Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study

ABSTRACT While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure. From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle, WA, area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a housekeeping gene. Participant data were recorded via online survey at the time of sample collection and 1 week later. Of the 4,572 consented participants, 4,359 (95.3%) received a home swab kit and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P relative cycle threshold (Crt) value of 19.0 (SD, 3.4), and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8.0 days (interquartile range [IQR], 7.0 to 14.0). A single adverse event occurred and did not cause long-term effects or require medical attention. Home-based surveillance using online participant enrollment and specimen self-collection is a safe and feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.

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Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study

10.1101/2020.12.07.415653 ◽

2020 ◽

Author(s):

Ashley E. Kim ◽

Elisabeth Brandstetter ◽

Naomi Wilcox ◽

Jessica Heimonen ◽

Chelsey Graham ◽

...

Keyword(s):

Online Survey ◽

Respiratory Infections ◽

Cross Sectional Study ◽

Respiratory Pathogen ◽

Respiratory Pathogens ◽

Sample Collection ◽

Community Based ◽

Cross Sectional ◽

Home Based ◽

Pathogen Screening

AbstractIntroductionWhile influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure.MethodsFrom October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a human marker. Participant data were recorded via online survey at the time of sample collection and one week later.ResultsOf the 4,572 consented participants, 4,359 (95.3%) received a home swab kit, and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P CRT value of 19.0 (SD: 3.4) and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8 days [IQR: 7.0-14.0].DiscussionHome-based surveillance using online participant enrollment and specimen self-collection is a feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.

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Seattle Flu Study - Swab and Send: Study Protocol for At-Home Surveillance Methods to Estimate the Burden of Respiratory Pathogens on a City-Wide Scale

10.1101/2020.03.04.20031211 ◽

2020 ◽

Cited By ~ 5

Author(s):

Ashley E. Kim ◽

Elisabeth Brandstetter ◽

Chelsey Graham ◽

Jessica Heimonen ◽

Audrey Osterbind ◽

...

Keyword(s):

Metropolitan Area ◽

Nasal Swab ◽

Community Dwelling ◽

Self Report ◽

Respiratory Pathogen ◽

List Type ◽

Respiratory Pathogens ◽

Sample Collection ◽

Cross Sectional ◽

Home Based

AbstractIntroductionWhile seasonal influenza and other respiratory pathogens cause significant morbidity and mortality each year, the community-based burden of these infections remains incompletely understood. Understanding the prevalence, epidemiology, and transmission dynamics of respiratory pathogen infections among community-dwelling individuals is essential during pandemic and epidemic settings and for developing pandemic-preparedness infrastructure.Methods and AnalysisWe present the protocol for a novel, city-wide home-based cross-sectional study in the Seattle Metropolitan area, utilizing rapid delivery systems for self-collection of a nasal swab and return to the laboratory for respiratory pathogen testing. All participation takes place electronically, including recruitment, consent, and data collection. Within 48 hours of participants self-reporting respiratory symptoms, a nasal swab kit is delivered to the household via a courier service. Demographic and illness characteristics are collected at the time of sample collection and recovery and behavioral information collected one week later. Specimens are tested in the laboratory for multiple respiratory pathogens, and results are available on a public website for participants.Ethics and DisseminationThe study was approved by the University of Washington Institutional Review Board (Protocol #00006181). Results will be disseminated through peer-reviewed publications, talks at conferences, and on the Study Website (www.seattleflu.org).Article SummaryThe findings of this study will inform whether a home-based approach to city-wide respiratory surveillance is possible in epidemic settingsA key strength of this study is that it is conducted across diverse neighborhoods spanning a major metropolitan areaClinical findings may not be generalizable, as they are reliant on self-report (vaccination status, symptoms, healthcare utilization, etc.)

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Prevalence of gastroenteritis among 4-year-old children in South Australia

Epidemiology and Infection ◽

10.1017/s0950268803008288 ◽

2003 ◽

Vol 130 (3) ◽

pp. 443-451 ◽

Cited By ~ 4

Author(s):

J. S. HEYWORTH ◽

P. BAGHURST ◽

K. A. McCAUL

Keyword(s):

Risk Factors ◽

Respiratory Symptoms ◽

School Health ◽

Respiratory Infections ◽

Gastrointestinal Symptoms ◽

South Australia ◽

Antibiotic Use ◽

Medical Attention ◽

Cross Sectional Survey ◽

Cross Sectional

The aim of this study was to determine the prevalence of gastroenteritis among children aged 4 years in South Australia. A cross-sectional survey of 9543 South Australian children aged 4 years was undertaken. Parents completed a questionnaire on behalf of their child who had attended a pre-school health check in 1998. The questionnaire covered gastrointestinal and respiratory symptoms experienced by the child in the previous 2 weeks and other risk factors for gastroenteritis. The 2-week prevalence of gastroenteritis among 4-year-old children was 14·2%. The major risk factors for gastroenteritis were presence of persons who had gastroenteritis inside the home, contact with persons who had gastroenteritis outside the home, antibiotic use and sore throat. Medical attention was sought for 20% of children who had gastroenteritis. Gastroenteritis is a significant cause of morbidity among young children and presents a considerable burden on the community. A substantial proportion of these occurrences of highly credible gastrointestinal symptoms may be manifestations of respiratory infections.

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Home-based hand hygiene practices of mothers in relation to infections in their infants

Nigerian Journal of Paediatrics ◽

10.4314/njp.v47i2.9 ◽

2020 ◽

Vol 47 (2) ◽

pp. 103-109

Author(s):

O.B. Ogunfowora ◽

T.A. Ogunlesi ◽

O.O. Oba-Daini

Keyword(s):

Hand Hygiene ◽

Respiratory Infections ◽

Cross Sectional Study ◽

Hand Washing ◽

Cross Sectional ◽

Hygiene Practices ◽

Young Infants ◽

Home Based ◽

Access To Water

Background: Infections are the leading causes of death in children. Most of these infections are transmitted through the hands of mothers, carers and health workers.Objective: To determine the pattern of home-based hand hygiene practices among mothers of young infants attending a tertiary facility clinic in relation to infections in their infants.Methods: A cross-sectional study of mothers of infants attending an immunization clinic was conducted using a self-designed, pretested questionnaire.Results: The mean age of the 203 mothers was 30.3 ±3.8 years. The majority of the mothers received counselling about hand washing as part of antenatal care (79.8%), had access to water at home (94.0%) and always washed hands with water and soap (48.3%). Although 149 (73.4%) knew hand sanitizers, only 28 (13.8%) used it. Close to half of their infants (46.3%) had various infections (diarrhoea, acute respiratory infections, and boils) within a month of the interview. Only counselling was associated with good quality hand washing practices (p<0.0001) while the age of child less than 6 months and good quality of hand washing were associated with the absence of infections in the infants (p = 0.029 and p<0.0001 respectively).Conclusion: Half of the cohort of mothers practiced good quality hand washing but with poor use of hand sanitizers. With various infections recorded in close to half of their infants, it is important to emphasise better hand washing techniques and improve access to alcohol-based hand sanitizers. Key words: Alcohol-based Hand sanitizers, Hand hygiene, Hand washing, Infants, Infections, Sagamu.

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Public preferences for using quantitative faecal immunochemical test versus colonoscopy as diagnostic test for colorectal cancer: evidence from an online survey

BJGP Open ◽

10.3399/bjgpopen20x101007 ◽

2020 ◽

Vol 4 (1) ◽

pp. bjgpopen20X101007 ◽

Cited By ~ 1

Author(s):

Christian von Wagner ◽

Wouter Verstraete ◽

Yasemin Hirst ◽

Brian D Nicholson ◽

Sandro T Stoffel ◽

...

Keyword(s):

Colorectal Cancer ◽

Diagnostic Test ◽

Online Survey ◽

False Negative ◽

Test Results ◽

Cross Sectional ◽

Public Preferences ◽

Faecal Immunochemical Test ◽

Home Based ◽

Immunochemical Test

BackgroundThere has been interest in using the non-invasive, home-based quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients.AimTo elicit public preferences for FIT versus colonoscopy (CC) and its delivery in primary care.Design & settingA cross-sectional online survey in England.MethodA total of 1057 adults (without CRC symptoms and diagnosis) aged 40–59 years were invited from an English online survey panel. Responders were asked to imagine they had been experiencing CRC symptoms that would qualify them for a diagnostic test. Participants were presented with choices between CC and FIT in ascending order of number of CRCs missed by FIT (from 1–10%). It was measured at what number of missed CRCs responders preferred CC over FIT.ResultsWhile 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred FIT to CC at that level of accuracy. However, this preference reduced to 427 (40.4%) when FIT missed one additional cancer. Women were more likely to tolerate missing CRC when using FIT. Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%).ConclusionWhile the majority of participants preferred FIT over CC when both tests had the same sensitivity, tolerance for missed CRCs was low.

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Willingness to Seek Diagnostic Testing for SARS-CoV-2 With Home, Drive-through, and Clinic-Based Specimen Collection Locations

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa269 ◽

2020 ◽

Vol 7 (7) ◽

Cited By ~ 3

Author(s):

Aaron J Siegler ◽

Eric Hall ◽

Nicole Luisi ◽

Maria Zlotorzynska ◽

Gretchen Wilde ◽

...

Keyword(s):

Online Survey ◽

Clinical Care ◽

Diagnostic Testing ◽

The United States ◽

Contact Tracing ◽

Cross Sectional ◽

Specimen Collection ◽

Home Based ◽

Home Testing

Abstract Background SARS-CoV-2 virus testing for persons with COVID-19 symptoms, and contact tracing for those testing positive, will be critical to successful epidemic control. Willingness of persons experiencing symptoms to seek testing may determine the success of this strategy. Methods A cross-sectional online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. Instructions clarified that home-collected specimens would be mailed to a laboratory for testing. We presented similar willingness questions regarding testing during follow-up care. Results Of 1435 participants, comprising a broad range of sociodemographic groups, 92% were willing to test with a home saliva specimen, 88% with home swab, 71% with drive-through swab, and 60% with clinic-collected swab. Moreover, 68% indicated they would be more likely to get tested if there was a home testing option. There were no significant differences in willingness items across sociodemographic variables or for those currently experiencing COVID-19 symptoms. Results were nearly identical for willingness to receive testing for follow-up COVID-19 care. Conclusions We observed a hierarchy of willingness to test for SARS-CoV-2, ordered by the degree of contact required. Home specimen collection options could result in up to one-third more symptomatic persons seeking testing, facilitating contact tracing and optimal clinical care. Remote specimen collection options may ease supply chain challenges and decrease the likelihood of nosocomial transmission. As home specimen collection options receive regulatory approval, they should be scaled rapidly by health systems.

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Self-Testing as an Invaluable Tool in Fighting the COVID-19 Pandemic

Journal of Primary Care & Community Health ◽

10.1177/21501327211047782 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110477

Author(s):

Paraskevi Goggolidou ◽

Ioannis Hodges-Mameletzis ◽

Satvinder Purewal ◽

Aikaterini Karakoula ◽

Tracy Warr

Keyword(s):

Online Survey ◽

Contact Tracing ◽

University Graduates ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Prick Test ◽

Home Based ◽

Self Testing ◽

Self Test

Objectives: The United Kingdom and a number of European Union countries are offering and distributing rapid antigen detection tests (RADTs) for self-test use to detect SARS-CoV-2. For instance, Greece, in the midst of its third wave of COVID-19, announced the provision of RADTs for self-testing through retail pharmacies. With the aim to determine the acceptability and feasibility of COVID-19 self-testing, we ran a cross-sectional survey on residents of Greece and Cyprus, aged over 18 years. Methods: An online survey using the JISC platform was distributed to 1000 individuals who completed the survey anonymously. Data was collated and analyzed for complete responses by chi-squared and logistic regression analyses. Results: A total of 248 complete responses were obtained, with balanced gender distribution and particular demographics representative of the 2 countries. The majority of participants (79%; n = 196) reported willingness to self-test and the remaining individuals reported no (10.5%; n = 26) or don’t know (10.5%; n = 26). Being a university graduate significantly predicted the likelihood of being willing to self-test (odds ratio [OR] = 3.455, P < .001). Pearson Chi-square test found significant differences between university graduates versus non-graduates on the type of COVID-19 test preferred (χ2 = 8.95, df = 3, P < .03); graduates were more likely to prefer saliva testing and less likely to prefer the finger prick test than non-graduates. Conclusions: Our survey data evidences the acceptability of home-based self-testing, with a preference for saliva as choice of biological material for sampling. A number of factors, such as accessible reporting, contact tracing infrastructures, central registration, and validation for the implementation of different RADTs need to be taken collectively into consideration before self-testing can be universally and reliably scaled up.

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Isolation of Bacterial causes of Respiratory Infections in Calves in Smallholder farms in and around Gonder Town, Ethiopia

10.21203/rs.3.rs-69366/v1 ◽

2020 ◽

Author(s):

Tefera Manaye ◽

Pawlos Wasihun Asnake ◽

Ashebr Abraha ◽

Tsegaw Fentie

Keyword(s):

Risk Factors ◽

Respiratory Disease ◽

Pasteurella Multocida ◽

Respiratory Infections ◽

Mannheimia Haemolytica ◽

Nasopharyngeal Swab ◽

Respiratory Pathogens ◽

Isolation Rate ◽

Cross Sectional ◽

Tract Infections

Abstract Background: Bovine respiratory disease (BRD) is considered as the major cause of severe respiratory tract infections in calves. Pasteurellosis is a multifactorial respiratory disease, which mainly affect calves within four weeks of weaning. A cross-sectional study was conducted from October 2017 to April 2018 in and around Gondar town, Amhara Regional State, North West of Ethiopia. The aim of the study was to isolate Mannheimia and Pasteurella species from calves up to six months old, and to assess the associated risk factors with the occurrence of respiratory disease. Sex, age (< 16 weeks and > 16 weeks), body condition status (poor, medium, good), breed (local and cross breed), livelihood (mixed crop and urban), farming systems (semi intensive and intensive), herd size (small medium, and large), maternity pens (present or absent), and method of colostrum feedings (hand bucket and suckling) were the examined risk factors.Results: A total of 84 nasopharyngeal swab samples were collected from calves with any signs of illness related to pasteurellosis. The overall isolation rate of the respiratory pathogens was 64/84 (76.2%) (95% CI=65.7-84.8), with 46.4% of Mannheimia haemolytica and 28.8% Pasteurella multocida isolates. The distribution of pathogens was statistically higher (P< 0.001) in calves with respiratory problems (93.6%; 95% CI= 82.5-98.7) compared to those with no symptoms of respiratory illness (54.1%; 95% CI= 36.9-70.5). Among the examined risk factors age, sex, breed, farming system were found to be potential risk factors and significantly associated with Pasteurella infection of calves (p<0.05). The higher isolation rate of Mannheimia haemolytica indicated that it is the major cause of respiratory disease in the study area.Conclusion: The present finding revealed that pasteurellosis is one of the major diseases of calves in the study area in which M. haemolytica and P. multocida were found to be commonly involved in respiratory infections. Improved farm management including timely feeding of colostrum, appropriate hygiene of the calf house and training of farmers is recommended to prevent and control of respiratory diseases in the study area.

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Etiology of Coinfections in Children with Influenza during 2015/16 Winter Season in Nepal

International Journal of Microbiology ◽

10.1155/2018/8945142 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Bishnu Prasad Upadhyay ◽

Megha Raj Banjara ◽

Ram Krishna Shrestha ◽

Masato Tashiro ◽

Prakash Ghimire

Keyword(s):

Influenza Virus ◽

Respiratory Syncytial Virus ◽

Influenza A ◽

Antimicrobial Agents ◽

Respiratory Infections ◽

Winter Season ◽

Parainfluenza Virus ◽

Respiratory Pathogen ◽

Respiratory Pathogens ◽

Syncytial Virus

Acute respiratory infections (ARIs) are one of the major public health problems in developing countries like Nepal. Besides the influenza, several other pathogens are responsible for acute respiratory infection in children. Etiology of infections is poorly characterized at the course of clinical management, and hence empirical antimicrobial agents are used. The objective of this study was to characterize the influenza and other respiratory pathogens by real-time PCR assay. A total of 175 throat swab specimens of influenza-positive cases collected at National Influenza Center, Nepal, during the 2015/16 winter season were selected for detecting other respiratory copathogens. Total nucleic acid was extracted using Pure Link viral RNA/DNA mini kit (Invitrogen), and multiplex RT-PCR assays were performed. Influenza A and B viruses were found in 120 (68.6%) and 55 (31.4%) specimens, respectively, among which coinfections were found in 106 (60.6%) specimens. Among the influenza A-positive cases, 25 (20.8%) were A/H1N1 pdm09 and 95 (79.2%) were A/H3 subtypes. Viruses coinfected frequently with influenza virus in children were rhinovirus (26; 14.8%), respiratory syncytial virus A/B (19; 10.8%), adenovirus (14; 8.0%), coronavirus (CoV)-HKU1 (14; 8.0%), CoV-OC43 (5; 2.9%), CoV-229E (2; 1.1%), metapneumovirus A/B (5; 2.9%), bocavirus (6; 3.4%), enterovirus (5; 2.9%), parainfluenza virus-1 (3; 1.7%), and parainfluenza virus-3 (2; 1.1%). Coinfection of Mycoplasma pneumoniae with influenza virus was found in children (5; 2.8%). Most of the viral infection occurred in young children below 5 years of age. In addition to influenza virus, nine different respiratory pathogens were detected, of which coinfections of rhinovirus and respiratory syncytial virus A/B were predominantly found in children. This study gives us better information on the respiratory pathogen profile and coinfection combinations which are important for diagnosis and treatment of ARIs.

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Dissatisfaction with family members’ medical care: the relationship with trust in personal physicians and physicians generally in Japan

10.1101/2021.04.21.21255773 ◽

2021 ◽

Author(s):

Nao Oguro ◽

Ryo Suzuki ◽

Nobuyuki Yajima ◽

Kosuke Sakurai ◽

Takafumi Wakita ◽

...

Keyword(s):

Medical Care ◽

Online Survey ◽

Family Members ◽

Long Term Effects ◽

Cross Sectional ◽

Negative Experiences ◽

Physician Trust ◽

Personal Physician ◽

Trust In Physicians ◽

The Impact

AbstractNegative experiences with medical care have long-term effects on family members’ attitudes and emotions. However, the impact of family members’ experiences on patients’ trust in their physicians and in physicians generally is poorly understood. We aimed to quantify these associations. Our cross-sectional online survey, conducted in Japan during April 2020, involved adults with non-communicable diseases (cardiac disease, diabetes, cancer, depression, and rheumatic disease). The main exposure variable was dissatisfaction with the medical care that family members had received. The main outcomes were patients’ (N=661) trust in their personal physicians and in physicians generally. The study adopted the Japanese version of the Abbreviated Wake Forest Physician Trust Scales. We translated and validated both 5-item scales (general and individual physician trust) for the study. The results showed a lower rating for trust in physicians generally compared to trust in the respondent’s personal physician. Furthermore, dissatisfaction with a family member’s medical care was associated with lower trust in physicians generally. Interestingly, dissatisfaction with a family member’s care was also associated with lower trust in the respondent’s personal physician, but the magnitude of this association was weaker. The lower trust in personal physicians may be mediated by reduced trust in physicians generally. We suggest that physicians enquire about past patients’ negative experiences, including dissatisfaction with family members’ medical care, to repair hidden loss of trust, when they sense that patients doubt them or physicians generally.

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