Testing indicators to monitor the COVID-19 pandemic.
Testing indicators to monitor the COVID-19 pandemic.
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DOI：
10.1016/s1473-3099(21)00461-8
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Spiteri G
中科院分区：
文献类型：
--
作者：
Beauté J;Adlhoch C;Bundle N;Melidou A;Spiteri G
评论www.我的天使com/感染率2021年10月21日1345率和测试阳性。5然而，该指南还指出，“在同一个人中进行的阳性确证性聚合酶链反应或重复性快速抗原诊断试验调查不应列入这些计数”。在无症状个体需要定期检测的环境中，如学校，频繁的快速抗原诊断检测的定义可能具有挑战性。在欧盟和欧洲经济区国家，快速抗原诊断检测现已广泛使用，但由于向ECDC报告的75%病例的实验室方法信息不可用，因此难以估计其影响。在斯洛伐克，2021年报告的病例中约有55%是通过快速抗原诊断检测确诊的。现在自我测试变得越来越普遍，测试数据可能变得更不可靠。关于使用COVID-19自我检测，ECDC根据不同情况描述了其对COVID-19监测的可能影响，考虑到系统性使用基于实验室的验证性检测、报告自我检测结果以及分发的检测数量。6如果没有这些组成部分，测试指标就有可能以不可预测的方式出现偏差。阴性自检可能不会被报告，阳性自检可能不会被实验室检测确认。检测数据很少用于传染病的常规监测。在大多数情况下，收集的实验室信息仅限于用于确定病例的实验室方法，但不收集阴性检测结果。一些国家，如英国，现在向其全体人口提供重复检测，邀请个人在线或通过电话报告结果。7假设所有结果都将报告，这些数据仍可能偏向于特定群体或地点，抽样策略对监测目的仍然很重要。8为了应对疫苗的推广和新变异的不断出现，这些策略应与测序策略相结合，以确保检测和监测令人担忧的变异。9
Comment www. thelancet. com/infection Vol 21 October 2021 1345 rates and test positivity. 5 However, the guidance also indicated that “positive confirmatory PCR or recurring rapid antigen diagnostic tests investigations in the same individual should not be included in these counts”. The definition of frequent rapid antigen diagnostic tests might be challenging in settings in which asymptomatic individuals are required to be tested on a regular basis, such as schools. In countries in the EU and EEA, rapid antigen diagnostic tests are now widely available, although it is difficult to estimate their impact since information on laboratory methods is not available for 75% of cases reported to the ECDC. In Slovakia, approximately 55% of cases reported in 2021 were diagnosed by rapid antigen diagnostic tests. Now that self-tests are becoming more widely available, testing data might become even less reliable. Regarding the use of self-tests for COVID-19, the ECDC describes their possible impact on COVID-19 surveillance according to different scenarios considering the systematic use of confirmatory laboratory-based test, the reporting of selftest results, and the number of tests distributed. 6 In the absence of these components, there is a risk that testing indicators will be biased in an unpredictable way. Negative self-tests might not be reported and positive self-tests might not be confirmed by a laboratory-based test. Testing data are seldomly used in routine surveillance of infectious diseases. In most instances, the laboratory information collected is limited to the laboratory methods used to ascertain cases, but negative tests are not collected. Some countries such as the UK are now offering repeated testing to their entire population, inviting individuals to report their results online or by telephone. 7 Assuming that all results will be reported, these data could still be biased toward specific groups or locations, and sampling strategies would remain of importance for surveillance purposes. 8 In response to the vaccine rollout and the continuous emergence of new variants, these strategies should be paired with sequencing strategies to ensure detection and monitoring of variants of concern. 9