Evaluating the Accuracy Index of Antigen Test Kits (ATK) Compared to Real-time Polymerase Chain Reaction (RT-PCR) Confirmation during COVID-19 Outbreaks in Special Areas: A Study on Diagnostic Accuracy During an Outbreak Investigation
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Abstract
BACKGROUND: In late 2020, antigen test kits (ATKs) were developed for screening Coronavirus disease 2019 (COVID-19) infections with the aim of preliminary screening in both the public and various organizations. Nevertheless, the accuracy indices could vary depending not just on the test kits, but also on the characteristics of the area and the specific population group where these test kits were used.
OBJECTIVES: This study aimed to evaluate the accuracy index of ATK compared to the RT-PCR method for diagnosing COVID-19 infections in special areas during outbreaks.
METHODS: In this cross-sectional study design, the sample group consisted of individuals in a designated prison facility with a COVID-19 outbreak who underwent testing using both ATK and the RT-PCR method to validate the outcomes. The data were analyzed using statistical analysis and the accuracy indices were determined.
RESULTS: In the conducted study, the total population under examination comprised 954 individuals. Among them, 274 ATK results could not be interpreted, and 30 samples could not be confirmed using the RT-PCR method. In one instance; as such, the ATK interpretation and RT-PCR confirmation were not possible. Consequently, a total of 651 results were available for comprehensive analysis. The accuracy indices for ATK were calculated as follows: Sensitivity=83.4% (95%CI, 80.3-86.2), Specificity=100% (95%CI, 82.4-100), Positive Predictive Value=100% (95%CI, 99.3-100), Negative Predictive Value=15.3% (95%CI, 9.48-22.9). The average cycle threshold (Ct) values in the ATK-positive and negative groups were 20.5±3.2 and 22.6±5.6, respectively.
CONCLUSIONS: In contexts closely related to this study, when an ATK test yielded a positive result, it allowed for immediate classification and treatment within the infected group. Thus, the group maintained their isolation from the non-infected population and awaited confirmation through RT-PCR testing. Therefore, strict preventive measures should be practiced to avoid getting infected or spreading the virus further.
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