ArticleEpidemics2022
Symptom-based vs asymptomatic testing for controlling SARS-CoV-2 transmission in low- and middle-income countries: A modelling analysis.
Article in Epidemics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- A systematic literature review on public health and healthcare resources for pandemic preparedness planning.BMC public health · 2024Pooled it
- Selective Wettability-Driven Evaporation-Enhanced Redox Cycling for Robust and Ultrasensitive Detection of Viral Particles.Small methods · 2026Article
- Diagnostic Concordance of Two- and Three-Gene SARS-CoV-2 Molecular Assays in Cameroon: Implications for Efficient Pandemic Response in Low- and Middle-Income Countries.Journal of clinical laboratory analysis · 2026Article
- The Role of Mathematical Modelling in Predicting and Controlling Infectious Disease Outbreaks in Underserved Settings: A Systematic Review and Meta-Analysis.Public health challenges · 2025Review
- Comparative analysis of frequentist, Bayesian, and machine learning models for predicting SARS-CoV-2 PCR positivity.Frontiers in artificial intelligence · 2025Article
- Optimization of Screening Strategies for COVID-19: Scoping Review.JMIR public health and surveillance · 2024Article
- Epidemic Management via Imperfect Testing: A Multi-criterial Perspective.Bulletin of mathematical biology · 2023Article
- Validation of a MALDI-TOF MS Method for SARS-CoV-2 Detection on the Bruker Biotyper and Nasopharyngeal Swabs: A Brazil-UK Collaborative Study.Diagnostics (Basel, Switzerland) · 2023Article
- Adaptive strategies for the deployment of rapid diagnostic tests for COVID-19: a modelling study.Gates open research · 2023Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnostic testing plays a critical role in the global COVID-19 response. Polymerase chain reaction (PCR) tests are highly accurate, but in resource-limited settings, limited capacity has led to testing delays; whereas lateral flow assays (LFAs) offer opportunities for rapid and affordable testing. We examined the potential epidemiological impact of different strategies for LFA deployment.
methodsWe developed a deterministic compartmental model of SARS-CoV-2 transmission, parameterised to resemble a large Indian city. We assumed that PCR would be used to test symptomatic individuals presenting to outpatient settings for care. We examined how the second epidemic wave in India could have been mitigated by LFA deployment in its early stages by comparing two strategies: (i) community-based screening, using LFAs to test a proportion of the population, irrespective of symptoms (in addition to symptom-driven PCR), and (ii) symptom-driven outpatient testing, using LFAs to replace PCR.
resultsModel projections suggest that a stock of 25 million LFAs, used over a 600-day period in a city of 20 million people, would reduce the cumulative symptomatic incidence of COVID-19 by 0.44% if used for community-based screening, and by 13% if used to test symptomatic outpatients, relative to a no-LFA, PCR-only scenario. Sensitivity analysis suggests that outpatient testing would be more efficient in reducing transmission than community-based screening, when at least 5% of people with symptomatic COVID-19 seek care, and at least 10% of SARS-CoV-2 infections develop symptoms. Under both strategies, however, 2% of the population would be unnecessarily isolated.
interpretationIn this emblematic setting, LFAs would reduce transmission most efficiently when used to test symptomatic individuals in outpatient settings. To avoid large numbers of unnecessary isolations, mass testing with LFAs should be considered as a screening tool, with follow-up confirmation. Future work should address strategies for targeted community-based LFA testing, such as contact tracing.
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