A descriptive study on feasibility of nasopharyngeal and oropharyngeal swab collection from pediatric research participants in Cebu, Philippines

TL;DR

This study explores the challenges of collecting nasal and throat swabs from children in Cebu, Philippines, finding that fear, discomfort, and perceived lack of necessity are major barriers.

Contribution

The study provides insights into the feasibility and acceptability of swab collection for respiratory virus surveillance among pediatric populations in a specific regional context.

Findings

Only 16.1% of participants agreed to undergo NPS/OPS collection, all from the community-based study.

Fear or discomfort was cited as a reason for refusal by 20.5% of participants.

None of the hospital-based participants agreed to NPS/OPS collection.

Abstract

Nasopharyngeal (NPS) and oropharyngeal (OPS) swab collection are vital in the diagnosis and surveillance of respiratory viruses. However, the acceptability of these procedures among children remains a challenge.

We conducted a descriptive study using data from two pediatric observational studies in Cebu, Philippines (July 2021–October 2022). One was a community-based study, involving febrile adolescents aged 13–19 years, and the other was a hospital-based study, involving febrile children aged 1 month to <5 years. Both studies aimed to collect NPS/OPS samples for respiratory pathogen testing, including SARS-CoV-2, influenza A/B, and respiratory syncytial virus. We described reasons for refusal of NPS/OPS collection obtained from parents or guardians who were approached for participation in these studies.

Among 180 children enrolled from study sites in Bogo and Balamban Cebu, 134 (74.4%) were from the community-based study and 46 (25.6%) from the hospital-based study. Twenty-nine (29/180; 16.1%) agreed to undergo NPS/OPS collection—all of whom were from the community-based study. None of the hospital-based participants agreed to undergo NPS/OPS collection as part of their participation in the study. Among the 151/180 (83.90%) participants who refused the research swab collection, 41 (27.2%) declined due to a prior swab, 31 (20.5%) cited fear or discomfort, and 28 (18.5%) felt it was unnecessary at the time.

NPS/OPS collection was less acceptable in both community and hospital settings, unless mandated by local authorities based on the experience during the COVID-19 pandemic. Prior swabbing, procedural discomfort, and perceived lack of necessity were key barriers, especially among younger children and their caregivers.

Figures