Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe
Open Access
- 4 May 2022
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Molecular Diagnostics
- Vol. 22 (5), 519-535
- https://doi.org/10.1080/14737159.2022.2094250
Abstract
Symptomatic testing and asymptomatic screening for SARS-CoV-2 continue to be essential tools for mitigating virus transmission. Though COVID-19 diagnostics initially defaulted to oropharyngeal or nasopharyngeal sampling, the worldwide urgency to expand testing efforts spurred innovative approaches and increased diversity of detection methods. Strengthening innovation and facilitating widespread testing remains critical for global health, especially as additional variants emerge and other mitigation strategies are recalibrated. A growing body of evidence reflects the need to expand testing efforts and further investigate the efficiency, sensitivity, and acceptability of saliva samples for SARS-CoV-2 detection. Countries have made pandemic response decisions based on resources, costs, procedures, and regional acceptability – the adoption and integration of saliva-based testing among them. Saliva has demonstrated high sensitivity and specificity while being less invasive relative to nasopharyngeal swabs, securing saliva’s position as a more acceptable sample type. Despite the accessibility and utility of saliva sampling, global implementation remains low compared to swab-based approaches. In some cases, countries have validated saliva-based methods but face challenges with testing implementation or expansion. Here, we review the localities that have demonstrated success with saliva-based SARS-CoV-2 testing approaches and can serve as models for transforming concepts into globally-implemented best practices.Keywords
Funding Information
- Rockefeller Foundation (2021 COV 006 PC)
This publication has 144 references indexed in Scilit:
- Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity studyClinical Microbiology & Infection, 2018
- Detection of Leishmania DNA in saliva among patients with HIV/AIDS in Trang Province, southern ThailandActa Tropica, 2018
- Detection of Plasmodium falciparum DNA in saliva samples stored at room temperature: potential for a non-invasive saliva-based diagnostic test for malariaMalaria Journal, 2017
- Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, UgandaPLOS ONE, 2017
- Detection of chikungunya virus in saliva and urine.Virology Journal, 2016
- Detection of Zika virus in salivaJournal of Clinical Virology, 2015
- Quantitative detection of Pf HRP2 in saliva of malaria patients in the PhilippinesMalaria Journal, 2012
- Saliva-Based HIV Testing among Secondary School Students in Tanzania using the OraQuick(R) Rapid HIV1/2 Antibody AssayAnnals of the New York Academy of Sciences, 2007
- Human Saliva as a Diagnostic SpecimenJournal of Nutrition, 2001
- Comparison of testing saliva and serum for detection of antibody to human immunodeficiency virus in Jamaica, West IndiesJournal of Clinical Virology, 2000