Enhancing the utility of SARS-CoV-2 antibody rapid diagnostic tests (RDTs) for disease surveillance

PI: Anuraj Shankar

Partner PI: Dr. Rina Agustina (Faculty of Medicine University of Indonesia)

Collaborators:

Jakarta Health Office, National Institute of Health Research and Development.

Primary objective:

To investigate if the integration of symptomatic, demographical and diet-related comorbidities data with antibody rapid diagnostic tests (RDTs) improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance.

Study location: Jakarta, Indonesia (May 2020)

Importance

RDT-IgM/IgG-positive tests were associated with infection (OR 10.8, 95% CI 4.43 to 26.4, p<0.001) with an area under the curve (AUC) of 0.708% and 50% sensitivity, 91.5% specificity, 30.8% positive predictive value (PPV) and 96.1% negative predictive value (NPV). RDT results combined with age, gender, contact history, symptoms and comorbidities increased the AUC to 0.787 and yielded 62.5% sensitivity, 87.0% specificity, 26.6% PPV and 96.9% NPV. SARS-CoV-2 RDT-IgM/IgG results integrated with other predictors increased test sensitivity by 25% indicating the approach may be an affordable tool for epidemiological surveillance for population-based Covid-19 exposure and current infection, especially in groups with outbreaks or high transmission. This may provide an affordable option for surveillance as RT-PCR is sensitive but costly, and antigen-based RDTs are cheap but of low sensitivity, and both detect current infection but not exposure, but SARS-CoV-2 IgM/IgG RDTs detect exposure but with poor sensitivity for current infection.

Research papers:

  • Agustina R, Syam AF, Wirawan F, Widyahening IS, Rahyussalim AJ, Yusra Y, Rianda D, Burhan E, Salama N, Daulay R, Halim ARV, Shankar AH. (2021) Integration of symptomatic, demographical and diet-related comorbidities data with SARS-CoV-2 antibody rapid diagnostic tests during epidemiological surveillance: a cross-sectional study in Jakarta, Indonesia. BMJ Open. 11:e047763.