Utility of early diagnosis, contact tracing and stakeholder engagement in outbreak response in three COVID-19 outbreak settings in Ghana

Objective: To describe how early case detection, testing and contact tracing measures were deployed by stakeholders in response to the COVID-19 outbreak in Ghana ­ using three outbreak scenarios. Design: A descriptive assessment of three case studies of COVID-19 outbreaks within three settings that occurred in Ghana from March 13 till the end of June 2020. Setting: A construction camp, a factory and a training institution in Ghana. Participants: Staff of a construction camp, a factory, workers and students of a training institution. Interventions: We described and compared the three COVID-19 outbreak scenarios in Ghana, highlighting identification and diagnosis of cases, testing, contact tracing and stakeholder engagement for each scenario. We also outlined the challenges and lessons learnt in the management of these scenarios. Main outcome measures: Approach used for diagnosis, testing, contact tracing and stakeholder engagement. Results: Index cases of the training institution and construction camp were screened the same day of reporting symptoms, whiles the factory index case required a second visit before the screening. All index cases were tested with RTPCR. The training institution followed and tested all contacts, and an enhanced contact tracing approach was conducted for staff of the other two sites. Multi-sectorial engagement and collaboration with stakeholders enabled effective handling of the outbreak response in all sites. Conclusion: Comparing all three settings, early diagnosis and prompt actions taken through multi-sectorial collaborations played a major role in controlling the outbreak. Engaging stakeholders in the COVID-19 response is an effective way to mitigate the challenges in responding to the pandemic.

Data management during COVID-19 outbreak response in Ghana: a reference laboratory perspective on key issues and measures

The COVID-19 pandemic caused by SARS-CoV-2 is an important subject for global health. Ghana experienced lowmoderate transmission of the disease when the first case was detected in March 12, 2020 until the middle of July when the number of cases begun to drop. By August 24, 2020, the country's total number of confirmed cases stood at 43,622, with 263 deaths. By the same time, the Noguchi Memorial Institute for Medical Research (NMIMR) of the University of Ghana, the primary testing centre for COVID-19, had tested 285,501 with 28,878 confirmed cases. Due to database gaps, there were initial challenges with timely reporting and feedback to stakeholders during the peak surveillance period. The gaps resulted from mismatches between samples and their accompanying case investigation forms, samples without case investigation forms and vice versa, huge data entry requirements, and delayed test results. However, a revamp in data management procedures, and systems helped to improve the turnaround time for reporting results to all interested parties and partners. Additionally, inconsistencies such as multiple entries and discrepant patient-sample information were resolved by introducing a barcoding electronic capture system. Here, we describe the main challenges with COVID-19 data management and analysis in the laboratory and recommend measures for improvement

Epidemiology of COVID-19 outbreak in Ghana, 2020

Objective: Describe the epidemiology of COVID-19 cases detected in the first four months of the pandemic in Ghana by person, place and time to provide an understanding of the local epidemiology of the disease. Methods: We conducted an exploratory descriptive study of all confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020. Data was merged from the country's electronic databases, cleaned and summarized using medians, proportions and geospatial analysis. Design: A cross-sectional study design Setting: Ghana Participants: All confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020 Interventions: None Main Outcome measures: Epidemiological characterization of all confirmed COVID-19 cases recorded from March 12 ­ June 30, 2020 in Ghana by person, place and time. Results: A total of 17,763 cases were recorded with median age (IQR) of 33years (One month to 85 years). Among the confirmed cases, 10,272 (57.8%) were males and 3,521 (19.8%) were symptomatic with cough recorded in 1,420 (40.3%) cases. The remaining 14,242 (80.2%) were asymptomatic. Greater Accra region recorded the highest number of confirmed cases 11,348 (63.9%). All 16 administrative regions had recorded cases of COVID-19 by June 30, 2020 due to internal migration between the hotspots and other regions. The epidemiological curve showed a propagated outbreak with 117 deaths (CFR= 0.67%) recorded. Conclusion: A propagated outbreak of COVID ­ 19 was confirmed in Ghana on March 12, 2020. Internal migration from hotspots to other regions led to the spread of the virus across the nation. Majority of cases were asymptomatic