Factors Associated with Severe Acute Respiratory Syndrome Coronavirus-2 Infection in Hohoe Municipality, Ghana: A Case-Control Study

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 the 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 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. Moderate/high level of social interaction was associated with increased odds of SARS-CoV-2 infection, and having no underlying condition and frequent exercise/physical activity was protective. 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.