Diagnosis of Tuberculosis among COVID-19 Suspected Cases in Ghana
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS
Abstract
Background
Tuberculosis (TB) and COVID-19 pandemics are both diseases of public health threat globally.
Both diseases are caused by pathogens that infect mainly the respiratory system, and
are involved in airborne transmission; they also share some clinical signs and symptoms.
We, therefore, took advantage of collected sputum samples at the early stage of COVID-19
outbreak in Ghana to conduct differential diagnoses of long-standing endemic respiratory illness,
particularly tuberculosis.
Methodology
Sputum samples collected through the enhanced national surveys from suspected COVID-
19 patients and contact tracing cases were analyzed for TB. The sputum samples were processed
using Cepheid’s GeneXpert MTB/RIF assay in pools of 4 samples to determine the
presence of Mycobacterium tuberculosis complex. Positive pools were then decoupled and
analyzed individually. Details of positive TB samples were forwarded to the NTP for appropriate
case management.
Results
Seven-hundred and seventy-four sputum samples were analyzed for Mycobacterium tuberculosis
in both suspected COVID-19 cases (679/774, 87.7%) and their contacts (95/774,
12.3%). A total of 111 (14.3%) were diagnosed with SARS CoV-2 infection and six (0.8%)
out of the 774 individuals tested positive for pulmonary tuberculosis: five (83.3%) males and
one female (16.7%). Drug susceptibility analysis identified 1 (16.7%) rifampicin-resistant
tuberculosis case. Out of the six TB-positive cases, 2 (33.3%) tested positive for COVID-19
indicating a coinfection. Stratifying by demography, three out of the six (50%) were from the
Ayawaso West District. All positive cases received appropriate treatment at the respective
sub-district according to the national guidelines. Conclusion
Our findings highlight the need for differential diagnosis among COVID-19 suspected cases
and regular active TB surveillance in TB endemic settings.
Description
Research Article
Keywords
tuberculosis, surveillance, Ghana
Citation
Afum T, Asare P, Asante-Poku A, Darko- Otchere I, Morgan PA, Bedeley E, et al. (2021) Diagnosis of tuberculosis among COVID-19 suspected cases in Ghana. PLoS ONE 16(12): e0261849. https://doi.org/10.1371/journal. pone.0261849