Usage of Diagnosis and Screening Tests in New Coronavirus Disease (Covıd-19)

Yıl 2023, Cilt: 32 Sayı: 4, 189 - 199, 31.12.2023

Kübra Doğanay Bulduk , Meltem Çöl

https://doi.org/10.17827/aktd.1226153

Öz

In the fight against COVID-19; It is extremely important to detect and subsequently isolate people infected with the disease. For this purpose, the diagnostic tests used around the world differ in terms of diversity and application criteria. In this review, from a public health perspective; The tests used for the diagnosis of COVID-19, for whom and how they are used, as well as approaches to test use are discussed. Polymerase chain reaction (PCR) based tests are considered the gold standard due to their high sensitivity and specificity. Although comparisons are made for different sampling methods, the general view is in the direction of nasopharyngeal swab. Although it is accepted as the gold standard diagnostic method, it has some disadvantages. The most important thing is that it takes a long time to result and high cost. In order to reduce the cost, it may be preferable to evaluate several samples as a single sample, that is, to pool them. As an alternative to these disadvantages, rapid antigen tests can be considered. There are many different market forms of rapid antigen tests. There are many studies on the specificity and sensitivity of these tests and there are different values. In general, it has been determined that their specificity is high and their sensitivity is lower. Community screening may be a solution for the difficulty of symptomatic diagnosis of the disease and the problems that some people do not show symptoms even though they are contagious. With the emergence of new variants, changes in testing policies and different approaches have been observed around the world. Efforts were made to make the tests available to the general public or for community screening in order to conduct more comprehensive screening. However, due to the increasing PCR test load, testing policies such as limiting the people to be tested or the additional use of alternative test methods such as rapid antigen tests had to be implemented in some countries.

Anahtar Kelimeler

COVID-19 testi, Tanısal Testler, Kitle taraması, COVID-19 testing, Diagnostic tests, Mass screening

Yeni Koronavirüs Hastalığında (Covid-19) Tanı Ve Tarama Testlerinin Kullanımı

Öz

COVID-19 ile mücadelede; hastalıkla enfekte olmuş kişilerin tespiti ve sonrasında izole edilmesi son derece önemlidir. Bu amaçla dünya genelinde kullanılan tanı testleri, çeşitlilik ve uygulama kriterleri açısından farklılık göstermektedir. Bu derlemede halk sağlığı bakış açısıyla; COVID-19 tanısı için kullanılan testler ile kimlere yönelik ve nasıl kullanıldığının yanısıra test kullanımı konusundaki yaklaşımlar ele alınmıştır. Polimeraz zincir reaksiyonu (PCR) tabanlı testler, yüksek duyarlılık ve özgüllük değerleri dolayısıyla altın standart olarak kabul edilmektedir. Farklı örnek alma yöntemlerine yönelik karşılaştırmalar yapılmakla birlikte genel görüş, nazofaringeal sürüntü yönündedir. Altın standart tanı yöntemi olarak kabul edilmesine karşın bazı dezavantajları vardır. En önemlisi sonuçlanmasının uzun sürmesi ve yüksek maliyettir. Maliyeti azaltmak için birkaç örneğin tek bir örnek gibi değerlendirilmesi yani havuzlandırılması tercih edilebilir. Bu dezavantajlara alternatif olarak hızlı antijen testleri göz önünde bulundurulabilir. Hızlı antijen testlerinin pek çok farklı piyasa formu vardır. Bu testlerin özgüllükleri ve duyarlılıklarına yönelik pek çok çalışma yapılmakta olup farklı değerler bulunmaktadır. Genel olarak özgüllüklerinin yüksek ve duyarlılığının ise daha düşük olduğu tespit edilmiştir. Hastalığın semptomatik tanısının zorluğu, bazı kişilerin hastalığı bulaştırmasına karşın semptom göstermemesi sorunları için toplum taramaları çözüm yolu olabilir. Yeni varyantların ortaya çıkması ile dünya genelinde test politikalarında değişiklikler ve farklı yaklaşımlar gözlenmiştir. Daha geniş kapsamlı tarama yapmak amacıyla testlerin tüm halka açık hale getirilmesi veya toplum taramaları yönünde çalışmalar gerçekleştirilmiştir. Ancak artan PCR test yükü dolayısıyla bazı ülkelerde test yapılacak kişilerin kısıtlanması veya hızlı antijen testleri gibi alternatif test yöntemlerinin ek olarak kullanılması gibi test politikalarının uygulanması gerekmiştir.

Anahtar Kelimeler

COVID-19 testi, Tanısal Testler, Kitle taraması, COVID-19 testing, Diagnostic tests, Mass screening

Kaynakça

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