GET Journal of Biosecurity and One Health

GET Journal of Biosecurity and One Health (2023)

Comparative Analysis of SARS-Cov-2 Detection Using Viral Swab in Viral Transport Medium Against Cotton Swab in 0.9% Normal Saline

Authors: Amaniampong A1, Akowuah E1, Boasiako MA1, Asamoah JA2, Adu-Gyamfi C2, Aryeetey S2, Acheampong G3, Agyei G4, Ayisi-Boateng NK5, Agyapong FO1, Kamasah JS1, Mutocheluh M1, Sylverken AA2,6, Phillips RO2,5, Owusu M2,3,7*

GET Journal of Biosecurity and One Health, Volume 2, Issue 2, (2023)

Article Keywords: SARS-CoV-2; COVID-19; Oropharyngeal sampling; Cotton swab; 0.9% Normal salin.


Journal Volume & Issue

Volume 2, Issue 2


Volume 1, No. 4, 2022

Pages 34-40

Ebola Survivors are not at Increased Risk for Gynecologic Surgeries

Gorpudolo-Dennis N1; Kennedy SB2*; Reilly C3 and Sankoh M1

1Department of Obstetrics and Gynecology, Redemption Hospital, New Kru Town, Montserrado County, Monrovia, Liberia.

2UL-PIRE Africa Center, An Infectious Disease Research Center, Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia.

3Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA.

*Corresponding Author: Stephen B. Kennedy, MD, MPH, UL-PIRE Africa Center, An Infectious Disease Research Center
Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia. Tel: +231 770 645 830

Orchid No:


As the result of multiple signs and symptoms, and complications observed among survivors of the Ebola virus disease (EVD), there is an assumption that survivors might experience perturbations within their clotting parameters. This may eventually lead to increased bleeding time, predisposing them to increased risk for surgical complications. This study aimed to comparatively review specific intra-operative parameters such as uterine fibroids and polyps among a number of EVD survivors and non survivors undergoing elective gynecologic surgeries at Redemption Hospital, a tertiary specialized referral hospital located within one of the EVD hotspots, in Liberia from January to October 2016. A case-control study was conducted wherein cases were referred from the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), an EVD clinical trial platform, while controls were sampled from the general patient population, at Redemption Hospital. The controls were matched based on age, employment status and parity. All surgeries were performed by single surgeon based on a surgical checklist that included designated intra- and post-operative parameters. Statistical analysis such as counts, percentiles, confidence intervals and relative risks were performed to assess the differences between the cases and controls, respectively. Survivors were between the ages of 42 years and 44 years for controls with an average interval between discharge from the Ebola Treatment Unit (ETU) and surgical intervention of greater than one year. The median duration of surgical procedure was 60 minutes and blood loss of 250 ml in both groups. Besides the relative risks (RR) of receiving antibiotics for more than 3 days of 1.5 (85.7% vs. 57.1%) and hospitalization of more than 7 days of 0.25 (14% vs. 57%) for survivors as compared to controls, most of the indicators were not significantly different. The findings revealed that EVD survivors who present with benign tumors such as uterine fibroids, polyps, or adenomyosis, requiring elective uterine surgery such as myomectomy and/or hysterectomy are generally not at increased risk of surgical complications because most of the indicators (hospitalization, blood loss, antibiotics, etc.) were not significantly different between the two groups. Findings from this study may potentially revise the approaches used by gynecologists and general surgeons during encounters and/or interventions with patient(s) concerning emerging infectious diseases (EIDs).

Keywords: Ebola Virus Disease (EVD), Emerging Infectious Diseases (EIDs), Ebola Survivors, Uterine Surgery, Females, Liberia


Coronavirus Disease 2019 (COVID-19) has become a major health problem causing severe acute respiratory illness in humans. With the high case count and mortality rate, a broad testing method is required to detect the virus in infected people, as well as less common clinical manifestations of the disease. Consequently, the high demand for testing has resulted in a depletion of commercially available consumables, including the recommended swabs and viral transport
media (VTM) required for oropharyngeal sampling. To address this issue, we evaluated the utility of a commonly found cotton swab in 0.9% normal saline against the viral swab in viral transport medium (VTM) for the molecular detection of SARS-CoV-2. The study was a cross-sectional analytical study that recruited 322 suspected COVID-19 patients from Kwadaso Seventh Day Adventist and Suntreso Government Hospitals, Kumasi, Ghana, between April and September
2021. Consecutive oropharyngeal swab samples were obtained with viral swabs and cotton swabs in parallel and inserted into the viral transport medium and 0.9% normal saline, respectively. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was performed on the samples concurrently for detection of SARS-CoV-2 genes (N and ORF1ab genes). Comparison of the cotton swab in 0.9% saline samples to the viral swab in VTM samples,
yielded the following results: the cotton swab samples were 61.9% (51.7-71.2) sensitive, 96.9% (93.8- 98.5) specific, and with positive and negative predictive values of 89.0% and 86.4% respectively. The median viral load was significantly higher in samples taken with a viral swab in VTM (276, IQR: 51.49- 9837.87) compared to samples taken with a cotton swab in 0.9% saline (252.86, IQR: 29.62-4235.93), p = 0.0059. Our study suggests that cotton swabs in 0.9% saline have low sensitivity and viral yield and hence not appropriate for collection of respiratory samples for SARS-
CoV-2 detection