞后于统计处 1 周的情况下。结论对重要呼吸道病原体的监测可基于自助服务机构内的快速抗原检测,与更大规模的监测计划具有很高的可比性,并能显示出超前检测(FluA)或同步检测(SC2)。需要在其他地区针对其他病原体实施类似计划。
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Rapid Antigen Testing in School Health Offices for Surveillance of SARS-CoV-2 and Influenza A.

Context: Evaluation of acute respiratory infections (ARIs) has been disrupted by the SARS-CoV-2 (SC2) pandemic, limiting comprehensive surveillance for respiratory pathogens in clinical settings. Alternatives to using medically attended ARI for public health surveillance are needed. A potential approach involves assessing children and school personnel in school health offices (SHOs) as pandemic-related responses enhanced innovative approaches for SC2 testing in novel settings. Objective: Evaluate the comparability of SC2 and influenza A (FLuA) detection based on rapid antigen testing in SHOs to traditional surveillance systems. Study Design: Prospective evaluation of results from rapid antigen testing for SC2 and FluA in SHOs of a suburban/rural school district compared to large-scale, countywide detection of SC2 and clinic-based surveillance of FluA using cross correlation analyses. Setting: Oregon School District (OSD) in Dane County (DC: southcentral Wisconsin) over two academic years (September 2021-April 2023). Population Studied: School-aged children (4-18 years) and school staff/teachers reporting to SHOs with ARI symptoms. Comparator data included all PCR-based testing for SC2 reported to Public Health Madison & Dane County and PCR-based testing for influenza at five family medicine clinics in DC. Intervention/Instrument: Quidel Sofia SARS/Influenza Fluorescent Immunoassay with wireless transmission of anonymous results to a cloud-based server with availability to the study team. Outcome Measures: Cross correlation and lag estimates for weekly counts of SC2 and FLuA cases comparing school-based and community-based results. Results: The SHOs at the 7 OSD schools performed 1,508 tests with few invalid tests (n=7; 0.46%). Participants had a wide age range [1-71 years] with a median age of 13 years, and included 1,145 (76%) students. SC2: 118 and 119,630 cases were identified in OSD and DC, respectively. The maximum cross correlation (r=0.82) occurred with no time lag. FluA: 61 and 75 cases were identified in OSD and DC, respectively. The maximum cross correlation (r=0.69) occurred with DC lagging OSD by 1 week. Conclusions: Surveillance for significant respiratory pathogens can be based on rapid antigen testing within SHOs, is highly comparable with larger scale surveillance programs, and demonstrates either advanced (FluA) or concurrent detections (SC2). Performance of similar programs are needed in other geographical areas and for other pathogens.

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来源期刊
Annals of Family Medicine
Annals of Family Medicine 医学-医学:内科
CiteScore
3.70
自引率
4.50%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Annals of Family Medicine is a peer-reviewed research journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve.
期刊最新文献
Prehospital Clinical Decision-Making for Medication Administration for Behavioral Emergencies. Rapid Antigen Testing in School Health Offices for Surveillance of SARS-CoV-2 and Influenza A. Assessment and comparison of the ILI case definition in clinical and school-based community settings: ORCHARDS/IISP. Efficacy and Safety of BB-12 Supplemented Strawberry Yogurt For Healthy Children on Antibiotics (PLAY ON). Exploratory Pilot Studies to Demonstrate Mechanisms of Preventing Antibiotic-Associated Diarrhea and the Role for Probiotics.
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