Published in PLOS One on 2026-07-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Sadat Ibrahim, Yussif Yakubu, Kwaku Appiagyei, Adjato Franklin Duncan Sylvester, Yahuza Sabit Tanko, Frank Baiden
Source: PLOS One • DOI 10.1371/journal.pone.0332561
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was a major public health challenge globally and in Ghana. To prepare better for future pandemics, an evidence-based understanding of the determinants of coronavirus disease is essential to inform public health guidelines and surveillance. Thus, we identified the factors for SARS-CoV-2 infection in Hohoe Municipality. We conducted a facility-based, sex and age-matched (1:2) case-control study. Cases were persons with a laboratory-confirmed SARS-CoV-2 infection by Reverse Transcription Polymerase Chain Reaction (RT-PCR) or rapid antigen test, while controls tested negative with the same techniques. Data on sociodemographic, clinical, and exposure-related factors were collected through structured interviews. We employed a conditional regression model to establish the factors independently associated with SARS-CoV-2 infection using Stata version 17.0. All statistical tests were two-sided, and a p-value <0.05 in the final multivariate logistic model was considered statistically significant. A total of 234 participants were enrolled (78 cases, 156 controls). The mean age of the cases and controls was 39.7 (±14.6) and 39.4 (±14.4) years, respectively. Moderate/high levels of social interaction increased the odds of infection (aOR=3.00, 95% CI:1.05–8.56, p = 0.040). Having no underlying health condition (aOR=0.25, 95% CI:0.09–0.65, p = 0.004) and regular physical activity or exercise (aOR=0.18, 95% CI:0.04–0.70, p = 0.014) reduced the risk of infection. Public health interventions should therefore prioritize strengthening community awareness about the risks of close social interactions and the benefits of healthy lifestyles, including regular physical activity.
Introduction
The novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) was the etiologic agent of the Coronavirus Disease 2019 (COVID-19) pandemic. It caused widespread infection, morbidity, and mortality from late 2019 and created a global health emergency [1]. On January 30, 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern, and on March 11, 2020, a pandemic [1,2]. Ghana’s index case was confirmed on March 12, 2020 [3]. In the African context, particularly in sub-Saharan Africa, the epidemiology of COVID-19 was shaped by unique demographic, socio-economic, and health system factors. Although the region reported comparatively lower case fatality rates than many high-income settings, limited testing capacity and under-detection contributed to uncertainty in the true burden of the disease [4,5]. Evidence from the region suggests that over 80% of infections were either asymptomatic or mild [2], indicating a substantial proportion of undetected cases within communities. Clinical presentations ranged from asymptomatic to severe or critical illness [6], complicating case identification and surveillance efforts. This, coupled with the high proportion of pre-symptomatic and asymptomatic infections, likely facilitated undetected community transmission, as infected individuals could spread the virus without being readily identified. This made pre-symptomatic and asymptomatic patients a hidden potential source of transmission. Direct or indirect contact with respiratory aerosols, droplets or other bodily fluids via contaminated surfaces was the known predominant mode of transmission [7,8].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Sadat Ibrahim, Yussif Yakubu, Kwaku Appiagyei, Adjato Franklin Duncan Sylvester, Yahuza Sabit Tanko, Frank Baiden. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Serological responses to SARS-CoV-2 in urban and rural Ghana: Antibody waning and implications for long-term population immunity
- Evidence brief: Cross-national disparities in healthcare workers’ perceptions: Examining fear of infection and confidence in the received COVID-19 vaccines amid emerging variants
- Evidence brief: The epidemiology of SARS-CoV-2, Influenza, and Respiratory Syncytial Virus circulation among adult patients with acute respiratory illness in Kampala Metropolitan Area in Uganda
