Diagnostic accuracy of a molecular-based point-of-care test for rapid detection of respiratory syncytial virus in children admitted to high-dependency care in Nepal.

Authors

Arun Kumar Sharma, Hari Prasad Kattel, Ram Hari Chapagain, Rupesh Shrestha, Prakash Joshi, Naresh Bahadur Khadka, Sangita Sharma, Yvette Löwensteyn, Neele Rave, Mattheus Cornelis Viveen, Louis Bont

Published in

Journal of global health. Volume 16. Pages 04191. Aug 28, 2026. Epub Aug 28, 2026.

Abstract

Rapid respiratory syncytial virus (RSV) diagnostics are largely unavailable in low-resource settings. We compared the diagnostic accuracy of a molecular-based point-of-care test (POCT) with standard reverse transcription polymerase chain reaction (RT-PCR) in children admitted to high-dependency care.
We analysed data from a larger study (RSV GOLD - ICU Network study) in two Nepali tertiary hospitals over two respiratory seasons. Children aged ≥4 days and <2 years admitted to high-dependency units were tested for RSV using POCT at admission. We calculated sensitivity, specificity, and predictive values of POCT against laboratory RT-PCR on stored samples as the gold standard.
We analysed 124 randomly selected stored samples, of whom 70 (56.5%) tested positive with POCT and 74 (59.7%) with RT-PCR. The median cycle threshold (CT) value was 29.1 (interquartile range = 25.1-33.4). All cases with false-negative POCT had low viral loads (CT value >31). The sensitivity (93.2%; 95% confidence interval (CI) = 86.0, 97.5), specificity (98.0%; 95% CI = 91.5, 99.9), positive predictive values (98.6%; 95% CI = 93.9, 99.9), and negative predictive values (90.7%; 95% CI = 81.1, 96.6) of POCT for RSV infection were all satisfactory.
We conducted the first prospective study showing excellent accuracy of molecular RSV POCT in a poor resource setting. Affordable molecular-based POCT in resource-constrained settings can improve care of children with acute respiratory infections and strengthen surveillance for vaccine effectiveness during rollout of RSV interventions.

PMID:
42659033
Bibliographic data and abstract were imported from PubMed on 28 Aug 2026.

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