True Scale Research Articles

An mHealth Intervention to Improve Pre-Exposure Prophylaxis Knowledge Among Young Black Women in Family Planning Clinics: Development and Usability Study.

BackgroundYoung Black women between the ages of 18 and 24 years are disproportionately impacted by HIV, yet they have a low self-perception of HIV risk and limited exposure to prevention strategies. Pre-exposure prophylaxis (PrEP) is a safe and effective biomedical HIV prevention strategy for those at risk for HIV infection, but uptake has been slow among cisgender women. Family planning clinics are a primary source of health care access for young women, providing an ideal opportunity to integrate PrEP information and care into existing clinic practices.ObjectiveThe aim of this study was to use a multistage, community-engaged process to develop a mobile health app and to evaluate the feasibility and acceptability of the app.MethodsUsing user-centered design, the In the Loop app was developed in collaboration with a community advisory board of young Black women. This study employed a multistage design, which included community-engaged app development, user testing, and evaluation of the app’s feasibility and acceptability. A pre- and postdesign was used to assess the impact of the app on PrEP knowledge immediately after app use. Descriptive statistics (eg, mean, SD, and percentage values) were used to describe the sample, and Wilcoxon matched-pairs signed-ranks test was used to detect changes in PrEP knowledge before and immediately after using the app.ResultsA total of 50 sexually active, young Black women, aged 18-24 (mean 21, SD 1.9) years, were enrolled in this study. Analysis comparing scores before and immediately after use of the app revealed a significant increase in PrEP content knowledge scores on a 7-item true or false scale (z=–6.04, P<.001). Overall, participants considered the In the Loop app feasible and acceptable to use while waiting for a family planning visit. The majority of participants (n=46, 92%) agreed that they would recommend In the Loop to friends to learn more about PrEP. Participants rated the overall quality of the app 4.3 on a 1-5 scale (1=very poor and 5=very good). Of 50 participants, 40 (80%) agreed that the app was easy to use, and 48 (96%) agreed that they found the information in the app easy to understand. Finally, 40 (80%) agreed that they had enjoyed using the app while waiting for their family planning visit.ConclusionsOur findings suggest that young Black women waiting for family planning visits found the In the Loop app to be feasible and acceptable. This study demonstrates the value of engaging young Black women in the app design process. As family planning clinics are a primary source of health care access for young women, they provide an ideal setting to integrate PrEP information and care into existing clinic practices. Next steps in the development of the In the Loop app include implementing user-suggested improvements and conducting efficacy testing in a randomized controlled trial to determine the app’s impact on PrEP uptake.

On the scale height of the molecular gas disc in Milky Way-like galaxies

ABSTRACT We study the relationship between the scale height of the molecular gas disc and the turbulent velocity dispersion of the molecular interstellar medium within a simulation of a Milky Way-like galaxy in the moving-mesh code arepo. We find that the vertical distribution of molecular gas can be described by a Gaussian function with a uniform scale height of ∼50 pc. We investigate whether this scale height is consistent with a state of hydrostatic balance between gravity and turbulent pressure. We find that the hydrostatic prediction using the total turbulent velocity dispersion (as one would measure from kiloparsec-scale observations) gives an overestimate of the true molecular disc scale height. The hydrostatic prediction using the velocity dispersion between the centroids of discrete giant molecular clouds (cloud–cloud velocity dispersion) leads to more accurate estimates. The velocity dispersion internal to molecular clouds is elevated by the locally enhanced gravitational field. Our results suggest that observations of molecular gas need to reach the scale of individual molecular clouds in order to accurately determine the molecular disc scale height.

Unpacking data-centric geotechnics

The purpose of this paper (presented online as a keynote lecture at the 25th Annual Indonesian Geotechnical Conference on 10 Nov 2021) is to broadly conceptualize the agenda for data-centric geotechnics, an emerging field that attempts to prepare geotechnical engineering for digital transformation. The agenda must include (1) development of methods that make sense of all real-world data (not selective input data for a physical model), (2) offering insights of significant value to critical real-world decisions for current or future practice (not decisions for an ideal world or decisions of minor concern to geotechnical engineers), and (3) sensitivity to the physical context of geotechnics (not abstract data-driven analysis connected to geotechnics in a peripheral way, i.e., engagement with the knowledge and experience base should be substantial). These three elements are termed “data centricity”, “fit for (and transform) practice”, and “geotechnical context” in the agenda. Given that a knowledge of the site is central to any geotechnical engineering project, data-driven site characterization (DDSC) must constitute one key application domain in data-centric geotechnics, although other infrastructure lifecycle phases such as project conceptualization, design, construction, operation, and decommission/reuse would benefit from data-informed decision support as well. One part of DDSC that addresses numerical soil data in a site investigation report and soil property databases is pursued under Project DeepGeo. In principle, the source of data can also go beyond site investigation, and the type of data can go beyond numbers, such as categorical data, text, audios, images, videos, and expert opinion. The purpose of Project DeepGeo is to produce a 3D stratigraphic map of the subsurface volume below a full-scale project site and to estimate relevant engineering properties at each spatial point based on actual site investigation data and other relevant Big Indirect Data (BID). Uncertainty quantification is necessary, as current real-world data is insufficient, incomplete, and/or not directly relevant to construct a deterministic map. The value of a deterministic map for decision support is debatable. The computational cost to do this for a 3D true scale subsurface volume must be reasonable. Ultimately, geotechnical structures need to be a part of a completely smart infrastructure that fits the circular economy and need to focus on delivering service to end-users and the community from project conceptualization to decommission/reuse with full integration to smart city and smart society. Although current geotechnical practice has been very successful in taking “calculated risk” informed by limited data, imperfect theories, prototype testing, observations, among others and exercising judicious caution and engineering judgment, there is no clear pathway forward to leverage on big data and digital technologies such as machine learning, BIM, and digital twin to meet more challenging needs such as sustainability and resilience engineering.

Competing risks predictions with different time scales under the additive risk model.

In the analysis for competing risks data, regression modeling of the cause-specific hazard functions has been usually conducted using the same time scale for all event types. However, when the true time scale is different for each event type, it would be appropriate to specify regression models for the cause-specific hazards on different time scales for different event types. Often, the proportional hazards model has been used for regression modeling of the cause-specific hazard functions. However, the proportionality assumption may not be appropriate in practice. In this article, we consider the additive risk model as an alternative to the proportional hazards model. We propose predictions of the cumulative incidence functions under the cause-specific additive risk models employing different time scales for different event types. We establish the consistency and asymptotic normality of the predicted cumulative incidence functions under the cause-specific additive risk models specified on different time scales using empirical processes and derive consistent variance estimators of the predicted cumulative incidence functions. Through simulation studies, we show that the proposed prediction methods perform well. We illustrate the methods using stage III breast cancer data obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute.

Belief in conspiracy theories and esoteric thinking during COVID-19 pandemic

IntroductionPsychological distress during the SARS-CoV-2 pandemic can manifest itself in interpretations of what is happening.ObjectivesTo analyze response to COVID-19 pandemic in people with high level of esoteric thinking.Methods Internet survey 23.03.20-29.01.21 (N=621); Constructive Thinking Inventory(CTI); SCL-90R. It was proposed to assess statements: “The authorities are hiding the true scale of the coronavirus pandemic”, “Coronavirus is the result of biological weapons development”, “Coronavirus is a punishment or a sign sent to people from above”, “The emergence of the coronavirus is the Earth’s response to its pollution”. It was offered to express an opinion about pandemic. The answers were coded on the basis of qualitative semantic analysis.ResultsThe growth of “esoteric thinking” was revealed (Std.J-T, p=.025). With a high level of esoteric thinking, emotional statements (“fear, anxiety, panic”) are more common (27.8% versus 16.9% for group with high and low level of «esoteric thinking»). Correlations of the level of «esoteric thinking» with level of depression (Spearman’s correlation ,085*), anxiety (,097*), GSI (,130**), «fears for the life» (23.4% versus 14.5%) show high emotional distress. With an increase in the level of «esoteric thinking», belief in various conspiracy theories increases; Spearman’s correlation ,370** with the belief is biological weapons, punishment for sins (,355**), belief in concealing information about the pandemic (,167**).ConclusionsA high level of esoteric thinking is associated with an increased emotional response to the pandemic and with belief in conspiracy theories, and can increase emotional instability by itself also making constructive decisions difficult in situations related to protecting personal health and safety.DisclosureNo significant relationships.

Speak truth to power and consolidate the nursing visibility gained during COVID-19.

AimTo provide a perspective on the visibility of nursing gained during the COVID‐19 pandemic and propose strategic options for nurses to consolidate their expanded roles and influence.BackgroundThe COVID‐19 pandemic has exposed long‐standing inequities across the world. Factors preserving discrimination weakened during the emergency are now being re‐established by neo‐liberalist influences that dismiss the true scale of the disaster and shape the narrative in ways that increase public risk and render nurses invisible.Sources of EvidenceAll evidence drawn from publicly available sources is presented through the lens of the authors' nursing, management, education, policy and research experience.DiscussionNurse advocacy will be needed during future decades of pandemic control and recovery and be in a position to deliver appropriate care and services.ConclusionFor nurses at all levels to remain visible, important, valued and respected, they need to be informed, engaged and willing to make a stand to preserve the hard‐won reputational gains of the last 30 months of the COVID‐19 pandemic.Implications for Nursing PracticeNurse advocacy and engagement are needed to maintain public awareness of the ongoing risks and safety options associated with the pandemic.Implications for Health and Social PolicyNurses and other health practitioners need to reveal the true level of devastation that continues to occur and guide the focus of political and administrative strategies in response to COVID‐19 impacts on services and public health orders.

Micro-particle entrapment dynamics in microfluidic pulmonary capillary networks

The journey of vascular targeted carriers (VTC) in the circulatory system is highly intricate and includes navigation through different vessel structures, such as the vast pulmonary capillary network (PCN) in the lungs where particles can get entrapped and lead to blockage. Here, we leverage microfluidic PCN models to explore, for the first time, micro-particle capillary entrapment, in a well-controlled biophysical environment mimicking human physiological hemodynamics at true scale. This in vitro strategy mimics the challenges of vascular carrier transport during their journey in the smallest capillaries of the body (∼5 µm). Specifically, we explore in the PCN model entrapment dynamics of spherical micro-particles of different diameters (i.e. 3, 4 and 4.5 µm) at different concentrations, comparing their motion in cell-free buffer to that in the presence of red blood cells (RBCs). Notably, while 3 µm particles exhibit undisturbed transport in all of the examined concentrations, both in cell-free buffer and in the presence of RBCs, particles of 4 and 4.5 µm exhibit a concentration-dependent transport where the presence of RBCs leads in fact to reduced entrapment. Our experiments suggest that collisions of micro-particles with RBCs can facilitate their navigability, allowing for carrier transport that would lead otherwise to rapid entrapment in a cell-free environment. Altogether, the proposed preclinical in vitro assays offer rapid screening opportunities for design optimization of VTC transport in capillary networks.

An exploration of the development of resilience in student midwives

Background Resilience has been considered a key personal characteristic for a healthcare professional to be able to cope with the demands of their profession. There is a paucity of research that has considered resilience in midwifery and none has used a resilience scale over the length of the midwifery programme. Methods A resilience scale was used with one cohort of student midwives on five occasions throughout their midwifery programme. Results The mean across all of the five scale scores for the 15 participants was 122 (range of mean scores:92–135). The majority of participants (n=13) had average, moderate or moderately high resilience and all student midwives except one increased their resilience between the first and fifth completion of the scale. Conclusions The true resilience scale is a useful tool to use in midwifery undergraduate programmes to determine the development of resilience in student midwives. Importantly, the scale could be used at an early opportunity to identify any support needs.

Widespread in situ follicular neoplasia in patients who subsequently developed follicular lymphoma.

In situ follicular neoplasia (ISFN) is usually an occasional incidental finding in lymph nodes by BCL2 immunohistochemistry, and its true scale is unknown. We have identified six cases of follicular lymphoma (FL) with a history of solid neoplasm 4–16 years ago, from which ISFN was identified widely in the surgically cleared lymph nodes (LNs). Using clone‐specific PCR and BaseScope in situ hybridisation with primers or probes specific to the VDJ or BCL2–IGHJ junction sequence, we confirmed the clonal identity among different ISFNs and overt‐FL in each of the four cases successfully investigated. Mutation analyses of overt‐FL by targeted next‐generation sequencing identified multiple potential pathogenic changes involving CREBBP, EZH2, KMT2D, TNFRS14, and STAT6. Further investigations of these mutations in paired ISFNs using Fluidigm PCR and Illumina sequencing showed the presence of the FL‐associated mutations in early lesions for two of the six cases investigated (CREBBP and KMT2D in one case and STAT6 in the other), with one case displaying stepwise accumulation of its observed mutations. Remarkably, there were considerable divergences in BCL2 variants among different ISFN‐involved lymph nodes in all four cases successfully investigated, indicating ongoing intraclonal diversification by somatic hypermutation machinery. Our findings demonstrate widespread distribution of ISFN lesions, further implicating their dynamic nature with the neoplastic cells undergoing active trafficking and clonal evolution. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Design and analysis of an electric bike chassis

Development of any vehicle, be it a two wheeler or a four wheeler, is a complex and detailed engineering process. For its progress, designers have to prepare concept sketches on 2D platforms (on sheets and graphic tablets), model them on 3D softwares and carry out a bunch of simulations and tests on various computer aided engineering softwares. The aim of this paper is to design and analyze an electric bike chassis and hence prove its stability by performing static structural test. Solidworks was used for modeling the chassis and ANSYS was utilized to analyze it. The frame presented in this study is an original concept and dissimilar to the conventional IC engine chassis. Aspects like the weight of the chassis, its strength, rigidness, and storage space available to the consumer were considered while designing it. Initially, three different frames were modeled and after brainstorming session with experts, the best one out of the three was finalized considering all the above mentioned parameters in mind. In total, four materials were applied on the skeleton for its analysis. These included carbon steel AISI 1018, alloy steel AISI 4130, aluminum alloy 2018, and aluminum alloy AISI 7068 T6. The simulations were completed in true scale. Later on the results were compared and the deformations were thoroughly revised by the team. Considering the cost, weight and the final results of the deformations, the best material was picked up.

Assessing the actions of the Brazilian Federal Government to respond to the 2019 mysterious oil spill: a perpective of the national environmental agency

On August 30, 2019, in the state of Paraíba, an oil spill of unprecedented characteristics reached Brazil, affecting 1009 coastal locations, in eleven states (from Maranhão to Rio de Janeiro). The objective of this paper is to present a description of the incident scenario from the perspective of the Brazilian Federal Government. Furthermore, the analysis of its performance regarding the actions and tools employed focuses on the role of the Federal Environment Agency (Ibama). Ibama led the Federal Government's initiatives for managing the spill when its true scale was yet unknown. Once the emergency was officially recognized, the Government acted through the implementation of the National Contingency Plan for Oil Pollution Incidents in Waters Under National Jurisdiction. From then on, the spill management was under the command of the "Grupo de Acompanhamento e Avaliação" (composed of Ibama, the Brazilian Petroleum Agency, and the Navy). The performance of other entities was crucial to make response actions feasible. Management tools were added to help the standardization, speed, and consolidation of the information collected in the field. Considering the specificities and limitations imposed by this event, we conclude that the Federal management of the spill was adequate, although opportunities for improvement were identified.

HERMES - a GUI-based software tool for pre-processing of X-ray absorption spectroscopy data from laboratory Rowland circle spectrometers.

HERMES, a graphical user interface software tool, is presented, for pre-processing X-ray absorption spectroscopy (XAS) data from laboratory Rowland circle spectrometers, to meet the data handling needs of a growing community of practice. HERMES enables laboratory XAS data to be displayed for quality assessment, merging of data sets, polynomial fitting of smoothly varying data, and correction of data to the true energy scale and for dead-time and leakage effects. The software is written in Java 15 programming language, and runs on major computer operating systems, with graphics implementation using the JFreeChart toolkit. HERMES is freely available and distributed under an open source licence.

Systematic Review of Excess Mortality in India during the Covid-19 Pandemic with Differentiation between Model-Based and Data-Based Mortality Estimates.

COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death.

Scientific schools of universities and character-building work

Scientific schools shape the image of universities, while the activity of the scientific schools enables sustainable and dynamic development of the universities. This paper is devoted to the role of scientific schools in characterbuilding work in the context of leading aerospace engineering universities of Russia. The paper stresses the value of building the students’ character based on the example of the older senior counterparts capable of transferring their experience and teaching the cutting-edge methods of educational and scientific work. Among these methods, the paper highlights a historical approach in the description of the logic and evolution of design and manufacturing solutions and the method of size effect, allowing in-depth comprehension of the true scale and composition of complex aerospace equipment. Aerospace universities of Russia implement these methods with special study laboratories called demonstration halls. Having unique specimens of spacecrafts in these laboratories helps preserve the historical memory of the forefront research of Russian scientists and engineers. Practical classes in such laboratories are a fine example of transferring the scientific legacy and positively affecting the motivation for professional growth.

"Reading. The encyclopedic dictionary"

The reading encyclopedia has been published for the first time in Russia. It generalizes the accumulated knowledge of the reading phenomenon in various science domains (philosophy, psychology, pedagogy, philology, bibliology, library studies, physiology, etc.) and represent it in its true scale – as the foundation, along with writing, of the civilization and a component of political, economical, humanitarian development of any state, as a keystone of full-fledged personal development. The dictionary comprises 371 definitions revealing various aspects of reading as a concept. The dictionary is intended for scientists and researchers, lecturers, teachers, librarians, under- and post-graduate students, for everyone who regards reading as “invaluable treasure” for a person and the humankind on the whole.

Revisiting Airflow and Aerosol Transport Phenomena in the Deep Lungs with Microfluidics.

The dynamics of respiratory airflows and the associated transport mechanisms of inhaled aerosols characteristic of the deep regions of the lungs are of broad interest in assessing both respiratory health risks and inhalation therapy outcomes. In the present review, we present a comprehensive discussion of our current understanding of airflow and aerosol transport phenomena that take place within the unique and complex anatomical environment of the deep lungs, characterized by submillimeter 3D alveolated airspaces and nominally slow resident airflows, known as low-Reynolds-number flows. We exemplify the advances brought forward by experimental efforts, in conjunction with numerical simulations, to revisit past mechanistic theories of respiratory airflow and particle transport in the distal acinar regions. Most significantly, we highlight how microfluidic-based platforms spanning the past decade have accelerated opportunities to deliver anatomically inspired in vitro solutions that capture with sufficient realism and accuracy the leading mechanisms governing both respiratory airflow and aerosol transport at true scale. Despite ongoing challenges and limitations with microfabrication techniques, the efforts witnessed in recent years have provided previously unattainable in vitro quantifications on the local transport properties in the deep pulmonary acinar airways. These may ultimately provide new opportunities to explore improved strategies of inhaled drug delivery to the deep acinar regions by investigating further the mechanistic interactions between airborne particulate carriers and respiratory airflows at the pulmonary microscales.

Phylogenomic Reappraisal of Fatty Acid Biosynthesis, Mycolic Acid Biosynthesis and Clinical Relevance Among Members of the Genus Corynebacterium.

The genus Corynebacterium encompasses many species of biotechnological, medical or veterinary significance. An important characteristic of this genus is the presence of mycolic acids in their cell envelopes, which form the basis of a protective outer membrane (mycomembrane). Mycolic acids in the cell envelope of Mycobacterium tuberculosis have been associated with virulence. In this study, we have analysed the genomes of 140 corynebacterial strains, including representatives of 126 different species. More than 50% of these strains were isolated from clinical material from humans or animals, highlighting the true scale of pathogenic potential within the genus. Phylogenomically, these species are very diverse and have been organised into 19 groups and 30 singleton strains. We find that a substantial number of corynebacteria lack FAS-I, i.e., have no capability for de novo fatty acid biosynthesis and must obtain fatty acids from their habitat; this appears to explain the well-known lipophilic phenotype of some species. In most species, key genes associated with the condensation and maturation of mycolic acids are present, consistent with the reports of mycolic acids in their species descriptions. Conversely, species reported to lack mycolic acids lacked these key genes. Interestingly, Corynebacterium ciconiae, which is reported to lack mycolic acids, appears to possess all genes required for mycolic acid biosynthesis. We suggest that although a mycolic acid-based mycomembrane is widely considered to be the target for interventions by the immune system and chemotherapeutics, the structure is not essential in corynebacteria and is not a prerequisite for pathogenicity or colonisation of animal hosts.

He was the best among us. In memory of our friend and colleague - Vitaly Vasilyevich Bezbakh (1947-2021)

It just so happens that you begin to understand the true scale of a scientists personality after his death. Vitaly Vasilievich Bezbakh left us on June 25, 2021, completing his life path in the prime of his talent as a scientist, organizer of science and teacher. The article is dedicated to the memory of Professor Bezbach. The main directions of scientific research, contribution to Russian civil law, arbitration process and private international law are analyzed.

Excess mortality in England during the COVID-19 pandemic

IntroductionExcess mortality monitoring is not dependent on completeness or consistency of coding of causes of death and captures deaths caused directly and indirectly by COVID-19. It takes account of existing inequalities in the baseline rates and shows the additional impact of COVID-19. We report weekly on excess mortality by age, gender, geographical area, deprivation, and ethnicity.MethodsA quasi-Poisson model was fitted to deaths data for 2015-2019 to estimate expected mortality in population sub-groups each week during the COVID-19 pandemic. This was compared with observed mortality reported each week. Information on deaths registered was obtained from death certificates. Ethnicity was obtained from hospital records linked to deaths data.ResultsEarly in the pandemic, excess deaths exceeded official reported COVID-19 deaths every week. Throughout the pandemic there were stark inequalities in excess death rates. Based on data from 21 March 2020 to 9 April 2021, people living in the most deprived areas in England experienced more excess (1.21 times; 95% CI 1.21-1.22) compared with people living in the least deprived areas (1.17; 1.16-1.18). Black (1.56; 1.53-1.58) and Asian groups (1.55; 1.53-1.56) experienced more excess than the White group (1.16; 1.16-1.17). There was wide variation between English regions.ConclusionsReporting overall excess mortality early in the pandemic is important to inform policy makers and public about the true scale of the death toll when coding is inconsistent and developing. This approach has highlighted the large increases in already established inequalities in mortality. It provides rapid surveillance of developing disparities for national and local decision makers. It has been used to inform policy around reducing disparities and to revise messaging to encourage hospital attendance for non- COVID-19 health problems.Key messages Excess deaths from all causes is a robust measure of overall impact, unaffected by coding consistency.COVID-19 has dramatically worsened established inequalities between ethnic groups and deprivation groups.

The cost of clinical management of SARS-COV-2 (COVID-19) infection by level of disease severity in Ghana: a protocol-based cost of illness analysis

BackgroundAs the global strategies to fight the SARS-COV-2 infection (COVID-19) evolved, response strategies impacted the magnitude and distribution of health-related expenditures. Although the economic consequence of the COVID-19 pandemic has been dire, and its true scale is yet to be ascertained, one key component of the response is the management of infected persons which its cost has not been adequately examined, especially in Africa.MethodsTo fill gaps in context-specific cost of treating COVID-19 patients, we adopted a health system’s perspective and a bottom-up, point of care resource use data collection approach to estimate the cost of clinical management of COVID-19 infection in Ghana. The analysis was based on the national protocol for management of COVID-19 patients at the time, whether in public or private settings. No patients were enrolled into the study as it was entirely a protocol-based cost of illness analysis.ResultWe found that resource use and average cost of treatment per COVID-19 case varied significantly by disease severity level and treatment setting. The average cost of treating COVID-19 patient in Ghana was estimated to be US$11,925 (GH¢68,929) from the perspective of the health system; ranging from US$282 (GH¢1629) for patients with mild/asymptomatic disease condition managed at home to about US$23,382 (GH¢135,149) for critically ill patients requiring sophisticated and specialised care in hospitals. The cost of treatment increased by some 20 folds once a patient moved from home management to the treatment centre. Overheard costs accounted for 63–71% of institutionalised care compared to only 6% for home-based care. The main cost drivers in overhead category in the institutionalised care were personal protective equipment (PPEs) and transportation, whilst investigations (COVID-19 testing) and staff time for follow-up were the main cost drivers for home-based care.ConclusionCost savings could be made by early detection and effective treatment of COVID-19 cases, preferably at home, before any chance of deterioration to the next worst form of the disease state, thereby freeing up more resources for other aspects of the fight against the pandemic. Policy makers in Ghana should thus make it a top priority to intensify the early detection and case management of COVID-19 infections.