The Respiratory Specimen Collection Trial (ReSpeCT): A Randomized Controlled Trial to Compare Quality and Timeliness of Respiratory Sample Collection in the Home by Parents and Healthcare Workers From Children Aged Beate Zoch-Lesniak  1   2 , Robert S Ware  3 , Keith Grimwood  3   4   5 , Stephen B Lambert  6 Affiliations Expand Affiliations 1 Centre of Rehabilitation Research, University of Potsdam, Germany. 2 PhD Programme, Epidemiology, Braunschweig-Hannover, Germany. 3 Menzies Health Institute Queensland, Queensland, Australia. 4 School of Medicine, Griffith University, Gold Coast, Queensland, Australia. 5 Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Queensland, Australia. 6 Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia. PMID: 30657971 PMCID: PMC7358654 DOI: 10.1093/jpids/piy136 Free PMC article Item in Clipboard

Beate Zoch-Lesniak, Robert S Ware, Keith Grimwood, Stephen B Lambert, Beate Zoch-Lesniak, Robert S Ware, Keith Grimwood, Stephen B Lambert

Abstract

Background: Most acute respiratory infection (ARI) research focuses on severe disease and overlooks the burden of community-managed illness. For community-based studies, home-based specimen collection by parents could be a resource-saving alternative to collection by healthcare workers (HCWs). In this study, we compared parent and HCW groups for their likelihood to collect specimens and the timeliness and quality of such collection.

Methods: In this unblinded randomized controlled trial, parents from Brisbane, Australia, were taught to identify new ARI episodes in their children aged <2 years. When their child had a new ARI, parents either collected a nasal swab from the child (P group) or contacted an HCW who visited to obtain a nasopharyngeal swab (HCW group). We compared the likelihood and timeliness of specimen collection and respiratory pathogen detection. A nested diagnostic study compared paired specimen collections from children in the HCW group.

Results: Included were 76 incident ARI episodes from 31 children and 102 episodes from 33 children in the P and HCW groups, respectively. The proportions of ARIs for which a specimen was collected were similar (P group, 69.7%; HCW group, 72.5%; P = .77), and pathogens were detected in 93.8% and 77.5% of the specimens, respectively (P = .03). The period between ARI onset and specimen collection was shorter in the P group than in the HCW group (mean difference, 1.9 days [95% confidence interval, 0.7-3.0 days]; P < .001). For the 69 paired specimens, viral loads were lower in the parent-collected swabs (mean cycle threshold difference, 4.5 [95% confidence interval, 3.1-5.9]; P < .001).

Conclusions: Parents and HCWs obtained samples in similar proportions of ARI episodes, but the parents collected the samples fewer days after ARI onset and with a resulting higher likelihood of pathogen identification. This method can be used in population-based epidemiological studies of ARI as a resource-saving alternative.

Trial registration: ClinicalTrials.gov identifier NCT00966069.

Keywords: acute respiratory infections; children; nasal swabs; parent; specimen collection.

© The Author(s) 2019. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Figure 1.
Figure 1.
Trial profile. Abbreviations: HCW, healthcare worker; NPS, nasopharyngeal swab.
Figure 2.
Figure 2.
Bland-Altman plot displaying the difference in ERV3 Ct values between paired nasal swabs (parent-collected nasal swab and HCW-collected nasopharyngeal specimen) obtained within the HCW group (n = 62). Abbreviations: Ct, cycle threshold; ERV3, endogenous retrovirus 3; HCW, healthcare worker; SD, standard deviation.

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Source: PubMed

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