The Pharmaceutical Society of Ghana (PSGH) in partnership with AstraZeneca (Ghana) organized a three-day insightful and interactive webcast for all pharmacists in the country. The meeting was chaperoned by some season experts in the medical field and from avid sectors of the pharmacy profession which included Hospital, Regulatory and Policy, as well as Research Pharmacy practice.
Dr Peter Puplampu, [Lecturer, Consultant Physician and Infectious Disease Specialist, KBTH and a member of the National Case Management Team], brought to light some of the atypical symptoms exhibited by confirmed cases who were on admission and explained that the gut as well as the renal system were special targets for the virus. He cited an example of a child who reported with rabies-like symptoms and upon investigation tested positive. Others included encephalitis, neuropsychiatric, worsening of previous hemiparesis, dyspepsia and CHD. Some suggestive laboratory findings he mentioned included evidence of coagulopathy, thrombocytopenia, leucopenia,acidosis,hyperbilirubin emia,D-Dimer, ferritin, troponins, Chest imaging (X-RAY), CT scan, bilateral peripheral opacities and lobar nodules. Dr Puplampu stressed on the need for autopsy to be carried out on the casualties recorded.
In line with WHO recommendation on how to combat this pandemic, Ghana was following such protocols of Testing, Testing and Testing. Pharm. Dr. Susan Adu-Amankwah who is a clinical research coordinator at the Noguchi Memorial Institute for Medical Research discussed the standing protocols used by the institution. She stated that the number of tests carried out was different from the number of people tested for the virus which stood at 161,000 tests as at the time of the meeting and also verified the claim made by the government that there were no backlogs at the institution. She made a case testing capacity comparison of Ghana to Iceland. Apparently, the number of tests per 1000 people in Iceland stood at 100 per 1000 people while that of Ghana stood at 4.43 per 1000 people as at the time the meeting was held. She explained the two broad categories of testing: 1. detection of the virus RNA using Polymerase Chain Reaction (PCR) and 2. serological tests that detect the host response to the virus RDT. This piqued interest in why the use of RDTs was not explored to scale up the testing capacity of the country.
Pharm. Adu-Amankwah explained that applications of antibody detections (including RDTs) for COVID-19 was currently limited to seroprevalence studies and for retrospective diagnosis of PCR negative patients presenting late during the course of COVID-19. She further discussed the WHO protocol for a person who tests positive. It is stipulated in the guidelines that after initial positive result, after 14 days, a second test needs to be repeated and if it turns negative, a third repeated a week after of which must include a stool sample. After two consecutive negative results, the person is declared to have recovered, but if test turns out positive, a weekly test needs to be carried out until two consecutive negative results are attained.
Currently, Noguchi receives an average of 1500 samples per day, down from an average of 5000 samples per day received during the lockdown period. The institution is equipped with 7 real time PCR machines but currently runs on 4 and uses 3 as backup, having a testing capacity of 10,000 samples per day. Pharm. Charles Ofei-Palm (Senior Specialist Pharmacist, KBTH and Head, KBTH Pharmacy COVID-19 team) emphasized the differences between isolation and quarantine. Pharm. Dr. Amah Nkansah (Consultant Clinical Pharmacist at KBTH) delved into some non- pharmacological interventions and therapies that could be used as adjuncts as well as prophylaxis against the virus which has proven to boost the immune system. These include neem leaves, ginger, garlic and some local foods. She also elaborated on the role of Pharmacists in public education as well as in the collective effort in combating the virus.
Pharm Jennifer Boateng (Senior Pharmacist and member of the Greater Accra Regional Hospital COVID-19 Management Team) discussed treatment objectives in the management of COVID-19, case classification and its clinical features as well as recommended therapy. She explained her role in the management of cases at the treatment center and her role as a pharmacist in terms of how and when the medications are administered. She further gave a case presentation and commented on delays in results which clearly increase cost and stay of hospitalization and suggested ways out to get results in on time.