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. 2023 Jul;113(7):768-777.
doi: 10.2105/AJPH.2023.307303. Epub 2023 May 18.

Stratified Simple Random Sampling Versus Volunteer Community-Wide Sampling for Estimates of COVID-19 Prevalence

Rachel J Keith  1 , Rochelle H Holm  1 , Alok R Amraotkar  1 , Megan M Bezold  1 , J Michael Brick  1 , Adrienne M Bushau-Sprinkle  1 , Krystal T Hamorsky  1 , Kathleen T Kitterman  1 , Kenneth E Palmer  1 , Ted Smith  1 , Ray Yeager  1 , Aruni Bhatnagar  1
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Stratified Simple Random Sampling Versus Volunteer Community-Wide Sampling for Estimates of COVID-19 Prevalence

Rachel J Keith et al. Am J Public Health. 2023 Jul.

Abstract

Objectives. To evaluate community-wide prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using stratified simple random sampling. Methods. We obtained data for the prevalence of SARS-CoV-2 in Jefferson County, Kentucky, from adult random (n = 7296) and volunteer (n = 7919) sampling over 8 waves from June 2020 through August 2021. We compared results with administratively reported rates of COVID-19. Results. Randomized and volunteer samples produced equivalent prevalence estimates (P < .001), which exceeded the administratively reported rates of prevalence. Differences between them decreased as time passed, likely because of seroprevalence temporal detection limitations. Conclusions. Structured targeted sampling for seropositivity against SARS-CoV-2, randomized or voluntary, provided better estimates of prevalence than administrative estimates based on incident disease. A low response rate to stratified simple random sampling may produce quantified disease prevalence estimates similar to a volunteer sample. Public Health Implications. Randomized targeted and invited sampling approaches provided better estimates of disease prevalence than administratively reported data. Cost and time permitting, targeted sampling is a superior modality for estimating community-wide prevalence of infectious disease, especially among Black individuals and those living in disadvantaged neighborhoods. (Am J Public Health. 2023;113(7):768-777. https://doi.org/10.2105/AJPH.2023.307303).

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Figures

FIGURE 1—
FIGURE 1—
Sampling Zones and Demographic Characteristics Within Jefferson County, KY
FIGURE 2—
FIGURE 2—
Prevalence Estimates for Probability and Volunteer Participants Who Tested Positive for SARS-CoV-2 Infections for (a) Waves 1–4 and (b) Waves 5–8: Jefferson County, KY, June 2020‒August 2021 Note. IgG = immunoglobulin G; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2. Vertical lines represent 95% confidence intervals. Waves 1–4 in panel a present participants positive for SARS-CoV-2 spike (S) protein‒specific IgG antibodies. Waves 5–8 in panel b present unvaccinated participants positive for SARS-CoV-2 S protein‒specific IgG antibodies and vaccinated participants positive for SARS-CoV-2 nucleocapsid (N)‒specific IgG antibodies and absence of any self-reported previous infection or related symptoms before sampling.
FIGURE 3—
FIGURE 3—
Prevalence Estimates for a Composite of Probability and Volunteer Participants Who Tested Positive for SARS-CoV-2 Infections and Administratively Reported Official Rates by Geographic Zones for (a) Waves 1–4 and (b) Waves 5–8: Jefferson County, KY, June 2020‒August 2021 Note. IgG = immunoglobulin G; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2. Administratively reported data are from the Jefferson County health authority, Louisville Metro Public Health and Wellness. Vertical lines represent 95% confidence intervals. Waves 1–4 in panel a present participants positive for SARS-CoV-2 spike (S) protein‒specific IgG antibodies and administratively reported official rates. Waves 5–8 in panel b present unvaccinated participants positive for SARS-CoV-2 spike (S) protein‒specific IgG antibodies and vaccinated participants positive for SARS-CoV-2 nucleocapsid (N)‒specific IgG antibodies and absence of any self-reported previous infection or related symptoms before sampling and administratively reported official rates.
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References

    1. Snow J. Mode of Communication of Cholera. 2nd ed. London, England: John Churchill; 1855.
    1. Hultsch DF, MacDonald SW, Hunter MA, Maitland SB, Dixon RA. Sampling and generalisability in developmental research: comparison of random and convenience samples of older adults. Int J Behav Dev. 2002;26(4):345–359. doi: 10.1080/01650250143000247. - DOI
    1. Kelly H, Riddell MA, Gidding HF, Nolan T, Gilbert GL. A random cluster survey and a convenience sample give comparable estimates of immunity to vaccine preventable diseases in children of school age in Victoria, Australia. Vaccine. 2002;20(25–26):3130–3136. doi: 10.1016/S0264-410X(02)00255-4. - DOI - PubMed
    1. Emborg HD, Simonsen J, Jørgensen CS, et al. Seroincidence of non-typhoid Salmonella infections: convenience vs. random community-based sampling. Epidemiol Infect. 2016;144(2):257–264. doi: 10.1017/S0950268815001417. - DOI - PubMed
    1. Cheung KL, Peter M, Smit C, de Vries H, Pieterse ME. The impact of non-response bias due to sampling in public health studies: a comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health. BMC Public Health. 2017;17(1):276. doi: 10.1186/s12889-017-4189-8. - DOI - PMC - PubMed

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