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. 2023 Aug 29;23(1):433.
doi: 10.1186/s12887-023-04201-z.

Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population

Laura Gallardo-Alfaro #  1   2   3 , Patricia Lorente-Montalvo #  4   5   6 , Margarita Cañellas  7 , Eugenia Carandell  2   3   8 , Antonio Oliver  2   9 , Estrella Rojo  2   9 , Beatriz Riera  7 , Joan Llobera  1   2   3 , Oana Bulilete  1   2   3 ; Balearic COVID-19 Pediatric Primary Care Research Group
Collaborators, Affiliations

Diagnostic accuracy of Panbio™ rapid antigen test for SARS-CoV-2 in paediatric population

Laura Gallardo-Alfaro et al. BMC Pediatr. .

Abstract

Background: Rapid antigen-detection tests (Ag-RDTs) are used to diagnose SARS-CoV-2 infection. Real-world studies of Ag-RDTs are necessary to evaluate their diagnostic yield in paediatric patients. Our aim was to evaluate the accuracy of the Panbio™ Rapid Antigen Test for SARS-CoV-2 in the setting of a primary health care centre (PHC), with use of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) as gold standard.

Methods: This prospective diagnostic study was conducted at PHCs in Mallorca, Spain. Patients were ≤ 18 years-old that attended sites for RT-PCR testing due to symptoms suggestive of infection (fever, headache, nasal congestion and dry cough, among others) or epidemiological exposure (close contacts). Two samples were collected: a nasal mid-turbinate sample for Ag-RDTs and a nasopharyngeal swab for RT-PCR testing. The sensitivity, specificity, and predictive values of the AgRDT were calculated using the RT-PCR results as the reference.

Results: We examined 1142 participants from 0 to 18 years (47.5% female, mean age 8.9 ± 4.8 years, median 9.0 [5.0-13.0]). There were 84 positive RT-PCR results (pre-test probability of 7.3%) and 52 positive Ag-RDT results. The sensitivity of the Ag-RDT was 59.5% (95% Confidence Interval (CI): 48.2-69.9%), the specificity was 99.8% (95%CI: 99.2-99.9%), the positive predictive value was 96.1% (95%CI: 85.6-99.4%), and the negative predictive value was 96.8% (95%CI: 95.6-97.7%). The sensitivity for individuals referred by a general practitioner (GP) or paediatrician due to symptoms was 71.4% (95%CI: 51.5-86.0%) and for asymptomatic individuals was 50.0% (95%CI: 9.1-90.8%). The specificity was greater than 98.9% overall and in all subgroups. The sensitivity was 73.0% (95%CI: 52.0-87.5%) for referred patients due to symptoms and who were tested within 5 days since symptom onset. No significant statistical differences between any groups were found. There were 34 false-negative Ag-RDT results (40.5%) and 2 false-positive Ag-RDT results (0.2%).

Conclusion: The sensitivity of the Panbio™ Test in paediatric individuals is below the minimum of 80% recommended by the World Health Organization for Ag-RDTs. This test had better accuracy in individuals referred by a GP or paediatrician due to symptoms, rather than those who were asymptomatic or referred due to epidemiological exposure. The RT-PCR test using a nasopharyngeal swab is accurate, but a less invasive alternative that has better sensitivity than the Panbio™ Test is needed for paediatric populations.

Keywords: COVID-19; Paediatric; Primary care; Rapid antigen test; SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Enrolment and clinical characteristics of children who received RT-PCR testing and the Panbio™ Test
Fig. 2
Fig. 2
Sensitivity of the Panbio™ Test in our paediatric population with different clinical status and N gene viral load
See this image and copyright information in PMC

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