Evidence map›Paper›PMID 39732649›Full record

Trial reportBMC infectious diseases2024

Four COVID-19 screening strategies for early case identification within the homeless shelter population: a cluster randomized controlled trial.

Vaibhav Mokashi, Jodi Gilchrist, Nicole Smieja, Julia Maciejewski, Sarah Marttala, Kerry Beal, Lawrence Mbuagbaw, David Bulir, Marek Smieja, Tim O'Shea

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04438070 (COVID Screening Strategies in Homeless Shelters), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04438070 naunknown statusnot on this map

COVID Screening Strategies in Homeless Shelters

TypeinterventionalSponsorSt. Joseph's Healthcare HamiltonRan2020 to 2020Enrolled400ConditionsCOVID-19ArmsCOVID-19 Swab
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Vaibhav MokashiDepartment of Medicine, McMaster University, Hamilton, ON, Canada.ORCID http://orcid.org/0000-0002-3775-9745
Jodi GilchristThe Research Institute of St. Joseph's Hamilton, Hamilton, ON, Canada.ORCID http://orcid.org/0000-0002-2965-9007
Nicole SmiejaThe Research Institute of St. Joseph's Hamilton, Hamilton, ON, Canada.
Julia MaciejewskiThe Research Institute of St. Joseph's Hamilton, Hamilton, ON, Canada.ORCID http://orcid.org/0009-0006-2838-081X
Sarah MarttalaThe Research Institute of St. Joseph's Hamilton, Hamilton, ON, Canada.
Kerry BealShelter Health Network, Hamilton, ON, Canada.
Lawrence MbuagbawDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.ORCID http://orcid.org/0000-0001-5855-5461
David BulirDepartment of Chemical Engineering, McMaster University, Hamilton, ON, Canada.
Marek SmiejaDepartment of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-1655-3761
Tim O'SheaDepartment of Medicine, McMaster University, Hamilton, ON, Canada. osheat@mcmaster.ca.ORCID http://orcid.org/0000-0002-0793-6915

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare the effectiveness of four surveillance strategies for detecting SARS-CoV-2 within the homeless shelter population in Hamilton, ON and assess participant adherence over time for each surveillance method.

methodsThis was an open-label, cluster-randomized controlled trial conducted in eleven homeless shelters in Hamilton, Ontario, from April 2020 to January 2021. All participants who consented to the study and participated in the surveillance were eligible for testing by self-swabbing. SARS-CoV-2 detection rate as the primary outcome, number of outbreaks, adherence, and overall acceptability were assessed. All participants, which included staff and residents, underwent daily symptom surveillance conducted by shelter staff and shelters were allocated to one of three asymptomatic surveillance arms (once weekly, self-collected oral swabs (OS); once-weekly self-collected oral-nasal swab (ONS); or once-weekly nurse collected nasopharyngeal swab (NPS) or a symptomatic only SARS-CoV-2 testing arm.

resultsA total of 9747 SARS-CoV-2 tests were performed on 1570 participants. There were 4527 participants allocated to oral swab collection and 4935 participants allocated to oral-nasal swab collection. For nasopharyngeal swab collection, 285 participants were assigned before this arm was discontinued. The OS group identified 5 new cases (1.1 per 1000; 95% CI 0.4-2.3), while the ONS group identified 15 new cases (3.0 per 1000; 95% CI 1.9-4.7), resulting in a Risk Ratio (RR) of 2.76 (95% CI 1.00-7.58; p = 0.040). However, the mixed-effect model did not show a significantly higher positivity rate in the ONS compared to OS (OR 1.64; 95% CI 0.76-9.14; p = 0.129). Both ONS and OS were preferred over NPS, which did not detect any cases due to low adherence. Three outbreaks were identified during the study period within the shelters, two of the outbreaks had 2 positive cases each and the third outbreak had 3 positive cases.

conclusionsThe two self-collection strategies were superior and showed the best adherence, with the ONS strategy shown to be superior or non-inferior in all measures. We are now studying the operationalization of a large-scale self-collected ONS surveillance strategy in a prospective cohort study of multiple homeless shelters. Funding was provided by the Hamilton Academic Hospital Organization (HAHSO) and Research St. Joseph's - Hamilton.

trial registrationThe trial was retrospectively registered with ClinicalTrials.gov on June 18, 2020, with the identifier NCT04438070.

Indexed as

COVID-19Ill-Housed PersonsMass ScreeningSARS-CoV-2AdultCOVID-19 TestingFemaleHumansMaleMiddle AgedOntarioSpecimen HandlingCoronavirusCOVID-19HomelessPCR testingShelterSurveillance

Identifiers

PMID39732649
PMCPMC11682648

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.