Impact of viral load on sample pooling for reverse-transcription polymerase chain reaction detection-based diagnosis of coronavirus disease 2019 in Nigeria.

IF 1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
African Journal of Laboratory Medicine Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI:10.4102/ajlm.v14i1.2514
Timan T Eliya, Elvis E Isere, Bassey Emmana, Chukwuebuka Ugwu, Jonathan Kushim, Precious Ishaku, Aisha E Ibrahim, John S Bimba
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引用次数: 0

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic strained diagnostic testing capacities globally, particularly in low- and middle-income countries like Nigeria. Reverse-transcription polymerase chain reaction (RT-PCR) remains the gold standard for COVID-19 detection, but limited testing resources caused bottlenecks in Nigeria's response during the pandemic. Sample pooling offers a cost-effective strategy to enhance testing capacity during future outbreaks.

Objective: This study determined the maximum number of COVID-19 samples that can be pooled for RT-PCR testing in Nigeria without compromising the detection sensitivity of a single positive sample.

Methods: A total of 1222 nasopharyngeal samples from symptomatic COVID-19 patients in Nasarawa State, Nigeria, collected between March 2021 and August 2022, were retrieved from the laboratory biorepository and analysed from November 2022 to February 2023. These included five positive samples with cycle threshold (Ct) values ranging from ≤ 20 to 40, and 1217 negative samples. Positive samples were pooled with negative ones at increasing dilution ratios (1:4-1:64), to assess detection sensitivity on the GeneXpert platform.

Results: A positive sample with a Ct value ≤ 25 could be pooled with up to 64 negative samples while maintaining a detectable positive result. However, samples with Ct values of 36-40 could only be pooled with a maximum of eight negative samples. Higher Ct values reduced pooling effectiveness.

Conclusion: Sample pooling is a feasible method for scaling up COVID-19 RT-PCR testing in resource-limited settings like Nigeria. The Ct value is critical in determining optimal pool sizes for accurate detection.

What this study adds: The findings provide critical guidelines for determining the optimal pool sizes based on Ct values, aiding in effective COVID-19 testing strategies. By optimising sample pooling based on viral load, health authorities can improve their response to future COVID-19 outbreaks and similar public health emergencies.

病毒载量对尼日利亚基于逆转录聚合酶链反应检测的2019冠状病毒病诊断样本池的影响
背景:2019年冠状病毒病(COVID-19)大流行使全球诊断检测能力紧张,特别是在尼日利亚等低收入和中等收入国家。逆转录聚合酶链反应(RT-PCR)仍然是检测COVID-19的金标准,但有限的检测资源导致尼日利亚在大流行期间的应对出现瓶颈。样本汇集提供了一种具有成本效益的战略,可以在未来疫情期间加强检测能力。目的:本研究确定了在不影响单个阳性样本检测灵敏度的情况下,尼日利亚可汇集用于RT-PCR检测的COVID-19样本的最大数量。方法:从实验室生物库中提取2021年3月至2022年8月采集的尼日利亚纳萨拉瓦州症状性COVID-19患者的1222份鼻咽样本,并于2022年11月至2023年2月进行分析。其中5个阳性样本周期阈值(Ct)≤20 ~ 40,1217个阴性样本。将阳性样本与阴性样本以增加稀释比(1:4-1:64)混合,在GeneXpert平台上评估检测灵敏度。结果:Ct值≤25的阳性样本可与多达64个阴性样本合并,同时保持可检测的阳性结果。然而,Ct值为36-40的样本最多只能合并8个阴性样本。较高的Ct值降低了池的有效性。结论:在尼日利亚等资源有限的国家,样本池化是扩大COVID-19 RT-PCR检测的可行方法。Ct值对于确定准确检测的最佳池大小至关重要。这项研究补充说:这些发现为根据Ct值确定最佳池大小提供了重要指导,有助于制定有效的COVID-19检测策略。通过优化基于病毒载量的样本汇集,卫生当局可以改善其对未来COVID-19疫情和类似公共卫生紧急情况的应对措施。
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来源期刊
African Journal of Laboratory Medicine
African Journal of Laboratory Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.70
自引率
9.10%
发文量
53
审稿时长
12 weeks
期刊介绍: The African Journal of Laboratory Medicine, the official journal of ASLM, focuses on the role of the laboratory and its professionals in the clinical and public healthcare sectors,and is specifically based on an African frame of reference. Emphasis is on all aspects that promote and contribute to the laboratory medicine practices of Africa. This includes, amongst others: laboratories, biomedical scientists and clinicians, medical community, public health officials and policy makers, laboratory systems and policies (translation of laboratory knowledge, practices and technologies in clinical care), interfaces of laboratory with medical science, laboratory-based epidemiology, laboratory investigations, evidence-based effectiveness in real world (actual) settings.
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