REACT-2.4: Usability and validity of LFIA self-testing in key workers

This study assesses whether LFIAs should be used as a self-administered test among key workers or whether better performance is obtained if they attend a central clinic facility, e.g. for blood draw


Keywords: SARS-CoV-2; COVID-19; virus; point-of-care diagnostics

Q&A with the REACT team: REACT researchers Dr Atchison and Prof Barclay host a public Q&A session on antibody testing.

Short of a vaccine, testing is the only way out of lockdown.

Prof ara darzi

Description of the Study:

  • Title: REACT-2: a study of SARS-CoV-2 antibody seroprevalence in the community in England.
    – Study 4: Usability and validity of LFIA self-testing in key workers, including the assessment of dry blood spots for SARS-CoV-2 antibody detection and saliva for SARS-CoV-2 viral detection
  • Principal Investigators: Steven Riley, Christina Atchison, Deborah Ashby, Christl A. Donnelly, Wendy Barclay, Graham Cooke, Helen Ward, Ara Darzi and Paul Elliott.
  • Centers of Implementation: Imperial College London, Imperial College Healthcare NHS Trust and Ipsos MORI.
  • Study Population: Up to 5,500 key workers aged 18 years and above.
    – Inclusion criteria: Adult ≥ 18 years old.
    – Exclusion criteria: Individuals with a medical condition (or are taking medication) that might increase bleeding risk from self-delivered finger prick with a lancet.
  • Study Type: A cross-sectional study.
  • Methods: LFIA performance, acceptability and usability among key workers are assessed with finger-prick self-testing, finger-prick healthcare professional-administered testing and plasma in the laboratory.

Objectives of the Study:

Principal Objective: To assess accuracy, acceptability, usability and feasibility of self- and healthcare professional administered LFIA among key workers.

Secondary Objective: To assess the use of dry blood spots as an alternative means of testing antibody response and use of a saliva sample compared with a throat and nose swab for RT-PCR testing.

More about this Study:

Conclusions: The REACT-2 results and statistics can be found on this page.

Added value: REACT-2 is a series of five sub-studies towards establishing the seroprevalence of antibodies to SARS-CoV-2 in England as an indicator of historical infection. The main study (study 5) uses the same design and sampling approach as REACT-1 using a self-administered lateral flow immunoassay (LFIA) test for IgG antibodies in repeated samples of 100,000 to 200,000 adults aged 18 years and above. To inform study 5, studies 1-4 evaluate performance characteristics of SARS-CoV-2 LFIAs (study 1) and different aspects of feasibility, usability and application of LFIAs for home-based testing in different populations (studies 2-4).

REACT: The REal-time Assessment of Community Transmission (REACT) programme is a series of epidemiological studies that are seeking to improve understanding of how the COVID-19 pandemic is progressing across England. To do this, the programme is carrying out two major pieces of work that are looking at the possibility of using home sampling and testing to track the infection. REACT-1 programme is monitoring coronavirus infection levels over time, while REACT-2 programme is assessing antibody finger-prick tests and using these to estimate how far the virus has spread.

Together REACT-1 and REACT-2 will improve our understanding of the transmission of the virus in the community to help guide policies on continued social distancing and other control measures.

Other studies of REACT: « A study of SARS-CoV-2 virus prevalence in the community in England« , « Clinical and laboratory evaluation of SARS-CoV-2 lateral flow immunoassays« , “Public involvement and pilot testing to assess the feasibility of in-home self-testing for SARS-CoV-2 antibodies” and « Acceptability and usability study of in-home self-testing for SARS-CoV-2 antibodies in a population-based sample ».

Study about COVID-19 supported by Imperial College London
Study about COVID-19 supported by Imperial College Healthcare
Study about COVID-19 supported by Ipsos



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