Performance and cost-effectiveness of a pooled testing strategy for SARS-CoV-2 using real-time polymerase chain reaction in Uganda

Abstract

Real-time polymerase chain reaction (RT-PCR) remains the gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study tested the performance of a pooled testing strategy for RT-PCR and its cost-effectiveness. In total, 1280 leftover respiratory samples collected be tween 19 April and 6 May 2021 were tested in 128 pools of 10 samples each, out of which 16 pools were positive. The positivity rate of the unpooled samples was 1.9% (24/1280). After parallel testing using the individual and pooled testing strategies, positive agreement was 100% and negative agree ment was 99.8%. The overall median cycle threshold (Ct) value of the unpooled samples was 29.8 (in terquartile range 22.3–34.3). Pools that remained positive when compared with the results of individ ual samples had lower median Ct values compared with those that turned out to be negative (28.8 versus 34.8; P=0.0.035). Pooled testing reduced the cost >4-fold. Pooled testing may be a more cost effective approach to diagnose SARS-CoV-2 in resource-limited settings without compromising diagnostic performance.

Description

Keywords

COVID-19, Pooled testing, RT-PCR, SARS-CoV-2, LMIC

Citation

Bogere, N., Bongomin, F., Katende, A., Ssebambulidde, K., Ssengooba, W., Ssenfuka, H., ... & Andia-Biraro, I. (2021). Performance and cost-effectiveness of a pooled testing strategy for SARS-CoV-2 using real-time polymerase chain reaction in Uganda. International Journal of Infectious Diseases, 113, 355-358.