Gallardo-Alfaro, LauraLorente Montalvo, PatriciaCañellas, Margarita ACarandell Jöger, EugeniaOliver, AntonioRojo Molinero, EstrellaRiera, BeatrizLlobera Cánaves, JoanBulilete, OanaLeiva Rus, AlfonsoObieta, AnaidaPascual, VictoriaPericàs Pulido, PauRaduán de Páramo, CarlosSegura, ElsaVega, VerónicaBalearic COVID-19 Pediatric Primary Care Research Group2024-10-092024-10-092023-08-29Gallardo-Alfaro L, Lorente-Montalvo P, Cañellas M, Carandell E, Oliver A, Rojo E, et al. Diagnostic accuracy of PanbioTM rapid antigen test for SARS-CoV-2 in paediatric population. BMC Pediatrics. 2023 Aug 29;23(1):433.1471-2431https://hdl.handle.net/20.500.13003/19328https://hdl.handle.net/20.500.12105/23632Background: 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.enghttp://creativecommons.org/licenses/by/4.0/COVID-19Rapid antigen testSARS-CoV-2Primary carePaediatricAdolescentCOVID-19 TestingCOVID-19ChildChild, PreschoolCoughFemaleFeverHumansMaleProspective StudiesSARS-CoV-2research articleAtribución 4.0 Internacional376443892343310.1186/s12887-023-04201-zBMC Pediatricsopen accessAdolescentePrueba de COVID-19COVID-19NiñoNiño preescolarTosFemeninoFiebrerSeres humanosMasculinoEstudios ProspectivosSARS-CoV-2