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Parents collect respiratory samples earlier in illness than HCWs
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Parents in Australia who were trained to collect nasal swabs did so nearly 2 days sooner after their children’s symptoms of an acute respiratory infection appeared compared with home visits by health care workers, according to results of a randomized trial published in the Journal of the Pediatric Infectious Diseases Society.
“Studying [acute respiratory infections (ARIs)] is important, not only for their direct effect on health and economic burden, but also because of their influence on chronic lung disease and the increasing recognition of their role in the ontogeny of the developing human immune system,” Stephen Lambert, MBBS, MAppEpid, PhD, FAFPHM, an adjunct associate professor at the University of Queensland’s Child Health Research Centre, and colleagues wrote.
Lambert and colleagues conducted an unblinded randomized controlled trial in which parents from Brisbane, Australia, were taught at the initial visit how to identify new ARIs in children aged younger than 2 years between Sept. 1, 2009, and Feb. 26, 2010. Each child was randomly assigned to a group in which parents would collect a nasal swab from the child when he or she had an ARI (P group; n = 31) or parents would contact a health care worker (HCW), who would visit to obtain a nasopharyngeal swab (HCW group; n = 33). The researchers also conducted a nested diagnostic study to compare paired specimen collection in the HCW group.
The researchers reported 76 incident ARI episodes in the P group and 102 ARI episodes in the HCW group, with similar proportions of specimens collected (69% in P group vs. 72.5% in HCW group). Pathogens were detected in a higher percentage of the P group’s samples (93.8%) compared with the samples from the HCW group (77.5%). The researchers wrote that there was a shorter period between ARI onset and specimen collection in the P group vs. the HCW group, with a mean difference of 1.9 days (95% CI, 0.7-3 days).
When the researchers compared 69 paired specimens, they reported that the viral loads were lower in the swabs collected in the P group, with a mean cycle threshold difference of 4. 5 (95% CI, 3.1-5.9).
“Training parents to collect a simple respiratory specimen is an effective and cost-saving way to do respiratory research in the community,” Lambert told Infectious Diseases in Children. – by Bruce Thiel
Disclosures: Lambert reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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