Feasibility of SARS-CoV-2 Surveillance Testing Among Children and Childcare Workers at German Day Care Centers: A Nonrandomized Controlled Trial.
Feasibility of SARS-CoV-2 Surveillance Testing Among Children and Childcare Workers at German Day Care Centers: A Nonrandomized Controlled Trial.
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DOI：
10.1001/jamanetworkopen.2021.42057
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发表时间：
2022-01-04
影响因子：
13.8
通讯作者：
Wü-KiTa-CoV Study Group
中科院分区：
文献类型：
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作者：
Forster J;Streng A;Rudolph P;Rücker V;Wallstabe J;Timme S;Pietsch F;Hartmann K;Krauthausen M;Schmidt J;Ludwig T;Gierszewski D;Jans T;Engels G;Weißbrich B;Romanos M;Dölken L;Heuschmann P;Härtel C;Gágyor I;Figge MT;Kurzai O;Liese J;Wü-KiTa-CoV Study Group
持续的SARS-CoV-2检测是否被儿童、父母和儿童保育工作者接受？它能否防止病毒在日托中心传播？在这项非随机对照试验中，如果在家中进行唾液采样，则儿童、父母和保育员都能很好地接受对954名合格个体进行的SARS-CoV-2监测检测。基于研究和文献数据的数学模型确定，每两周至少对50%的儿童和儿童保育工作者进行一次检测，这是限制继发感染的最低要求。这些发现表明，SARS-CoV-2监测检测是可行的，并允许在COVID-19大流行期间继续为儿童提供日托服务。这项非随机对照试验研究了在德国日托中心的儿童和保育员中进行SARS-CoV-2监测的可行性，并模拟了监测预防病毒传播的有效性。为遏制COVID-19疫情，全球已关闭日托中心，但对儿童的健康和心理健康产生负面影响。探讨在儿童和保育员中进行监测的可行性，并建立监测预防病毒传播的有效性模型。这项非随机对照试验于2020年10月至2021年3月在德国维尔茨堡的9家日托中心进行。参加者包括参加日托的儿童、儿童保育工作者和家庭成员。在一项非随机可行性研究中，参与的日托中心被分配到不同的监测模块。建立了SARS-CoV-2在日托中心传播的数学模型，以确定最佳监测。模块1、2和3涉及通过SARS-CoV-2聚合酶链反应检测中鼻甲鼻拭子每周两次（模块1）或每周一次（模块2）或自采样唾液样本每周两次（模块3）对无症状儿童和保育员进行持续监测。模块4涉及通过口咽拭子对儿童、儿童保育工作者及其家庭成员进行的基于组织的按需检测。所有参与者在采样期前后进行了SARS-CoV-2抗体状态检测。在第1周、第6周和第12周进行了关于对大流行的态度和看法的问卷调查。数学模型被用来估计SARS-CoV-2在日托中心的传播。主要结果是接受各自的监测方案（可行性研究）和估计的继发感染数量（数学建模）。在954名合格人员（772名儿童和182名保育员）中，592名（62%），包括442名儿童（中位数[IQR]年龄，3 [2-4]岁; 214名[48.6%]女性）和150名保育员（中位数[IQR]年龄，29 [25-44]岁; 129名[90.8%]女性）参加了监测。总共有4755次SARS-CoV-2检测发现2例感染（1名儿童保育员和1名成年家庭成员）。每两周一次的唾液检测对持续监测的接受度最高（150/221例合格个体[67.9%; 95% CI，61.5%-73.7%]）与每两周一次相比（117名个体中的51名[43.6%; 95%CI，35.0%-52.6%]）和每周（128名个体中的44名[34.4%; 95%CI，26.7%-43.0%]）进行中鼻甲拭子（P < .001）。中鼻甲拭子的脱落率（每两周一次，62名参与者中有11名[18%];每周一次，55名参与者中有11名[20%]）高于唾液测试（156名参与者中有6名[4%]）。基于研究和文献数据的数学模型确定，每两周至少对50%的儿童和儿童保育工作者进行一次检测，这是限制继发感染的最低要求。在这项非随机对照试验中，在9个德国日托中心监测SARS-CoV-2是可行的，并得到了广泛接受。数学模型估计，检测可以最大限度地减少SARS-CoV-2在日托中心的传播。这些调查结果有助于建立监测方案，以维持机构托儿服务。德国临床试验注册处标识符：DRKS 00023721
Is continuous SARS-CoV-2 testing accepted by children, parents, and childcare workers and can it prevent viral spreading in day care centers? In this nonrandomized controlled trial, surveillance testing for SARS-CoV-2 among 954 eligible individuals was well accepted by children, parents, and childcare workers if saliva sampling at home was used. Mathematical modeling based on study and literature data identified biweekly testing of at least 50% of children and childcare workers as minimal requirements to limit secondary infections. These findings suggest that SARS-CoV-2 surveillance testing is feasible and allows for continued day care attendance for children during the COVID-19 pandemic. This nonrandomized controlled trial investigates the feasibility of SARS-CoV-2 surveillance among children and childcare workers at day care centers in Germany and models the efficacy of surveillance for preventing viral spread. Closure of day care centers has been implemented globally to contain the COVID-19 pandemic but has negative effects on children’s health and psychosocial well-being. To investigate the feasibility of surveillance among children and childcare workers and to model the efficacy of surveillance on viral spread prevention. This nonrandomized controlled trial was conducted at 9 day care centers in Wuerzburg, Germany, from October 2020 to March 2021. Participants included children attending day care, childcare workers, and household members. Participating day care centers were assigned to different surveillance modules in a nonrandomized feasibility study. A mathematical model for SARS-CoV-2 spread in day care centers was developed to identify optimal surveillance. Modules 1, 2, and 3 involved continuous surveillance of asymptomatic children and childcare workers by SARS-CoV-2 polymerase chain reaction testing of either midturbinate nasal swabs twice weekly (module 1) or once weekly (module 2) or self-sampled saliva samples twice weekly (module 3). Module 4 involved symptom-based, on-demand testing of children, childcare workers, and their household members by oropharyngeal swabs. All participants underwent SARS-CoV-2 antibody status testing before and after the sampling period. Questionnaires on attitudes and perception of the pandemic were administered in weeks 1, 6, and 12. Mathematical modeling was used to estimate SARS-CoV-2 spread in day care centers. The primary outcomes were acceptance of the respective surveillance protocols (feasibility study) and the estimated number of secondary infections (mathematical modeling). Of 954 eligible individuals (772 children and 182 childcare workers), 592 (62%), including 442 children (median [IQR] age, 3 [2-4] years; 214 [48.6%] female) and 150 childcare workers (median [IQR] age, 29 [25-44] years; 129 [90.8%] female) participated in the surveillance. In total, 4755 tests for SARS-CoV-2 detected 2 infections (1 childcare worker and 1 adult household member). Acceptance for continuous surveillance was highest for biweekly saliva testing (150 of 221 eligible individuals [67.9%; 95% CI, 61.5%-73.7%]) compared with biweekly (51 of 117 individuals [43.6%; 95% CI, 35.0%-52.6%]) and weekly (44 of 128 individuals [34.4%; 95% CI, 26.7%-43.0%]) midturbinate swabbing (P < .001). Dropout rates were higher for midturbinate swabbing (biweekly, 11 of 62 participants [18%]; once weekly, 11 of 55 participants [20%]) than for saliva testing (6 of 156 participants [4%]). Mathematical modeling based on study and literature data identified biweekly testing of at least 50% of children and childcare workers as minimal requirements to limit secondary infections. In this nonrandomized controlled trial, surveillance for SARS-CoV-2 in 9 German day care centers was feasible and well accepted. Mathematical modeling estimated that testing can minimize the spread of SARS-CoV-2 in day care centers. These findings enable setup of surveillance programs to maintain institutional childcare. German Registry for Clinical Trials Identifier: DRKS00023721
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DOI：
10.3390/ijerph17218114
发表时间：
2020-11-03
影响因子：
--
作者：
Lelieveld J;Helleis F;Borrmann S;Cheng Y;Drewnick F;Haug G;Klimach T;Sciare J;Su H;Pöschl U
通讯作者：
Pöschl U
影响因子：
36.4
作者：
Goetzinger, Florian;Santiago-Garcia, Begona;Tebruegge, Marc
通讯作者：
Tebruegge, Marc
影响因子：
26.1
作者：
Tönshoff B;Müller B;Elling R;Renk H;Meissner P;Hengel H;Garbade SF;Kieser M;Jeltsch K;Grulich-Henn J;Euler J;Stich M;Chobanyan-Jürgens K;Zernickel M;Janda A;Wölfle L;Stamminger T;Iftner T;Ganzenmueller T;Schmitt C;Görne T;Laketa V;Olberg S;Plaszczyca A;Cortese M;Bartenschlager R;Pape C;Remme R;Huzly D;Panning M;Weigang S;Giese S;Ciminski K;Ankerhold J;Kochs G;Schwemmle M;Handgretinger R;Niemeyer CM;Engel C;Kern WV;Hoffmann GF;Franz AR;Henneke P;Debatin KM;Kräusslich HG
通讯作者：
Kräusslich HG
影响因子：
36.4
作者：
Macartney, Kristine;Quinn, Helen E.;Wood, Nicholas
通讯作者：
Wood, Nicholas
影响因子：
56.9
作者：
Jones, Terry C.;Biele, Guido;Muhlemann, Barbara;Veith, Talitha;Schneider, Julia;Beheim-Schwarzbach, Joern;Bleicker, Tobias;Tesch, Julia;Schmidt, Marie Luisa;Sander, Leif Erik;Kurth, Florian;Menzel, Peter;Schwarzer, Rolf;Zuchowski, Marta;Hofmann, Joerg;Krumbholz, Andi;Stein, Angela;Edelmann, Anke;Corman, Victor Max;Drosten, Christian
通讯作者：
Drosten, Christian