All authors read and accorded final approval to the paper. Funding:Ministry of Research and Technology/National Research and Innovation Agency through Postgraduate Grant (NKB471/UN2.RST/HKP.05.00/2020). and in combination with other predictors, including symptom components derived from principal component analysis. == Results == There were 24 PCR-confirmed infections. RDT-IgM/IgG-positive tests were associated with contamination (OR 10.8, 95% CI 4.43 to 26.4, p<0.001) with an area under the curve (AUC) of 0.708% and 50% sensitivity, 91.5% specificity, 30.8% positive predictive value (PPV) and 96.1% negative predictive value (NPV). RDT results combined with age, gender, contact history, symptoms and comorbidities increased the AUC to 0.787 and yielded 62.5% sensitivity, 87.0% Rabbit Polyclonal to TNFAIP8L2 specificity, 26.6% PPV and 96.9% NPV. == Conclusions == SARS-CoV-2 RDT-IgM/IgG results integrated with other predictors may be an affordable tool for epidemiological surveillance for population-based COVID-19 exposure and current contamination, especially in groups with outbreaks or high transmission. Keywords:COVID-19, epidemiology, public health == Strengths and limitations of this study. == Data for symptoms, contact history, comorbidities, rapid diagnostic test (RDT)-IgM/IgG, RDT antigen and reverse transcription-PCR test were obtained on the same day from each person. The data were from COVID-19 active surveillance and self-reporting to SARS-CoV-2 screening centres in high-risk communities as part of routine surveillance and active case obtaining. Analyses used progressive integration of Bipenquinate meta-data with Bipenquinate RDT results, including the use of principal component analysis to identify patterns of data, assess predictive value and broaden the power of RDT-IgM/IgG for concurrent contamination, rapid surveillance and identification of high-transmission areas. The sensitivity of the first-generation RDTs used in this study may limit the ability to fully assess the value of progressive data integration for test interpretation. == Introduction == Since COVID-19 was first detected in Indonesia in early March 2020, cases increased rapidly. Indonesia became the country with the highest infections in Southeast Asia by mid-June 2020.1The municipal government of Jakarta took action through case tracing, extensive testing and quarantine of infected and exposed persons. 2By late November 2020, testing rates in Jakarta for SARS-CoV-2 through reverse transcription-PCR (RT-PCR) had reached 9.2 per 1000 persons per week, with a positivity rate of 8.3%,3much higher than the 5% threshold suggested by the WHO as adequate for reopening.4A surge in cases peaked in January 2021 before declining to a persistent plateau in April with spikes throughout the country. This underscores the need for intensified routine epidemiological surveillance and targeted action to detect and contain surges at an earlier stage. However, affordable surveillance and diagnostic tools for routine large-scale deployment remain limited. The current gold standard for COVID-19 diagnosis is the detection of SARS-CoV-2 RNA by RT-PCR through nasopharyngeal or oropharyngeal swabs.5However, RT-PCR requires a certified laboratory, expensive Bipenquinate gear and trained personnel and can be time-consuming. These limitations create challenges for RT-PCR use for rapid mass screening for SARS-COV-2 infections, especially in countries with limited resources,6and it cannot detect past contamination. An alternative is the immuno-chromatographic rapid diagnostic test (RDT), or lateral flow assay (LFA), as a quick and affordable point-of-care test that can detect SARS-CoV-2 antigens from swabs or IgM or IgG antibody in the blood.5However, the antigen RDT sensitivity for current contamination is below that for RT-PCR and still provides no information on past contamination. The IgM/IgG antibody RDT typically has poor predictive value for current contamination due to the lag in onset of antibody production and is therefore much less sensitive than RT-PCR or antigen RDT and not suitable as a diagnostic tool.710However, the antibody RDT may be useful.