Improvement of SARS-COV-2 screening using pooled sampling testing in limited RT-qPCR resources

BACKGROUND: COVID-19 is a worldwide pandemic representing the most challenging global health crisis currently. Screening tests availability are a problematic task due to resource-limited abilities of some countries using RT-qPCR technique for SARS−COV-2 detection. OBJECTIVE: To cope with these health emergencies, in particular with this COVID-19 pandemic, states with low molecular diagnostic resources must optimize their capacity in molecular tests. We aimed to design a simple and effective strategy to improve inputs in the RT-qPCR tests as we attempted to check the financial advisability of using such an approach by calculating reduction rate of the test unit cost. METHODS: The used RNA was taken from suspected Covid-19 positive people. Nasopharyngeal swabs were collected at Pasteur Institute Diagnostic Center, Constantine, Algeria, 2020. We have optimized a screening strategy by grouping 16 individuals per pool, without reducing the sensitivity of RT-qPCR. RESULTS: A 1/16 dilution of a positive sample was a practical limit that does not require the use of robotic systems or mathematical modeling to construct the pools. The financial analysis of our strategy has shown that the costs can be reduced to 90 %. The pooled testing strategy that was proven in this study could be recommended to help COVID-19 containment in countries with low potential screening infrastructures using RT-qPCR technique by reducing the number of tests required to identify all positive subjects.