{"doi":"10.1371/journal.pone.0284659","title":"Integration of serial self-testing for COVID-19 as part of contact tracing in the Brazilian public health system: A pragmatic trial protocol","abstract":"The coronavirus disease (COVID-19) pandemic has led to an unprecedented public health crisis. Insufficient testing continues to limit the effectiveness of the global response to the COVID-19 pandemic. Molecular testing methods such as reverse transcriptase polymerase chain reaction (RT-PCR) continue to be highly centralized and are a sub-optimal option for population surveillance. Rapid antigen tests (Ag-RDTs) offer multiple benefits including low costs, high flexibility to conduct tests in a wide variety of settings, and faster return of results. Self-test Ag-RDTs (STs) have gained approval in several markets and offer the possibility to expand testing, reaching at-risk populations. While STs have the potential to assist the COVID-19 response, test result integrity, reporting, and appropriate linkage to care continue to hinder the widespread implementation of self-testing programs. This protocol presents a mixed-methods pragmatic trial (ISRCTN91602092) to better understand the feasibility of self-testing as part of a contact tracing strategy within the Brazilian public health system. Approximately 604 close contacts of 150 index cases testing positive for COVID-19 will be enrolled. Index cases will be randomized for their close contacts to participate in either serial (daily) self-testing over a 10-day follow-up period or a more traditional approach to contact tracing with a professional Ag-RDT at one time point post-exposure. Usability workshops and focus group discussions will also be conducted. This study protocol presents a comprehensive plan to assess the effectiveness, operational feasibility, and stakeholder preferences of a serial self-testing strategy for contact tracing within the Brazilian public health system. Our results will contribute to better understanding of the feasibility of a self-testing strategy within the public sector. Potential risks and limitations are discussed. Our findings will have important implications as governments continue working to mitigate the impact of COVID-19, particularly in the context of where to direct limited resources for testing and healthcare infrastructure. Registration: This trial is registered at ISCTRN (ISRCTN91602092).","journal":"PLoS ONE","year":2023,"id":412220,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":true,"deposit_databanks":{"ISRCTN":["ISRCTN91602092"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1193170,"name":"Camilo Manchola","orcid":null,"position":1,"is_corresponding":false},{"id":660524,"name":"Emily Gerth‐Guyette","orcid":"0000-0002-3719-3892","position":2,"is_corresponding":false},{"id":1193171,"name":"Michelle Oliveira Silva","orcid":null,"position":3,"is_corresponding":false},{"id":1193172,"name":"Raissa Stephanie","orcid":null,"position":4,"is_corresponding":false},{"id":1192757,"name":"Tainá dos Santos Soares","orcid":"0000-0001-6492-7815","position":5,"is_corresponding":false},{"id":1193173,"name":"Luiza Bastos Gottin","orcid":null,"position":6,"is_corresponding":false},{"id":1193174,"name":"Milena Coelho","orcid":null,"position":7,"is_corresponding":false},{"id":1192758,"name":"Kimberly E. Green","orcid":"0000-0002-0848-8480","position":8,"is_corresponding":false},{"id":960326,"name":"Alexandre Dias Tavares Costa","orcid":"0000-0001-8434-2152","position":9,"is_corresponding":false},{"id":363606,"name":"Dhélio B. Pereira","orcid":"0000-0002-7761-5498","position":10,"is_corresponding":false},{"id":702345,"name":"Rebecca K. Green","orcid":"0000-0002-4384-5324","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T01:21:46.548301Z","pmid":"37792740","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}