Field Performance of the QuickVue Flu A+B Rapid Test in Nicaragua

Session III – Gordon, Aubree – Young Investigator and Poster Only, Abstract 2 of 2

Title of Contribution: Field Performance of the QuickVue Flu A+B Rapid Test in Nicaragua
Author(s): Aubree Gordon1, Elsa Videa2, Saira Saborio3, Guiermina Kuan4, Angel Balmaseda3, Eva Harris5
Affiliation(s): 1Division of Epidemiology, School of Public Health, University of California, Berkeley, California; 2Sustainable Sciences Institute, Managua, Nicaragua; 3Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua;4Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua; 5Division of Infectious Diseases, School of Public Health, University of California, Berkeley, California


Abstract:
Rapid influenza tests are being used increasingly throughout the world as a component of influenza surveillance systems. The most commonly used test in Latin America is the QuickVue Influenza A+B test (Quidel Corporation, San Diego, CA).  Use of this test in a developing country primary care facility where laboratory clinicians commonly have no previous experience in collecting respiratory samples and water and electricity service is sporadic has not been evaluated.  To assess the performance of the QuickVue test in such a primary healthcare setting, we performed a study comparing the rapid test to reverse transcriptase-polymerase chain reaction (RT-PCR) in Managua, Nicaragua. This study was performed as a part of the Nicaraguan Influenza Cohort Study, which prospectively follows children 2 to 12 years old for influenza-like-illness.  Test performance was examined by influenza type, subtype, day of presentation, and patient symptom status.  In total, 1,215 nasal swab samples were collected and tested from children aged 2 to 12 presenting with a history of fever and cough and/or sore throat.  For all influenza types and patients, test sensitivity was 64.7% (59.1%, 69.9%); specificity was 96% (94.5%, 97.2%); positive predictive value (PPV) was 85.1% (79.9%, 89.3%); and negative predictive value (NPV) was 88.5% (86.3%, 90.4%).  Restricting the analysis to patients presenting within three days and/or to patients presenting with a fever of ≥37.8°C with cough and/or sore throat resulted in higher sensitivity, specificity, PPV, and NPV. Test performance was higher for samples positive for influenza A as compared to those positive for influenza B. Overall, we found that the QuickVue test was easy to use and useful as an influenza diagnostic test and surveillance tool in a resource-limited setting.