Epidemiology and alternative approaches for SARS-CoV-2 testing within limited resources settings.
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Date
2023
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Abstract
Background: In the context of the global battle to contain the rapidly mutating SARS-CoV-2,
diagnostic testing for SARS-CoV-2 infection remains a challenge, particularly in low-middleincome
countries (LMICs) due to low socioeconomic backgrounds. Concerningly, because less
attention is paid to asymptomatic cases, particularly in LMICs with limited resources for SARSCoV-
2 testing, the virus is spreading silently in communities, and the majority of these individuals
could be contributing to the resurgence of SARS-CoV-2 infection. This study aimed to determine
the epidemiology and alternative approaches for SARS-CoV-2 testing within limited resources
settings Methods: A total sample size of 1335 residual patient samples from the Global Health
Innovation (GHI) laboratory was used for the epidemiology study and methods comparison.
Results and Discussion: Literature review showed that high income countries (HICs) test more
frequently for SARS-CoV-2 infection, with a range of 113% to 146% higher than LMICs (1% to
43%). The present study demonstrated a higher proportion of asymptomatic cases (68%) among
SARS-CoV-2 infected patients. Regarding the methods comparison for the detection of SARSCoV-
2, the evaluated alternative methods [three RNA extraction (Lucigen QuickExtract™ RNA
Extraction Kit, Bosphore EX-Tract Dry Swab RNA Solution, Sonicator method and four
commercial SARS-CoV-2 RT-PCR assay kits (Nucleic Acid COVID-19 Test Kit (SARS-CoV-2),
abTESTM COVID-19 qPCR I Kit, PCL COVID19 Speedy RT-PCR Kit, and PCLMD nCoV One-
Step RT-PCR Kit)] were found to be cheaper and faster. Conclusion: Notably LMICs are
undertesting for SARS-CoV-2 infection compared to HICs, and there was a higher proportion of
asymptomatic cases among SARS-CoV-2 infected patients in South Africa. This study suggests
that using the above-mentioned cost-effective, quick, and accurate evaluated alternative methods
for mass SARS-CoV-2 testing in routine diagnostic laboratories with limited resources can help to
increase testing capacity for SARS-CoV-2 infection in LMICs. This means that the sooner SARSCoV-
2 infection control and prevention measures can be implemented to reduce community
transmission.
Description
Doctoral Degree. University of KwaZulu-Natal, Durban.