Post-pandemic SARS-CoV-2 Antigen Detection and Clinical Patterns among Patients in a Tertiary Hospital in North Central Nigeria

Author's Information:

Ibrahim Ismaila*

Department of Medical Laboratory Services, Federal Medical Centre, Keffi, PMB 1004, Keffi, Nasarawa State, Nigeria.

Ismaila Abdulraufu

Department of Medical Laboratory Services, Federal Medical Centre, Keffi, PMB 1004, Keffi, Nasarawa State, Nigeria.

Uguru Ikenna Daniel

Barts Health NHS Trust, London, United Kingdom.

Olley Mitsan

Department of Medical Laboratory Sciences, College of Health Sciences, Igbinedion University, Okada, Nigeria.

Ugbomoiko Daniel

Department of Medical Laboratory Sciences, College of Health Sciences, Igbinedion University, Okada, Nigeria.

David Ishaleku

Global Health and Infectious Diseases Control Institute (GHIDI), PMB 1022, Keffi, Nasarawa State University, Keffi, Nasarawa State, Nigeria. 

Usman, Rahila Ukwo

Brightway International Academy, G.R.A. Keffi, Nasarawa State, Nigeria.

Maryoms Nelson Gideon

Department of Medical Laboratory Sciences, College of Health Sciences, Igbinedion University, Okada, Nigeria.

Uguru Legbel Ikenna

Department of Medical Laboratory Services, Federal Medical Centre, Keffi, PMB 1004, Keffi, Nasarawa State, Nigeria.

Vol 3 No 5 (2026):Volume 03 Issue 05 May 2026

Page No.: 257-266

Abstract:

Background: The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has posed a major public health challenge globally. Early diagnosis of infectious diseases such as COVID-19 is essential in limiting the spread and associated complications. Also, understanding the local disease dynamics, including its risk factors and clinical patterns, is critical for guiding preventive and control measures.

Objective: This study aimed to detect SARS-CoV-2 antigen in nasopharyngeal swabs from patients and to determine the associated risk factors and clinical patterns of infection among patients attending the Federal Medical Centre (FMC), Keffi, Nasarawa State, Nigeria.

Methods: A cross-sectional study was conducted between March and July 2023, recruiting 400 patients who presented with symptoms suggestive of COVID-19. Nasopharyngeal swab samples were collected and analyzed for SARS-CoV-2 antigen using the STANDARD Q COVID-19 Ag Test (SD BIOSENSOR, Inc, Korea) rapid test kit following the manufacturer’s instructions. Socio-demographic and clinical data, including age, sex, and symptoms, were collected using a questionnaire after consent was obtained. Results were analyzed using SPSS Version 25.0 (IBM Corp., USA). Descriptive statistics, Chi-square test and Fisher’s exact test were used to summarise and determine the association between categorical variables with a significance level of P < 0.05.

Results: Out of the 400 patients tested, 4 (1.0%) (95% CL: 0.3% - 1.97%) were positive. There was no statistically significant difference with gender (P > 0.05). However, a borderline significant association with infection status (P = 0.05) was observed for age, with higher prevalence in older age groups, suggesting vulnerability. Cough (P < 0.05), loss of smell (P < 0.05), and nasal congestion (P < 0.05) were significant. No significant association was observed for fever, loss of taste, or shortness of breath, occupation and hand hygiene (P > 0.05). Additionally, SARS-CoV-2 antigen positivity was significantly associated with lack of vaccination and the use of a facemask (P < 0.05).

Conclusion: The outcome of this study suggests a reduction in the number of COVID-19 infection cases among patients in the study area. Age was identified as a significant risk factor. Though the RDT method used and sample size may limit categorical conclusions, the RDT facilitates rapid detection, which is cost-effective and timely. It serves as an alternative for mass testing and public health surveillance. 

KeyWords:

COVID-19, SARS-CoV-2 rapid test antigen detection, risk factors, post-pandemic, North Central

References:

  1. Africa CDC. (2024). Continental COVID-19 Update – 2024 Report. https://africacdc.org
  2. Akwa, V. L., Binbol, N. L., Samaila, K. L., & Marcus, N. D. (2007). Geographical perspective of Nassarawa State (p. 3). Onaiv Printing Publishing Company, Keffi.
  3. Aloui-Zarrouk, Z., Youssfi, L. E., Badu, K., Fagbamigbe, A. F., Matoke-Muhia, D., Ngugi, C., Dukhi, N., & Mwaura, G. (2020). The wearing of face masks in African countries under the COVID-19 crisis: luxury or necessity? AAS Open Research, 3, 36. https://doi.org/10.12688/aasopenres.13079.1
  4. Arikpo, D. I., Onyema, O. A., Oku, A. O., Meremikwu, C., Hamilton-Hurwitz, H., Toledo, J. P., Dunn, K., Baller, A., Smith, H. J., & Meremikwu, M. M. (2025). Factors influencing mask use and physical distancing for COVID-19: A qualitative evidence synthesis. Journal of public health in Africa16(2), 614. https://doi.org/10.4102/jphia.v16i2.614
  5. Augustine, O. (n.d.) Base map of Keffi town. https://www.slideshare.net/slideshow/base-map-of-keffi-town/165158049).
  6. Awopolagha, J. K., Awanye, A. M., Frank-Peterside, N., Cookey, T. I., Ibezim, C. N. E., Innocent-Adiele, H. C., Adim, C. C., Okerentugba, P. O., Onu, E. N., Okonko, B. J., & Okonko, I. O. (2024). Evaluation and validation of four rapid diagnostic test (RDTs) kits available for SARS-CoV-2 detection in Rivers State, Nigeria (Version 1). HAL Open Science. https://hal.science/hal-04575288v1
  7. Beale, S., Hoskins, S., Byrne, T., Fong, W. L. E., Fragaszy, E., Geismar, C., Kovar, J., Navaratnam, A. M. D., Nguyen, V., Patel, P., Yavlinsky, A., Johnson, A. M., Van Tongeren, M., Aldridge, R. W., Hayward, A., & Virus Watch Collaborative (2023). Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales. Journal of occupational medicine and toxicology (London, England)18(1), 5. https://doi.org/10.1186/s12995-023-00371-9
  8. Bostanghadiri, N., Ziaeefar, P., Mofrad, M. G., Yousefzadeh, P., Hashemi, A., & Darban-Sarokhalil, D. (2023). COVID-19: An Overview of SARS-CoV-2 Variants-The Current Vaccines and Drug Development. BioMed research international2023, 1879554. https://doi.org/10.1155/2023/1879554
  9. Centers for Disease Control. (2021). Scientific Brief: SARS-CoV-2 Transmission. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html
  10. Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine35(2), 121–126. https://doi.org/10.4103/0253-7176.116232.
  11. Chauhan S. (2020). Comprehensive review of coronavirus disease 2019 (COVID-19). Biomedical Journal43(4), 334–340. https://doi.org/10.1016/j.bj.2020.05.023
  12. Chen, T. P., Yao, M., Midya, V., Kolod, B., Khan, R. F., Oduwole, A., Camins, B., Leitman, I. M., Nabeel, I., Oliver, K., & Valvi, D. (2023). Symptoms predicting SARS-COV-2 test results in resident physicians and fellows in New York City. COVID, 3(5), 671–681. https://doi.org/10.3390/covid3050049
  13. Chukwuocha, U. M., Ogboeze, J. C., Bosede, A. O., Dozie, U. W., Ekeleme, U. G., Akam, V. N., & Chukwu, R. O. (2022). Use of facemask during the COVID-19 pandemic in Southeastern Nigeria: an observational study. Journal of Public Health and Development, 20(2). https://doi.org/10.55131/jphd/2022/200209
  14. Demboux Lyelet, J. E., Mayengue, P. I., Koukouikila-Koussounda, F., Doniama Essialaba, A. J., Vembe Mahounga, C. M. S., Mandiangou, A. F., Fila-Fila, G. P. U., Lenguiya, L. H., Bobouaka Bonguili, N. C., Elguero, E., Leroy, E. M., Becquart, P., & Niama, F. R. (2025). Prevalence of post-pandemic SARS-CoV-2 in patients with respiratory syndrome in Brazzaville, Republic of the Congo. BMC infectious diseases25(1), 217. https://doi.org/10.1186/s12879-025-10541-1
  15. Diamreyan, O. O., Justice, K. A., Seleipiri, H., Jemina, & Oluwatoyin, O. F. (2024). Regional disparities in COVID-19 case fatality rates: A comparative analysis of Nigerian Geopolitical Regions in 2020 and 2023. GSC Advanced Research and Reviews, 18(3), 281–290. https://doi.org/10.30574/gscarr.2024.18.3.0495
  16. Dinnes J. (2021). COVID-19 rapid antigen testing strategies require careful evaluation. EBioMedicine70, 103491.https://doi.org/10.1016/j.ebiom.2021.103491
  17. Elimian, K. O., Aderinola, O., Gibson, J., Myles, P., Ochu, C. L., King, C., Okwor, T., Gaudenzi, G., Olayinka, A., Zaiyad, H. G., Ohonsi, C., Ebhodaghe, B., Dan-Nwafor, C., Nwachukwu, W., Abdus-Salam, I. A., Akande, O. W., Falodun, O., Arinze, C., Ezeokafor, C., . . . Ihekweazu, C. (2021). Assessing the capacity of symptom scores to predict COVID-19 positivity in Nigeria: a national derivation and validation cohort study. BMJ Open, 11(9), e049699. https://doi.org/10.1136/bmjopen-2021-049699
  18. Enabulele, O., & Mobolaji, A. (2022). COVID-19 pandemic: an assessment of risk perception and the implementation of precautionary measures in a group of primary care workers in Nigeria. Journal of preventive medicine and hygiene62(4), E822–E829. https://doi.org/10.15167/2421-4248/jpmh2021.62.4.2145
  19. Filgueiras, P. S., Corsini, C. A., Almeida, N. B., Assis, J. V., Pedrosa, M. L. C., De Miranda, D. A., Gomes, S. V., Silva, R. A., Medeiros, M. I. V., Lourenço, A. J., Bicalho, C. M., Vilela, R. V., Fernandes, G. R., & Grenfell, R. F. (2022). COVID-19 rapid antigen test at hospital admission associated to the knowledge of individual risk factors allow overcoming the difficulty of managing suspected patients in hospitals. Fortune Journal of Health Sciences, 05(02). https://doi.org/10.26502/fjhs.055
  20. Fisher, K. A., Barile, J. P., Guerin, R. J., Vanden Esschert, K. L., Jeffers, A., Tian, L. H., Garcia-Williams, A., Gurbaxani, B., Thompson, W. W., & Prue, C. E. (2020). Factors Associated with Cloth Face Covering Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020. MMWR. Morbidity and Mortality Weekly Report69(28), 933–937. https://doi.org/10.15585/mmwr.mm6928e3
  21. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., ... & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5
  22. Karia, R., Gupta, I., Khandait, H., Yadav, A., & Yadav, A. (2020). COVID-19 and its Modes of Transmission. SN comprehensive clinical medicine2(10), 1798–1801. https://doi.org/10.1007/s42399-020-00498-4
  23. Kiani, P., Hendriksen, P. A., Kim, A. J., Garssen, J., & Verster, J. C. (2024). Comparative Analysis of the Clinical Presentation of Individuals Who Test Positive or Negative for SARS-CoV-2: Results from a Test Street Study. Viruses16(7), 1031. https://doi.org/10.3390/v16071031
  24. Kolude, O., Emmanuel, E. E., Aibinuomo, A. O., Ipinnimo, T. M., Ilesanmi, M. O., & Adu, J. A. (2022). Assessment of the quality of COVID-19 antigen rapid diagnostic testing in the testing sites of Ekiti State, Nigeria: A quality improvement cross-sectional study. Cureus, 14(4), e24173. https://doi.org/10.7759/cureus.24173
  25. Laguna-Goya, R., Utrero-Rico, A., Talayero, P., Lasa-Lazaro, M., Ramirez-Fernandez, A., Naranjo, L., Segura-Tudela, A., Cabrera-Marante, O., Rodriguez de Frias, E., Garcia-Garcia, R., Fernández-Ruiz, M., Aguado, J. M., Martinez-Lopez, J., Lopez, E. A., Catalan, M., Serrano, A., & Paz-Artal, E. (2020). IL-6-based mortality risk model for hospitalized patients with COVID-19. The Journal of allergy and clinical immunology146(4), 799–807.e9. https://doi.org/10.1016/j.jaci.2020.07.009
  26. Meltzer, L., Amit, S., Gilboa, M., Tal, I., Mechnik, B., Irony, A., Engelrad, H., Epstein, A., Frenkel-Nir, Y., Levy, Y., Kreiss, Y., & Regev-Yochay, G. (2023). The use of rapid COVID-19 antigen test in the emergency Department as a Decision-Support tool. Microorganisms, 11(2), 284. https://doi.org/10.3390/microorganisms11020284
  27. Morawska, L., Tang, J. W., Bahnfleth, W., Bluyssen, P. M., Boerstra, A., Buonanno, G., Cao, J., Dancer, S., Floto, A., Franchimon, F., Haworth, C., Hogeling, J., Isaxon, C., Jimenez, J. L., Kurnitski, J., Li, Y., Loomans, M., Marks, G., Marr, L. C., . . . Yao, M. (2020). How can airborne transmission of COVID-19 indoors be minimised? Environment International, 142, 105832. https://doi.org/10.1016/j.envint.2020.105832
  28. Nigeria Centre for Disease Control (NCDC). (2022). COVID-19 Nigeria Situation Reports. https://ncdc.gov.ng
  29. Obi, I. R., Obi, K. M., Seer-Uke, E. N., Onuorah, S. I., & Okafor, N. P. (2021). Preventive health care services utilization and its associated factors among older adults in rural communities in Anambra State, Nigeria. The Pan African medical journal39, 83. https://doi.org/10.11604/pamj.2021.39.83.26997
  30. Ogunsola, F. T., Ejekam, C. S., Balogun, M., Ugonna, I., Odukoya, O., Oduyebo, O., Adeyemo, W. L., Oladele, R. O., & Akanmu, S. A. (2023). Universal use of face mask for the prevention of the spread of COVID-19 in community settings in a South-western State of Nigeria: willingness and barriers. Antimicrobial Resistance and Infection Control12(1), 64. https://doi.org/10.1186/s13756-023-01267-3
  31. Oluwale, Y. (2025). Commissioning the Multi-Specialty Complex at the Federal Medical Centre Keffi, Nasarawa State. Federal Ministry of Health and Social Welfare. https://health.gov.ng/commissioning-the-multi-specialty-complex-at-the-federal-medical-centre-keffi-nasarawa-state/
  32. Omonkhua, A. A., Faneye, A., Akinwande, K. S., Evaezi, O., Shehu, N. Y., Onayade, A., Ochu, C. L., Popoola, M., Emmanuel, N., Ojo, T., Ohonsi, C., Abubakar, A., Odeh, E., Akinduti, P., Folarin, O., Bimba, J. S., Igumbor, E., Elimian, K., Edem, V. F., . . . Group, C. R. V. I. N. S. (2024). Performance evaluation of SARS-CoV-2 rapid diagnostic tests in Nigeria: A cross-sectional study. PLOS Global Public Health, 4(7), e0003371. https://doi.org/10.1371/journal.pgph.0003371
  33. Orji, B., Oliveras, E., Odio, B., Anoke, C., Onuoha, H., Ugwa, E., Howard, M., Idris, I., Akpan, E., Okoh, F., Nwani, C., Adetiloye, O., Lawrence, N., Oduenyi, C., Ogharu, E., Enne, J., Abolaji, F. W., Adegbulu, R. S., & Bryce, E. (2023). Knowledge, attitudes and practices of infection prevention and control among healthcare workers during the COVID 19 pandemic: a descriptive cross-sectional study in three Nigerian states. BMC health services research23(1), 253. https://doi.org/10.1186/s12913-023-09218-9
  34. Perra N. (2021). Non-pharmaceutical interventions during the COVID-19 pandemic: A review. Physics reports, 913, 1–52. https://doi.org/10.1016/j.physrep.2021.02.001
  35. Rahman, H. S., Aziz, M. S., Hussein, R. H., Othman, H. H., Omer, S. H. S., Khalid, E. S., Abdulrahman, N. A., Amin, K., & Abdullah, R. (2020). The transmission modes and sources of COVID-19: A systematic review. International Journal of Surgery Open, 26, 125–136. https://doi.org/10.1016/j.ijso.2020.08.017
  36. Sarkar, M., & Madabhavi, I. (2024). COVID-19 mutations: An overview. World journal of methodology14(3), 89761. https://doi.org/10.5662/wjm.v14.i3.89761
  37. Sarker, R., Roknuzzaman, A. S. M., Nazmunnahar, Shahriar, M., Hossain, M. J., & Islam, M. R. (2023). The WHO has declared the end of pandemic phase of COVID‐19: Way to come back in the normal life. Health Science Reports, 6(9), e1544. https://doi.org/10.1002/hsr2.1544
  38. Turcato, G., Zaboli, A., Pfeifer, N., Sibilio, S., Tezza, G., Bonora, A., Ciccariello, L., & Ausserhofer, D. (2021). Rapid antigen test to identify COVID-19 infected patients with and without symptoms admitted to the Emergency Department. The American Journal of Emergency Medicine, 51, 92–97. https://doi.org/10.1016/j.ajem.2021.10.022
  39. Uchenna, T., Ismaila, I., Emmanuel, A., Emmanuel, O., Emmanuel, O., Mercy, O., & Usman, M. (2024). COVID-19 in suspected cases at Federal Medical Centre Keffi. International Journal of Research and Scientific Innovation, XI(VII), 1–9. https://doi.org/10.51244/ijrsi.2024.1107001
  40. Utulu, R., Ajayi, I. O., Bello, S., Balogun, M. S., Madubueze, U. C., Adeyemi, I. T., Omoju, O. T., Adeke, A. S., Adenekan, A. O., & Iyare, O. (2022). Risk factors for COVID-19 infection and disease severity in Nigeria: a case-control study. The Pan African medical journal41, 317. https://doi.org/10.11604/pamj.2022.41.317.34307
  41. World Health Organisation. (2021). Tracking SARS-CoV-2 Variants. World Health Organization. Retrieved from: https://www.who.int/en/activities/tracking-SARS-CoV-2-variants
  42. World Health Organization. (2025). Coronavirus disease (COVID-19). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/coronavirus-disease-(covid-19)
  43. World Health Organization: WHO. (2020). Coronavirus. https://www.who.int/health-topics/coronavirus
  44. World Health Orginisation. (2025). COVID-19 Dashboard. https://covid19.who.int
  45. Yazdi-Feyzabadi, V., Sabermahani, M., Borhaninejad, V., & Iranmanesh, M. (2025). Breaking barriers: challenges faced by the older adults in accessing primary healthcare in a developing country. BMC geriatrics25(1), 946. https://doi.org/10.1186/s12877-025-06712-z
  46. Zabidi, N. Z., Liew, H. L., Farouk, I. A., Puniyamurti, A., Yip, A. J. W., Wijesinghe, V. N., Low, Z. Y., Tang, J. W., Chow, V. T. K., & Lal, S. K. (2023). Evolution of SARS-CoV-2 Variants: Implications on Immune Escape, Vaccination, Therapeutic and Diagnostic Strategies. Viruses15(4), 944. https://doi.org/10.3390/v15040944
  47. Zhang, J., Wang, X., Jia, X., Li, J., Hu, K., Chen, G., Wei, J., Gong, Z., Zhou, C., Yu, H., Yu, M., Lei, H., Cheng, F., Zhang, B., Xu, Y., Wang, G., & Dong, W. (2020). Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clinical Microbiology and Infection, 26(6), 767–772. https://doi.org/10.1016/j.cmi.2020.04.012