title: Collection by trained pediatricians or parents of mid-turbinate nasal flocked swabs for the detection of influenza viruses in childhood.
abstract: This study evaluated the efficiency of pediatric mid-turbinate nasal flocked swabs used by parents in 203 children aged 6 months to 5 years with signs and symptoms of respiratory disease. Two nasal samples were collected from each child in a randomised sequence: one by a trained pediatrician and one by a parent. The real-time polymerase chain reaction influenza virus detection rates were similar in the samples collected using the two methods (Cohen's kappa = 0.86), as were the cycle threshold values. In comparison with the pediatrician-collected samples, the sensitivity and specificity of the parental collections were respectively 89.3% (95% confidence interval [CI]: 77.8-100%) and 97.7% (95% CI: 95.5-100%), and the positive and negative predictive values were respectively 86.2% (95% CI: 73.7-95.1%) and 98.2% (95% CI: 96.4-100%). The children were significantly more satisfied with the parental collections (median values +/- standard deviation, 1.59 +/- 0.55 vs 3.51 +/- 0.36; p < 0.0001). These findings show that mid-turbinate nasal flocked swabs specifically designed for infants and children can be used by parents without reducing the influenza virus detection rate. Moreover, the direct involvement of parents significantly increases patient acceptance, thus simplifying collection and suggesting that this novel swab design should be considered for epidemiological surveys and vaccine efficacy studies.
authors.affiliation: Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Claudio G
authors.initials: CG
authors.lastname: Molteni
authors.forename: Cristina
authors.initials: C
authors.lastname: Daleno
authors.forename: Antonia
authors.initials: A
authors.lastname: Valzano
authors.forename: Claudia
authors.initials: C
authors.lastname: Tagliabue
authors.forename: Carlotta
authors.initials: C
authors.lastname: Galeone
authors.forename: Gregorio
authors.initials: G
authors.lastname: Milani
authors.forename: Emilio
authors.initials: E
authors.lastname: Fossali
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000175:diagnosis* / Q000821:virology*; D009297:Nasal Mucosa / Q000821:virology*; D009975:Orthomyxoviridae / Q000302:isolation & purification*; D010290:Parents; D010820:Physicians; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D014420:Turbinates / Q000821:virology*; D014773:Virology / Q000379:methods*