Performance of two SARS-CoV-2 rapid antigen detection tests in resource limited settings, the case of Mali

• DOI: 10.4314/ahs.v23i4.15
• Publication Date: 2024-04-04T10:22:53Z
• Authors: Fatimata Diallo; Bassirou Diarra; Sadio Sarro Yeya dit; Mohamed Tolofoudie; Mahamoudou Toure; Dramane Diallo; Georges Togo Anti...; Sidy Bane; Mohamed Abdou; Sy Konate Mama; Razakou Dicko Abdoul; Ibrehima Guindo; Shaw Saliba Katy; Amadou Kone; Mahamadou Diakite; Seydou Doumbia
• Keywords: Male; Adult; SARS-CoV-2; COVID-19; Articles; Mali; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Resource-Limited Settings; COVID-19 Serological Testing; 03 medical and health sciences; Cross-Sectional Studies; COVID-19 Testing; 0302 clinical medicine; COVID-19 Nucleic Acid Testing; Prevalence; Humans; Female; Antigens, Viral

Introduction: While real-time reverse transcription PCR (RT-PCR) is the recommended laboratory method to diagnose severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, its use in resource limited settings can be difficult to maintain due to high testing demand and shortage of reagents. The aim of this study was to evaluate the performances of Realy Tech™ and Standard Q™ in comparison to RT-PCR in a relatively low COVID-19 prevalence setting, Mali.Methods: We conducted a cross-sectional study between January and April 2021 in Bamako and Kati regions to evaluate both rapid tests during a large SARS-CoV-2 prevalence study in Mali.Results: Of the 390 samples tested, the sensitivity and specificity of Realy Tech™ and Standard Q™ were 57.1% (95%CI: 44.1-69.2), 95.8% (95%CI: 93.1-97.5); 61.9% (95%CI: 46.8-75.0), and 94.1% (95%CI: 89.5-96.8) respectively. Using RT-PCR, the global prevalence of SARS-CoV-2 was 14.4% (56/390). In both rapid antigen tests, the performance was better when used in suspected patients compared to positive patients under treatment. Moreover, higher viral loads equivalent to Ct < 25 were associated with better detection rates.Conclusion: While waiting for more complete data, these preliminary studies suggest that Realy Tech™ and Standard Q™ should not be used alone for COVID-19 diagnosis in Mali.