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

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].

Mother collects nose swab from son in kitchen

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).

Lead author of the study, Dr Claire Woodall, 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.

Paper: ‘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, Hannah Thornton, Emma Anderson, Suzanne Ingle, Peter Muir, Barry Vipond, Denise Longhurst, John Leeming, Charles Beck and Alastair Hay published in Microbiology Spectrum November 2021.


Further information

About the NIHR Health Protection Research Unit [HPRU] in Behavioural Science and Evaluation at the University of Bristol 

The NIHR HPRU in Behavioural Science and Evaluation at University of Bristol is one of 14 HPRUs across England, part of a £58.7 million investment by the NIHR to protect the health of the nation. 

The NIHR HPRU in Behavioural Science and Evaluation is a partnership between the UK Health Security Agency (UKHSA) and University of Bristol, in collaboration with MRC Biostatistics Research Unit at the University of Cambridge and University of the West of England. 

Each NIHR HPRU undertakes high quality research that is used by UKHSA to keep the public safe from current and emerging public health threats.

About the NIHR 

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.