The feasibility and performance of participant-collected mid-turbinate nasal swabs for detection of influenza virus, respiratory syncytial virus, and human metapneumovirus infections among pregnant women.

Background We assessed performance of participant-collected mid-turbinate nasal swabs compared to study staff-collected mid-turbinate nasal swabs for the detection of respiratory viruses among pregnant women in Bangkok, Thailand. Methods We enrolled pregnant women aged ≥18 years and followed them throughout the 2018 influenza season. Women with acute respiratory illness (ARI) self-collected mid-turbinate nasal swabs at homes for influenza viruses, RSV, and hMPV real-time RT-PCR testing while the study nurse collected a second mid-turbinate nasal swab during home visits. Paired specimens were processed and tested on the same day. Results The majority (109, 60%) of 182 participants were 20-30 years old. All 200 paired swabs had optimal specimen quality. The median time from symptom onsets to participant-collected swabs was two days and to staff-collected swabs was also two days. The median time difference between the two swabs was two hours. Compared to staff-collected swabs, the participant-collected swabs were 93% sensitive and 99% specific for influenza virus detection, 94% sensitive and 99% specific for RSV detection, and 100% sensitive and 100% specific for hMPV detection. Conclusions Participant-collected mid-turbinate nasal swabs were a valid alternative approach for laboratory confirmation of influenza-, RSV-, and hMPV-associated illnesses among pregnant women in a community setting.