The Ministry
of Health has revised the diagnostic tests for COVID-19 and included
radiological equipment like chest X-rays and CT scans.
According to the World Health Organization-WHO, the effective way to test for
COVID-19 is by using a Polymerase Chain Reaction(PCR) test that has a high
sensitivity to detecting the viral load of the virus. However due to the first
progression of the disease in patients with the delta variant, at times PCR
tests fail to detect the disease on time. As such, some cases go undetected.
Previously, the
treatment protocol necessitated severe COVID-19 patients to have a positive PCR
test before they could be admitted into the ICU in case their condition
worsened. Patients who were critical but lacked a positive test were not given
priority.
Now, clinicians will be
able to use CT scans as one of the main diagnostic equipment for
COVID-19. According to clinicians, the use of X-rays or chest CT scans
will help doctors identify possible COVID-19 patients that would otherwise go
undetected and lead to avoidable deaths.
Dr Misaki Wayegera, the chair of the ministerial COVID-19 Scientific task force
says the use of X-rays are part of new clinical diagnostic measures that the
health ministry has adopted.
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According to Dr Misaki,
in addition to having a positive PCR test, patients seeking care in hospitals
will also need to present a chest CT scan or X-ray. Results from both testing
methods will then be used to determine how sick a patient is.
Prof Pontiano Kaleebu, the Executive Director of the Uganda Virus Research
Institute says the radiological equipment is needed because the COVID-19 virus
gets flashes out of the body fast.
" The virus leaves the body at a very fast rate. We estimate that within
10 days, the virus is no longer traceable in the nasopharyngeal passage.
However it would have damaged other parts of the body like the lungs that can
indicate whether one is infected or not depending on the damage that results
from testing positive for the disease," he said.
Dr Rosemary Byanyima, the Deputy Executive Director of Mulago National Referral
Hospital and also the head of the COVID-19 treatment unit says that the use of
radiological equipment will enable them to pick cases that would go undetected
but continue spreading the disease.
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Dr Fred Nakwagala, the Clinical Head of Directorate of Medicine at Mulago Hospital says that it is high time the health
ministry included the use of x-rays and CT scans as diagnostic tools for the
disease.
"We have patients
who have presented with negative COVID-19 PCR tests but had all other symptoms
of COVID-19. They had difficulty breathing and radiological diagnosis showed they
had COVID but could not be admitted to the ICUs because they didn't have a
positive PCR test," Nakwagala said.
In addition to using
chest x-rays to determine COVID-19 positive cases, Dr Wayengera says they will
also be using new criteria to determine the cause of deaths of suspected COVID
cases.
According to
pathologists from Mulago National Referral, postmortem carried out have shown
that persons who succumb to COVID-19 have congestion in the lungs, bleeding in
multiple organs, solid beefy lungs (instead of spongy feel/appearance) and
scared kidneys. In addition to this, the lungs are three times heavier than
their normal weight of around 1000g.
