Acceptance of different self-sampling methods for semiweekly SARS-CoV-2 testing in asymptomatic children and childcare workers at German Day Care Centers: A nonrandomized controlled trial.

Engels G, Forster J, Streng A, Rücker V, Rudolph P, Pietsch F, Wallstabe J, Wallstabe L, Krauthausen M, Schmidt J, Ludwig T, Bauer C, Gierszewski D, Bendig J, Timme S, Jans T, Weißbrich B, Romanos M, Dölken L, Heuschmann P, Härtel C, Gágyor I, Figge MT, Liese J, Kurzai O (2022) Acceptance of different self-sampling methods for semiweekly SARS-CoV-2 testing in asymptomatic children and childcare workers at German Day Care Centers: A nonrandomized controlled trial. JAMA Netw Open 5(9), e2231798.

Abstract

Importance  Closure of day care centers (DCCs) to contain the COVID-19 pandemic has been associated with negative effects on children’s health and well-being.

Objective  To investigate the acceptance of self-sampling methods for continuous SARS-CoV-2 surveillance among asymptomatic children and childcare workers (CCWs) in DCCs.

Design, Setting, and Participants  This nonrandomized pilot study included children and CCWs at 9 DCCs in Wuerzburg, Germany, from May to July 2021.

Interventions  Twice weekly testing for SARS-CoV-2 was conducted by self-sampled mouth-rinsing fluid (saliva sampling [SAL], with subsequent pooled polymerase chain reaction test) plus nasal rapid antigen self-test (RAgT) (group 1), SAL only (group 2), or RAgT only (group 3) in children and CCWs.

Main Outcomes and Measures  Main outcomes were rates for initial acceptance and successful (≥60% of scheduled samples) long-term participation. The probability of SARS-CoV-2 introduction into DCCs was modeled as a function of age-adjusted background incidence and DCC size.

Results  Of 836 eligible children, 452 (54.1%; 95% CI, 50.7%-57.4%) participated (median [IQR] age: 4 [3-5] years; 213 [47.1%] girls), including 215 (47.6%) in group 1, 172 (38.1%) in group 2, and 65 (14.4%) in group 3. Of 190 CCWs, 139 (73.2%; 95% CI, 66.4%-79.0%) participated (median [IQR] age: 30 [25-46] years; 128 [92.1%] women), including 96 (69.1%) in group 1, 29 (20.9%) in group 2, and 14 (10.1%) in group 3. Overall, SARS-CoV-2 PCR tests on 5306 SAL samples and 2896 RAgTs were performed in children, with 1 asymptomatic child detected by PCR from SAL. Successful long-term participation was highest in group 2 (SAL only; children: 111 of 172 [64.5%]; CCWs: 18 of 29 [62.1%]). Weekly participation rates in children ranged from 54.0% to 83.8% for SAL and from 44.6% to 61.4% for RAgT. Participation rates decreased during the study course (P < .001). The probability of SARS-CoV-2 introduction into a DCC with 50 children was estimated to reach at most 5% for an age-adjusted SARS-CoV-2 incidence below 143.

Conclusions and Relevance  Self-sampling for continuous SARS-CoV-2 testing was well accepted, with SAL being the preferred method. Given the high number of negative tests, thresholds for initiating continuous testing should be established based on age-adjusted SARS-CoV-2 incidence rates.

Trial Registration  German Registry for Clinical Trials Identifier: DRKS00025546

Leibniz-HKI-Autor*innen

Marc Thilo Figge
Oliver Kurzai
Paul Rudolph
Sandra Timme

Identifier

doi: 10.1001/jamanetworkopen.2022.31798

PMID: 36107424