{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T09:03:21Z","timestamp":1777021401240,"version":"3.51.4"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Coronavirus disease-19 (COVID-19), which started in late December, 2019, has spread to affect 216 countries and territories around the world. Globally, the number of cases of SARS-CoV-2 infection has been growing exponentially. There is pressure on countries to flatten the curves and break transmission. Most countries are practicing partial or total lockdown, vaccination, massive education on hygiene, social distancing, isolation of cases, quarantine of exposed and various screening approaches such as temperature and symptom-based screening to break the transmission. Some studies outside Africa have found the screening for fever using non-contact thermometers to lack good sensitivity for detecting SARS-CoV-2 infection. The aim of this study was to determine the usefulness of clinical symptoms in accurately predicting a final diagnosis of COVID-19 disease in the Ghanaian setting.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>The study analysed screening and test data of COVID-19 suspected, probable and contacts for the months of March to August 2020. A total of 1,986 participants presenting to Tamale Teaching hospital were included in the study. Logistic regression and receiver operator characteristics (ROC) analysis were carried out.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall SARS-CoV-2 positivity rate was 16.8%. Those with symptoms had significantly higher positivity rate (21.6%) compared with asymptomatic (17.0%) [chi-squared 15.5, p-value, &lt;0.001]. Patients that were positive for SARS-CoV-2 were 5.9 [3.9\u20138.8] times more likely to have loss of sense of smell and 5.9 [3.8\u20139.3] times more likely to having loss of sense of taste. Using history of fever as a screening tool correctly picked up only 14.8% of all true positives of SARS-CoV-2 infection and failed to pick up 86.2% of positive cases. Using cough alone would detect 22.4% and miss 87.6%. Non-contact thermometer used alone, as a screening tool for COVID-19 at a cut-off of 37.8 would only pick 4.8% of positive SARS-CoV-2 infected patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The use of fever alone or other symptoms individually [or in combination] as a screening tool for SARS-CoV-2 infection is not worthwhile based on ROC analysis. Use of temperature check as a COVID-19 screening tool to allow people into public space irrespective of the temperature cut-off is of little benefit in diagnosing infected persons. We recommend the use of facemask, hand hygiene, social distancing as effective means of preventing infection.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257450","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T17:27:56Z","timestamp":1631899676000},"page":"e0257450","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Performance of COVID-19 associated symptoms and temperature checking as a screening tool for SARS-CoV-2 infection"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-508X","authenticated-orcid":true,"given":"Benjamin Demah","family":"Nuertey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwame","family":"Ekremet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul-Rashid","family":"Haidallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kareem","family":"Mumuni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Addai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary Ivy E.","family":"Attibu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Damah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvis","family":"Duorinaa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anwar Sadat","family":"Seidu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor C.","family":"Adongo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Kujo","family":"Adatsi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisyovi Caedenas","family":"Suri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abass Abdul-Karim","family":"Komei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Braimah Baba","family":"Abubakari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enoch","family":"Weyori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Allegye-Cudjoe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustina","family":"Sylverken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Owusu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard O.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"pone.0257450.ref001","volume-title":"Coronavirus Disease (COVID-19) Dashboard","author":"World Health Organization","year":"2020"},{"key":"pone.0257450.ref002","unstructured":"Worldometer. COVID-19 Coronavirus pandemic. coronavirus live update. 2020. https:\/\/www.worldometers.info\/coronavirus\/#countries."},{"key":"pone.0257450.ref003","volume-title":"Flattening The Exponential Growth Curve of COVID-19 in Ghana and Other Developing Countries; Divine Intervention Is A Necessity. SSRN Scholarly Paper","author":"GO Fosu","year":"2020"},{"key":"pone.0257450.ref004","volume-title":"Quarantine Role in the Control of Corona Virus in the World and Its Impact on the World Economy. SSRN Scholarly Paper.","author":"N Khan","year":"2020"},{"key":"pone.0257450.ref005","article-title":"Covid-19: Africa records over 10 000 cases as lockdowns take hold","volume":"369","author":"O. Dyer","year":"2020","journal-title":"BMJ"},{"key":"pone.0257450.ref006","article-title":"Voluntary and mandatory social distancing: Evidence on covid-19 exposure rates from chinese provinces and selected countries","author":"A Chudik","year":"2020","journal-title":"National Bureau of Economic Research"},{"key":"pone.0257450.ref007","first-page":"27","article-title":"Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak","author":"A Wilder-Smith","year":"2020","journal-title":"J Travel Med"},{"key":"pone.0257450.ref008","article-title":"Tropism, replication competence, and innate immune responses of the coronavirus SARS-CoV-2 in human respiratory tract and conjunctiva: an analysis in ex-vivo and in-vitro cultures","author":"KPY Hui","year":"2020","journal-title":"The Lancet Respiratory Medicine"},{"key":"pone.0257450.ref009","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1007\/s11606-020-05762-w","article-title":"Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19)","volume":"35","author":"F Jiang","year":"2020","journal-title":"J GEN INTERN MED"},{"key":"pone.0257450.ref010","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"F Zhou","year":"2020","journal-title":"The Lancet"},{"key":"pone.0257450.ref011","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study","author":"X Yang","year":"2020","journal-title":"The Lancet Respiratory Medicine"},{"key":"pone.0257450.ref012","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/S0140-6736(20)30154-9","article-title":"A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster","volume":"395","author":"JF-W Chan","year":"2020","journal-title":"The Lancet"},{"key":"pone.0257450.ref013","doi-asserted-by":"crossref","DOI":"10.3332\/ecancer.2020.ed98","article-title":"Anosmia and ageusia are emerging as symptoms in patients with COVID-19: What does the current evidence say?","volume":"14","author":"B Russell","year":"2020","journal-title":"Ecancermedicalscience."},{"key":"pone.0257450.ref014","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3390\/jcm9030623","article-title":"Potential rapid diagnostics, vaccine and therapeutics for 2019 novel coronavirus (2019-nCoV): a systematic review.","volume":"9","author":"J Pang","year":"2020","journal-title":"Journal of clinical medicine"},{"key":"pone.0257450.ref015","first-page":"4","article-title":"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)","volume":"7","author":"Y-H Jin","year":"2020","journal-title":"Mil Med Res"},{"key":"pone.0257450.ref016","doi-asserted-by":"crossref","first-page":"200463","DOI":"10.1148\/radiol.2020200463","article-title":"Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection","volume":"295","author":"A Bernheim","year":"2020","journal-title":"Radiology."},{"key":"pone.0257450.ref017","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.2214\/AJR.20.22954","article-title":"Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management","volume":"214","author":"Y Li","year":"2020","journal-title":"American Journal of Roentgenology"},{"key":"pone.0257450.ref018","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1148\/radiol.2020200370","article-title":"Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19).","volume":"295","author":"F Pan","year":"2020","journal-title":"Radiology"},{"key":"pone.0257450.ref019","article-title":"Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT","author":"HX Bai","year":"2020","journal-title":"Radiology"},{"key":"pone.0257450.ref020","article-title":"Automatic Detection of Coronavirus Disease (COVID-19) Using X-ray Images and Deep Convolutional Neural Networks","author":"A Narin","year":"2020","journal-title":"arXiv:200310849"},{"key":"pone.0257450.ref021","article-title":"Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients","author":"HYF Wong","year":"2020","journal-title":"Radiology"},{"key":"pone.0257450.ref022","article-title":"Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)","volume":"1","author":"G Lippi","year":"2020","journal-title":"Clinical Chemistry and Laboratory Medicine (CCLM)."},{"key":"pone.0257450.ref023","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3390\/mi11030306","article-title":"2019 Novel Coronavirus Disease (COVID-19): Paving the Road for Rapid Detection and Point-of-Care Diagnostics","volume":"11","author":"T Nguyen","year":"2020","journal-title":"Micromachines"},{"key":"pone.0257450.ref024","article-title":"Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis","author":"Z Li","journal-title":"Journal of Medical Virology"},{"key":"pone.0257450.ref025","article-title":"portable tests come online to curb coronavirus pandemic","volume":"10","author":"Sheridan C. Fast","year":"2020","journal-title":"Nat Biotechnol"},{"key":"pone.0257450.ref026","article-title":"Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases","author":"T Ai","year":"2020","journal-title":"Radiology"},{"key":"pone.0257450.ref027","article-title":"Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths","author":"C-C Lai","year":"2020","journal-title":"Journal of Microbiology, Immunology and Infection"},{"key":"pone.0257450.ref028","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/JCMA.0000000000000270","article-title":"The outbreak of COVID-19: An overview","volume":"83","author":"Y-C Wu","year":"2020","journal-title":"J Chin Med Assoc"},{"key":"pone.0257450.ref029","doi-asserted-by":"crossref","first-page":"2000180","DOI":"10.2807\/1560-7917.ES.2020.25.10.2000180","article-title":"Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020","volume":"25","author":"K Mizumoto","year":"2020","journal-title":"Eurosurveillance"},{"key":"pone.0257450.ref030","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1111\/1742-6723.13578","article-title":"Temperature screening has negligible value for control of COVID-19","volume":"32","author":"B Mitra","year":"2020","journal-title":"Emergency Medicine Australasia"},{"key":"pone.0257450.ref031","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.jemermed.2020.09.048","article-title":"Clinical Features of Patients with COVID-19: is Temperature Screening Useful?","volume":"59","author":"GM Vilke","year":"2020","journal-title":"The Journal of Emergency Medicine"},{"key":"pone.0257450.ref032","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/gutjnl-2020-322125","article-title":"Alteration of taste or smell as a predictor of COVID-19","volume":"70","author":"J-M Liou","year":"2021","journal-title":"Gut"},{"key":"pone.0257450.ref033","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1001\/jama.2020.3227","article-title":"Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient","volume":"323","author":"SWX Ong","year":"2020","journal-title":"JAMA"},{"key":"pone.0257450.ref034","doi-asserted-by":"crossref","first-page":"2000045","DOI":"10.2807\/1560-7917.ES.2020.25.3.2000045","article-title":"Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR","volume":"25","author":"VM Corman","year":"2020","journal-title":"Eurosurveillance"},{"key":"pone.0257450.ref035","article-title":"COVID-19 in Tamale Teaching Hospital, Northern Region, Ghana","author":"BD Nuertey","year":"2021"},{"key":"pone.0257450.ref036","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/POC.0b013e318246a642","article-title":"ROC Curves\u2014What are They and How are They Used?","volume":"11","author":"S. Ekelund","year":"2012","journal-title":"Point of Care"},{"key":"pone.0257450.ref037","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1097\/JTO.0b013e3181ec173d","article-title":"Receiver operating characteristic curve in diagnostic test assessment","volume":"5","author":"JN Mandrekar","year":"2010","journal-title":"Journal of Thoracic Oncology"},{"key":"pone.0257450.ref038","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s41182-020-00201-2","article-title":"Coronavirus disease-2019: is fever an adequate screening for the returning travelers?","volume":"48","author":"GM Bwire","year":"2020","journal-title":"Tropical Medicine and Health"},{"key":"pone.0257450.ref039","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/jmv.25722","article-title":"Understanding of COVID-19 based on current evidence","volume":"92","author":"P Sun","year":"2020","journal-title":"Journal of Medical Virology"},{"key":"pone.0257450.ref040","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1016\/j.puhe.2015.07.023","article-title":"Comparison of Infrared Thermal Detection Systems for mass fever screening in a tropical healthcare setting","volume":"129","author":"MR Tay","year":"2015","journal-title":"Public Health"},{"key":"pone.0257450.ref041","doi-asserted-by":"crossref","first-page":"e55570","DOI":"10.7554\/eLife.55570","article-title":"Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19","volume":"9","author":"K Gostic","year":"2020","journal-title":"eLife"},{"key":"pone.0257450.ref042","first-page":"2000080","article-title":"Effectiveness of airport screening at detecting travellers infected with novel coronavirus (2019-nCoV)","volume":"25","author":"Group2 C nCoV working","year":"2020","journal-title":"Eurosurveillance"},{"key":"pone.0257450.ref043","doi-asserted-by":"crossref","first-page":"101832","DOI":"10.1016\/j.tmaid.2020.101832","article-title":"Body temperature screening to identify SARS-CoV-2 infected young adult travellers is ineffective","volume":"37","author":"M Bielecki","year":"2020","journal-title":"Travel Med Infect Dis"},{"key":"pone.0257450.ref044","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofaa603","article-title":"Why Temperature Screening for Coronavirus Disease 2019 With Noncontact Infrared Thermometers Does Not Work.","volume":"8","author":"WF Wright","year":"2021","journal-title":"Open Forum Infectious Diseases."},{"key":"pone.0257450.ref045","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1002\/alr.22602","article-title":"Smell and taste symptom-based predictive model for COVID-19 diagnosis.","volume":"10","author":"LT Roland","year":"2020","journal-title":"International Forum of Allergy & Rhinology"},{"key":"pone.0257450.ref046","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm6913e1","article-title":"Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility\u2014King County, Washington, March 2020","volume":"69","author":"A Kimball","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0257450.ref047","article-title":"COVID-19 transmission through asymptomatic carriers is a challenge to containment","author":"X Yu","journal-title":"Influenza and Other Respiratory Viruses"},{"key":"pone.0257450.ref048","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1001\/jama.2020.2565","article-title":"Presumed Asymptomatic Carrier Transmission of COVID-19","volume":"323","author":"Y Bai","year":"2020","journal-title":"JAMA"},{"key":"pone.0257450.ref049","article-title":"Asymptomatic Transmission, the Achilles\u2019 Heel of Current Strategies to Control Covid-19","author":"M Gandhi","year":"2020","journal-title":"New England Journal of Medicine"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T17:28:47Z","timestamp":1631899727000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257450"}},"subtitle":[],"editor":[{"given":"Martin Chtolongo","family":"Simuunza","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,9,17]]},"references-count":49,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0257450","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,17]]}}}