Observational studyJournal of global health2025
Validation of polyester nasal swabs for post-mortem SARS-CoV-2 diagnosis in Karachi, Pakistan: a prospective surveillance analysis.
Observational study in Journal of global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Background: The COVID-19 pandemic has significantly impacted global health, with low- and middle-income countries (LMICs) facing unique healthcare challenges. Polyester nasal swabs stored in dry tubes have emerged as a cost-effective and scalable method for routine testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to assess the prevalence of SARS-CoV-2 among deceased individuals in an urban slum in Karachi, Pakistan, using dry and wet polyester nasal swabs, and to validate their use for post-mortem detection of the virus. Methods: We conducted a prospective observational study from July 2022 to August 2023 in a low-income setting. We collected nasal samples from 350 deceased individuals based on community death alerts using dry polyester and wet swabs with transport media. These were then processed for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR), with the positive samples sequenced on the Illumina platform to identify circulating variants. We also performed a comparative analysis between dry and wet swab methods for diagnostic performance. Results: Of the 350 samples, 21 (6.0%) tested positive for SARS-CoV-2. Males accounted for 15/21 (71.4%) of positive cases, with the majority aged 60 and above (n/N = 12/21, 57.1%). The Omicron (22F) variant was the most prevalent, detected in 16/21 (76%) cases. The diagnostic performance of wet swabs showed a sensitivity of 76.19%, while dry swabs were more accurate, with a sensitivity of 90.48%, achieving a diagnostic odds ratio of 3120.5. Conclusions: Our study demonstrated the feasibility and effectiveness of using dry polyester nasal swabs for post-mortem detection of SARS-CoV-2 in resource-constrained settings. These findings emphasise the method's potential for monitoring respiratory infectious diseases and guiding public health strategies in LMICs.
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