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Title: Validation of self-collected buccal swab and saliva as a diagnostic tool for COVID-19
Authors: Ku, Chee Wai 
Shivani, Durai
Kwan, Jacqueline Q. T.
Loy, See Ling 
Erwin, Christina
Ko, Karrie K. K. 
Ng, Xiang Wen
Oon, Lynette
Thoon, Koh Cheng 
Kalimuddin, Shirin 
Chan, Jerry K. Y.
Keywords: Buccal swab
Diagnostic tests
Saliva test
Issue Date: 1-Mar-2021
Publisher: Elsevier B.V.
Citation: Ku, Chee Wai, Shivani, Durai, Kwan, Jacqueline Q. T., Loy, See Ling, Erwin, Christina, Ko, Karrie K. K., Ng, Xiang Wen, Oon, Lynette, Thoon, Koh Cheng, Kalimuddin, Shirin, Chan, Jerry K. Y. (2021-03-01). Validation of self-collected buccal swab and saliva as a diagnostic tool for COVID-19. International Journal of Infectious Diseases 104 : 255-261. ScholarBank@NUS Repository.
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
Abstract: Background: Effective management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires large-scale testing to identify and isolate infectious carriers. Self-administered buccal swab and saliva collection are convenient, painless, and safe alternatives to the current healthcare worker (HCW)-collected nasopharyngeal swab (NPS). Methods: A cross-sectional single-centre study was conducted on 42 participants who had tested positive for SARS-CoV-2 via an NPS within the past 7 days. Real-time polymerase chain reaction (RT-PCR) was performed and cycle threshold (Ct) values were obtained for each test. The positive percent agreement (PPA), negative percent agreement (NPA), and overall agreement (OA) were calculated for the saliva samples and buccal swabs, and compared with NPS. Results: Among the 42 participants, 73.8% (31/42) tested positive by any one of the three tests. With reference to NPS, the saliva test had PPA 66.7%, NPA 91.7%, and OA 69.0%; the buccal swab had PPA 56.7%, NPA 100%, and OA 73.8%. Conclusion: Self-collected saliva tests and buccal swabs showed only moderate agreement with HCW-collected NPS. Primary screening for SARS-CoV-2 may be performed with a saliva test or buccal swab, with a negative test warranting a confirmatory NPS to avoid false-negatives, minimize discomfort, and reduce the risk of spread to the community and HCWs. © 2021 The Author(s)
Source Title: International Journal of Infectious Diseases
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2020.12.080
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
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