Discussion
throat
DISEASE
We found that the ANS had high accuracy for detection of respiratory viruses by PCR when compared with CTN (positive percentage agreement 96% and negative percentage agreement 99%). When rated by children, parents, and nurses, the ANS revealed high acceptability, with most indicating they would prefer ANS than CTN for future testing.Selection of respiratory sampling methods in children require consideration of comfort, feasibility, diagnostic yield, time taken, and cost. Several avenues exist for respiratory viral testing including nasopharyngeal, nasal, oropharyngeal and saliva specimens. Nasal swab specimens are most frequently used in children and have high positive percentage agreement when compared to more invasive nasopharyngeal swabs [Large-scale testing of symptomatic and asymptomatic patients requires innovation in sampling methods and self-sampling [Methods which allow for self-collection reduce the need for clinician involvement, and associated resource and workforce requirements, personal protective equipment usage and nosocomial exposure risk. Moreover, self-collected samples for respiratory viruses have the advantage of earlier collection timed with the onset of symptoms, which may allow better detection [Although Australian and Victorian guidelines recommend combined anterior nasal and throat swabs for SARS- CoV-2 detection, many international guidelines accept nasal swabs alone for SARS-CoV-2 detection including the US Centers for Disease Control and Prevention [Our novel ANS method has some limitations. First, PCR inhibition occurred in some samples. Whilst inhibition occurs infrequently in PCR testing, the frequency was higher than expected. We suspect the inhibition was likely attributable to the 3-D printing material used in this study for the “small” and “regular” ANS, as this has not been described in other studies using the production version of the adult sized swab [