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Parent-collected nose swabs are as good as nurse-collected nose swabs at detecting respiratory infections in children

Press release issued: 10 November 2021

Nose swab samples collected by parents are as good as those collected by nurses at detecting respiratory infections in children, according to a study by researchers at the University of Bristol published in the journal Microbiology Spectrum today (10 November).

Respiratory tract infections in children, such as coughs, colds and flu, and more recently, COVID-19, are some of the most common illnesses treated in primary care.

The study, which was conducted before the COVID-19 pandemic, compared the quality and performance of parent-collected nose and saliva swab samples with nurse-collected samples. Over 300 parents and 485 children aged around five years in the Bristol area took part.

Both parent-collected and nurse-collected samples were sent to a clinical testing laboratory for the detection of over 40 common respiratory pathogens. While parent-collected nose swabs performed well compared to those collected by nurses (91.6 per cent inter-rater agreement for viral infections and 91.4 per cent inter-rater agreement for bacterial infections), parent-collected saliva swabs did not perform as well (69 per cent and 78.1 per cent for viral and bacterial infections respectively).

Dr Claire Woodall, lead author of the study and Research Associate in Primary Care Infectious Diseases Epidemiology at the Centre for Academic Primary Care and Elizabeth Blackwell Institute/Daphne Jackson Fellow, said: “If a parent is worried about collecting a nose swab from their child for laboratory analysis of coronavirus or any other common respiratory pathogen – my response would be that they should have the confidence to do so. In fact, our study showed that parents collected a higher number of human cells on the nose swabs compared to the nurses, which suggests that children are more tolerant of a parent performing the swabbing technique.”

Alastair Hay, a GP and Professor of Primary Care Research at the Centre for Academic Primary Care at the University of Bristol who supervised the study, said: “Our study shows that it is possible for parents to collect good quality nose swab samples from children. Given the widespread use of nasal swabbing throughout the COVID-19 pandemic, this study has highlighted the suitability, benefits and convenience of parent-collected swabs for subsequent identification of respiratory microbes.”

The research was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, the Medical Research Council (MRC) and the Elizabeth Blackwell Institute via the Wellcome Trust Institutional Strategic Support Fund in collaboration with the Daphne Jackson Trust.


‘Performance of parent-collected nasal and saliva swabs compared with nurse-collected swabs for the molecular detection of respiratory microorganisms: a prospective study’ by Claire Woodall, Alastair Hay et al in Microbiology Spectrum

Further information

About the Centre for Academic Primary Care, University of Bristol

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

Follow us on Twitter: @capcbristol

About the National Institute for Health Research

The mission of the National Institute for Health Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care.
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services.
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research.
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges.
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system.
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

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