SARS-CoV-2 saliva testing using RT-PCR: a systematic review.

OBJECTIVES: There remain challenges in using SARS-CoV-2 RNA diagnostic assays in the respiratory tract in a pandemic. More so certain countries such as Hong Kong have already included saliva as part of their mass-testing protocol. The aim of this study was to conduct a systematic review on the alternate use of saliva as a SARS-CoV-2 RNA testing specimen in the context of mass screening with reverse transcription polymerase chain reaction. METHODS: Our search methodology was modeled after the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, and the risk of bias of the selected studies was qualitatively assessed. The percentage individual positive and percentage agreement of both index (saliva) and reference (nasopharyngeal swab), in preference to specificity and sensitivity, were estimated using Kappa statistics. RESULTS: A total of 44 studies met the inclusion criteria. The average percentage positive saliva cases was 72.7% (95% confidence interval), which was lower but not substantially different from the percentage positive NPS of 78.7% (95% confidence interval), and there was an average overall agreement of 89.7% (95% confidence interval). CONCLUSION: Although the literature supports nasopharyngeal swab as a superior testing specimen, an alternative clinical specimen in saliva may offer potential benefits such that a potentially reduced accuracy may be tolerated, especially in low socioeconomic regions.

Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use.

BACKGROUND: Electronic cigarettes (e-cigarettes) have emerged in the Nigerian market, and if used without supervision, may have damaging effects on the physical and mental health of users. Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria. METHOD: An online cross-sectional study among participants aged between 15-35 years. The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a 7-item Generalized Anxiety Disorder (GAD-7) scale. Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. P-values <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS: Data from a total of 949 respondents was analysed. Participants had a mean age of 23.36 years (±3.97) and were predominantly female (55.64%). The prevalence of e-cigarette ever-use was 7.9% (95% CI: 5.8,10.0). Older age and being male were independently associated with higher odds of e-cigarette use. After adjusting for age and sex, alcohol use (p<0.001), friend's use (p<0.001), and other tobacco product or substance use (p:0.05) remained significantly associated with higher odds of e-cigarette use. There was no association between anxiety levels and e-cigarette use. CONCLUSION: These findings suggest a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who use e-cigarettes. Health providers and policy makers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years.

Association between anxiety, alcohol, poly-tobacco use and waterpipe smoking: A cross-sectional study in Lagos, Nigeria.

BACKGROUND: Waterpipe smoking (WPS) has been reported to have a wide range of damaging health effects on pulmonary and cardiovascular systems. Studies suggest that waterpipe tobacco smoking is associated with reduced harm perceptions, mental health problems and the use of psychoactive substances. We investigate the patterns of use and the association of WPS with anxiety, poly-tobacco and alcohol use in Lagos, Nigeria. MATERIALS AND METHODS: A cross-sectional study design was used to assess the data from 818 adolescents and adults in Lagos State, Nigeria. An online questionnaire obtained demographic information, waterpipe, e-cigarette, alcohol and other tobacco product use from respondents. Anxiety was assessed using the validated Generalised Anxiety Disorder 7-point scale. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with waterpipe ever-use. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of respondents was 23.43 (±3.96), over half were female (55.2%) and a majority had a college diploma or more (88.59%). Among study participants, 18.58% reported waterpipe ever-use. Among ever waterpipe users, 17.33% reported current use (past 30-days), with a majority having smoked waterpipe in a bar or pub. Alcohol use (P < 0.001), e-cigarette ever-use (P: 0.010) and poly-tobacco ever-use (P: 0.030) were significantly associated with higher odds of waterpipe use in the multivariate regression model. Further, there was a lower likelihood of waterpipe ever-use in the bivariate regression model among respondents with mild and moderate to severe anxiety levels than those with normal anxiety levels (P: 0.030); however, this association was no longer significant in the adjusted model. CONCLUSIONS: Our findings suggest a relatively high prevalence of WPS in Lagos, Nigeria. Concurrent alcohol consumption, e-cigarette and poly-tobacco use are associated with WPS, and most waterpipe smokers have normal anxiety levels. The Nigerian Government should consider surveillance measures for WPS and a more comprehensive smoke-free policy.