Feasibility of a Pilot Crowdsourced Syndromic and Virological Surveillance Platform for Respiratory Illness in South Africa, CoughWatchSA, 2022

Le résumé fourni par la source

Background Digital participatory surveillance (DPS) may provide information on non-medically attended influenza-like illnesses (ILI). Combining DPS with laboratory testing allows pathogen identification. We assessed the feasibility of DPS and home-based swabbing in South Africa. Methods We enrolled a cohort of individuals aged ≥18 years who completed weekly respiratory symptoms questionnaires from March–October 2022. We calculated the percent of weekly DPS-reports consistent with ILI and COVID-19 syndromes and compared with weekly private respiratory consultations. Symptomatic participants in 3 provinces were offered self-administered nasal swabbing for influenza and SARS-CoV-2 detection by polymerase chain reaction (PCR). We assessed six feasibility indicators: recruitment capability, representativeness, reliability, accuracy, acceptability, and usefulness. Results Recruitment capability: 26% (249/954) of participants who accessed the platform enrolled and 92% (81/88) of participants eligible for self-swabbing were enrolled. Acceptability: 84% (210/249) of participants remained enrolled until the end of follow-up, 15% (32/249) completed the acceptability questionnaire with 100% (32/32) indicating willingness to participate in future studies, whereas 16% (39/210) withdrew from the study. Representativeness: 50% (125/249) were aged 18-39 years and 50% were older than 40 years (124/249), 71% (178/249) were female and 79% (196/249) had a tertiary qualification. Reliability: median weekly participation was 23% (interquartile range (IQR): 19%-29%) and 38% (80/210) submitted >1 weekly symptoms questionnaire. Accuracy: 2% (31/1440) and 25% (359/1440) of weekly questionnaires met ILI and COVID-19 case definitions, respectively. Influenza and SARS-CoV-2 were detected in 7% (6/81) and 32% (26/81) of tested samples, respectively. There was low correlation with respiratory consultations (0.08, 95% CI -0.27–0.43) for ILI and (0.36, 95% CI 0.11–0.62) COVID19. Usefulness: symptoms were reported in 32% (459/1440) of reports and 11% (49/459) sought medical care. Conclusion The study was feasible, however, the low enrolment numbers limit power. Linkage to self-swabbing was successful and demonstrates the potential for pathogen confirmation.

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