{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:30:21Z","timestamp":1740162621195,"version":"3.37.3"},"reference-count":40,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,6,25]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Affordable options for COVID-19 epidemiological surveillance are needed. Virus detection by reverse transcription-PCR (RT-PCR) is sensitive but costly, and antigen-based rapid diagnostic tests (RDTs) are cheap but with reduced sensitivity; both detect current infection but not exposure. RDT-IgM\/IgG antibodies to SARS-CoV-2 detect exposure but have poor sensitivity for current infection. We investigated if the integration of symptomatic, demographical and diet-related comorbidities data with antibody RDTs improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We conducted a cross-sectional study using data from community surveillance for SARS-CoV-2. Health workers collected nasopharyngeal swabs for RT-PCR and RDT antigen assessments and venous blood for RDT-IgM\/IgG from symptomatic and asymptomatic persons. Data on age, gender, contact history, symptoms (ie, fever, cough, runny nose, sore throat, headache, dyspnoea and diarrhoea), diet-related comorbidities (ie, diabetes and hypertension) and chest radiology were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>High-risk communities in Jakarta, Indonesia, in May 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>343 community members\u2019 data were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>RDT-IgM\/IgG sensitivity, specificity and predictive values and area under receiver operating characteristic curve for RT-PCR positivity using RDT results alone and in combination with other predictors, including symptom components derived from principal component analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 24 PCR-confirmed infections. RDT-IgM\/IgG-positive tests were associated with infection (OR 10.8, 95%\u2009CI 4.43 to 26.4, p&lt;0.001) with an area under the curve (AUC) of 0.708% and 50% sensitivity, 91.5% specificity, 30.8% positive predictive value (PPV) and 96.1% negative predictive value (NPV). RDT results combined with age, gender, contact history, symptoms and comorbidities increased the AUC to 0.787 and yielded 62.5% sensitivity, 87.0% specificity, 26.6% PPV and 96.9% NPV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SARS-CoV-2 RDT-IgM\/IgG results integrated with other predictors may be an affordable tool for epidemiological surveillance for population-based COVID-19 exposure and current infection, especially in groups with outbreaks or high transmission.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-047763","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T17:26:38Z","timestamp":1628616398000},"page":"e047763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Integration of symptomatic, demographical and diet-related comorbidities data with SARS-CoV-2 antibody rapid diagnostic tests during epidemiological surveillance: a cross-sectional study in Jakarta, Indonesia"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8464-1037","authenticated-orcid":false,"given":"Rina","family":"Agustina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari Fahrial","family":"Syam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadila","family":"Wirawan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indah S","family":"Widyahening","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Jabir","family":"Rahyussalim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusra","family":"Yusra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davrina","family":"Rianda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erlina","family":"Burhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngabila","family":"Salama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekka","family":"Daulay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Rhyza Vertando","family":"Halim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuraj H","family":"Shankar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"2024112509061984000_11.8.e047763.1","unstructured":"Task force for the acceleration of coronavirus handling. Available: https:\/\/covid19.go.id\/ [Accessed 22 Jun 2020]."},{"key":"2024112509061984000_11.8.e047763.2","doi-asserted-by":"crossref","first-page":"100091","DOI":"10.1016\/j.pdisas.2020.100091","article-title":"Review and analysis of current responses to COVID-19 in Indonesia: period of January to March 2020","volume":"6","author":"Djalante","year":"2020","journal-title":"Prog Disaster Sci"},{"key":"2024112509061984000_11.8.e047763.3","unstructured":"Provincial Government of DKI Jakarta . Available: https:\/\/corona.jakarta.go.id\/id\/data-pemantauan [Accessed 2 Dec 2020]."},{"key":"2024112509061984000_11.8.e047763.4","unstructured":"World Health Organization . Public health criteria to adjust public health and social measures in the context of COVID-19, 2020."},{"key":"2024112509061984000_11.8.e047763.5","doi-asserted-by":"crossref","unstructured":"Tang Y-W , Schmitz JE , Persing DH , et al . Laboratory diagnosis of COVID-19: current issues and challenges. J Clin Microbiol 2020;58.doi:10.1128\/JCM.00512-20","DOI":"10.1128\/JCM.00512-20"},{"key":"2024112509061984000_11.8.e047763.6","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1515\/cclm-2020-0398","article-title":"Routine blood tests as a potential diagnostic tool for COVID-19","volume":"58","author":"Ferrari","year":"2020","journal-title":"Clin Chem Lab Med"},{"key":"2024112509061984000_11.8.e047763.7","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1002\/jmv.25727","article-title":"Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis","volume":"92","author":"Li","year":"2020","journal-title":"J Med Virol"},{"key":"2024112509061984000_11.8.e047763.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcv.2020.104455","article-title":"Low performance of rapid antigen detection test as frontline testing for COVID-19 diagnosis","volume":"129","author":"Scohy","year":"2020","journal-title":"J Clin Virol"},{"key":"2024112509061984000_11.8.e047763.9","first-page":"13","article-title":"Diagnostic performance of COVID-19 serology assays","volume":"42","author":"Zainol Rashid","year":"2020","journal-title":"Malays J Pathol"},{"key":"2024112509061984000_11.8.e047763.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104500"},{"key":"2024112509061984000_11.8.e047763.11","doi-asserted-by":"crossref","unstructured":"World Health Organization . Surveillance strategies for COVID-19 human infection. World Health Organization, 2020.","DOI":"10.15557\/PiMR.2020.0006"},{"key":"2024112509061984000_11.8.e047763.12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1159\/000507587","article-title":"Epidemic surveillance of Covid-19: considering uncertainty and Under-Ascertainment","volume":"38","author":"Peixoto","year":"2020","journal-title":"Port J Public Health"},{"key":"2024112509061984000_11.8.e047763.13","unstructured":"Provincial Government of DKI Jakarta . Available: https:\/\/corona.jakarta.go.id\/id\/data-pemantauan [Accessed 8 Aug 2020]."},{"key":"2024112509061984000_11.8.e047763.14","article-title":"Sample Size Calculation Guide - Part 4: How to Calculate the Sample Size for a Diagnostic Test Accuracy Study based on Sensitivity, Specificity, and the Area Under the ROC Curve","volume":"3","author":"Negida","year":"2019","journal-title":"Adv J Emerg Med"},{"key":"2024112509061984000_11.8.e047763.15","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"2024112509061984000_11.8.e047763.16","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"2024112509061984000_11.8.e047763.17","doi-asserted-by":"publisher","DOI":"10.2307\/1268228"},{"key":"2024112509061984000_11.8.e047763.18","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/71.1.1"},{"key":"2024112509061984000_11.8.e047763.19","first-page":"627","article-title":"Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation","volume":"4","author":"Hajian-Tilaki","year":"2013","journal-title":"Caspian J Intern Med"},{"key":"2024112509061984000_11.8.e047763.20","unstructured":"Tenny S , Hoffman M . Prevalence. StatPearls, 2020."},{"key":"2024112509061984000_11.8.e047763.21","unstructured":"Maxim LD , Niebo R , Utell MJ . Screening tests: a review with examples. Inhalation Toxicology 2019."},{"key":"2024112509061984000_11.8.e047763.22","doi-asserted-by":"crossref","unstructured":"Castro R , Luz PM , Wakimoto MD , et al . COVID-19: a meta-analysis of diagnostic test accuracy of commercial assays registered in Brazil. Sociedade Brasileira de Infectologia 2020.","DOI":"10.1016\/j.bjid.2020.04.003"},{"key":"2024112509061984000_11.8.e047763.23","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.ijid.2021.01.016","article-title":"Clinical applications of detecting IgG, IgM or IgA antibody for the diagnosis of COVID-19: a meta-analysis and systematic review","volume":"104","author":"Chen","year":"2021","journal-title":"Int J of Dis"},{"key":"2024112509061984000_11.8.e047763.24","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.3390\/jcm9051515","article-title":"Point-of-Care diagnostic tests for detecting SARS-CoV-2 antibodies: a systematic review and meta-analysis of real-world data","volume":"9","author":"Ricc\u00f2","year":"2020","journal-title":"J Clin Med"},{"key":"2024112509061984000_11.8.e047763.25","unstructured":"Bond K , Nicholson S , Hoang T , et al . Post-market validation of serological assays for COVID-19 2020."},{"key":"2024112509061984000_11.8.e047763.26","unstructured":"Labhouse . COVID-19 IgG\/IgM WB\/S\/P cassette. Available: https:\/\/www.labhouse.id\/products\/detail\/covid_19_igg_igm_wb_s_p_cassette [Accessed 15 Apr 2021]."},{"key":"2024112509061984000_11.8.e047763.27","unstructured":"Serology Test Evaluation Report for \u201cGenBody COVID-19 IgM\/IgG\u201d from GenBody Inc, 2020. Available: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/presentations\/maf\/maf3300-a001.pdf [Accessed 15 Apr 2021]."},{"key":"2024112509061984000_11.8.e047763.28","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0897-1"},{"key":"2024112509061984000_11.8.e047763.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.05.098"},{"key":"2024112509061984000_11.8.e047763.30","doi-asserted-by":"crossref","unstructured":"Corman VM , Haage VC , Bleicker T . Comparison of seven commercial SARS-CoV-2 rapid point-of-care antigen tests 2020.","DOI":"10.1101\/2020.11.12.20230292"},{"key":"2024112509061984000_11.8.e047763.31","first-page":"1754538","article-title":"Evaluation of a COVID-19 IgM and IgG rapid test; an efficient tool for assessment of past exposure to SARS-CoV-2","volume":"10","author":"Hoffman","year":"2020","journal-title":"Infect Ecol Epidemiol"},{"key":"2024112509061984000_11.8.e047763.32","doi-asserted-by":"crossref","first-page":"m2516","DOI":"10.1136\/bmj.m2516","article-title":"Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis","volume":"24","author":"Lisboa Bastos","year":"2020","journal-title":"BMJ"},{"key":"2024112509061984000_11.8.e047763.33","doi-asserted-by":"crossref","first-page":"m1328","DOI":"10.1136\/bmj.m1328","article-title":"Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal","volume":"04","author":"Wynants","year":"2020","journal-title":"BMJ"},{"key":"2024112509061984000_11.8.e047763.34","doi-asserted-by":"crossref","unstructured":"Burhan E , Syam AF , Rahyussalim AJ . The emergence of COVID-19 in Indonesia: analysis of predictors of infection and mortality using independent and clustered data approaches 2020.","DOI":"10.1101\/2020.07.10.20147942"},{"key":"2024112509061984000_11.8.e047763.35","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0916-2"},{"key":"2024112509061984000_11.8.e047763.36","first-page":"100111","article-title":"Testing on the move: South Korea\u2019s rapid response to the COVID-19 pandemic","volume":"5","author":"Lee","year":"2020","journal-title":"Transp Res Interdiscip Perspect"},{"key":"2024112509061984000_11.8.e047763.37","doi-asserted-by":"publisher","DOI":"10.1126\/science.abc0473"},{"key":"2024112509061984000_11.8.e047763.38","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70840-0"},{"key":"2024112509061984000_11.8.e047763.39","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2016.0371"},{"key":"2024112509061984000_11.8.e047763.40","doi-asserted-by":"crossref","first-page":"100801","DOI":"10.1016\/j.eclinm.2021.100801","article-title":"SARS-CoV-2 prevalence associated to low socioeconomic status and overcrowding in an LMIC megacity: a population-based seroepidemiological survey in Lima, Peru","volume":"34","author":"Reyes-Vega","year":"2021","journal-title":"EClinicalMedicine"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-047763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T17:08:50Z","timestamp":1732554530000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-047763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,10]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bmjopen-2020-047763"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-047763","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}