Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population

Abstract

Objective

To assess the feasibility and validity of unsupervised participant-collected nasal swabs to detect respiratory pathogens in a low-income, urban minority population.

Methods

This project was conducted as part of an ongoing community-based surveillance study in New York City to identify viral etiologies of acute respiratory infection. In January 2014, following sample collection by trained research assistants, participants with acute respiratory infection from 30 households subsequently collected and returned a self-collected/parent-collected nasal swab via mail. Self/parental swabs corresponding with positive reverse transcription polymerase chain reaction primary research samples were analyzed.

Results

Nearly all (96.8%, n=30/31) households agreed to participate; 100% reported returning the sample and 29 were received (median time: 8 days). Most (18; 62.1%) of the primary research samples were positive. For eight influenza-positive research samples, seven (87.5%) self-swabs were also positive. For ten other respiratory pathogen-positive research samples, eight (80.0%) self-swabs were positive. Sensitivity of self-swabs for any respiratory pathogen was 83.3% and 87.5% for influenza, and specificity for both was 100%. There was no relationship between level of education and concordance of results between positive research samples and their matching participant swab.

Conclusion

In this pilot study, self-swabbing was feasible and valid in a low-income, urban minority population.

Keywords:

• influenza
• upper respiratory infection
• influenza-like illness
• self-swab
• community-based

Acknowledgments

The authors would like to thank Carrie Reed and Lyn Finelli from the Centers for Disease Control and Prevention. The research swabs mentioned in this study were obtained as part of a project supported by the Centers for Disease Control and Prevention (U01IP000618).

Disclosure

The authors report no conflicts of interest in this work.