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Some Covid-19 infections could be missed due to poor technique when swabbing patients for a test, new Irish research suggests *.
With Covid-19 placing great pressure on healthcare systems and public health measures to control the virus that rely heavily on testing, a team of researchers from Beaumont Hospital in Dublin decided to test the quality of the swabs. , which are used to collect samples for analysis in the laboratory.
This is the first time the quality of the nasopharyngeal swab technique has been tested in this way, they believe.
The study comes as the National Public Health Emergency Team (Nphet) announced three additional deaths from Covid-19, bringing the total to 1,830. There were also 811 confirmed cases of the virus announced Tuesday night.
So far, more than 1.3 million people in Ireland have been tested for Covid-19, starting with a sample taken with a swab inserted into the back of the throat and nose. The sample is then placed in a liquid and transported to a laboratory for processing using a technique known as PCR (polymerase chain reaction), which looks for fragments of the virus’ DNA.
PCR is considered the “gold standard” of Covid-19 testing, but it relies on the smear being carried out efficiently to collect sputum from inside the patient’s nose and throat.
In the Beaumont study, 229 staff members were evaluated using a swab navigated on a three-dimensional model head at the hospital for two days.
The model is typically used by ear, nose and throat (ENT) surgeons in the hospital to plan procedures, according to study co-author Dr. Eoghan de Barra. The progress made by the “guinea pig” swabs could be viewed and measured on a computer screen.
Angle and length of the swab
According to the study, the technique was poor, with a nasopharyngeal swab success rate of 38.6%. The angle and length of insertion of the swab varied significantly between those with a successful and unsuccessful technique.
Doctors were significantly more accurate in taking samples than nurses and non-healthcare professionals, the study found.
In a successful test, the swab is inserted deep into the nasal passages and then rotated 360 degrees. According to Dr. de Barra, the smear “shouldn’t hurt, but you’ll know when it’s done.”
The authors say that inaccurate sample collection from a poor swab technique could contribute to a high false-negative rate of tests for Covid-19. They suggest the provision of training in the anatomy of the nose and throat and swab technique to improve precision levels.
Dr. de Barra said it was not yet known whether poor technique ultimately had an impact on the positivity of the tests, adding that researchers in other countries had found that rubbing the front of the throat could provide acceptable samples.
The study was presented by associate physician Kellie Nwaokorie last weekend at the Irish Society of Otolaryngology / Head and Neck academic meeting, where it won the award for best oral presentation.
* Clarification: Dr. de Barra added Wednesday that the study was carried out in April at the height of the pandemic. Since then, more training has been provided to testers that will have improved the quality of the collected samples.
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