Factors associated with Coronavirus disease 2019 (COVID-19) and an assessment of adherence to infection prevention and control (IPC) guidelines among health workers —Nakonde District, Zambia, 2020

Abstract

Introduction: Health workers play a critical role in the clinical management of COVID-19 patients. However, research on their infection risk and clinical characteristics, particularly in Africa, is emerging. We investigated risk factors for COVID-19 infection and assessed adherence to infection prevention and control (IPC) guidelines among health workers in Nakonde District. Methods: A case-control study among health workers at Nakonde Urban Health Centre and Nakonde District Hospital was conducted from 15 to 25 May 2020. A standardized questionnaire covering demographic information; possible exposure to persons with COVID-19; adherence to infection prevention and control measures was administered to all health workers present at these facilities. Descriptive statistics were performed and logistic regression was used to calculate the odds ratio (OR) and 95% CIs. Results: A total of 197 HCWs are deployed in the two facilities out of which we obtained 138 responses. Seventy-five (54%) had complete responses that were analyzed in this study. Among the 75, 54 (72%) were female. The median age for all the HCWs that responded was 30 years (IQR 26-33). Thirty-seven (49%) were laboratory-confirmed COVID-19 cases. Symptoms that were exhibited among HCWs with COVID-19 included cough (49%), headache (43%), runny nose (32%) and fatigue (18%); fever was rarely reported (8%). Cough was associated with being a case of COVID-19 (OR 4.2 95% CI 1.5-11.9). Coexisting conditions were similar among the cases and controls. There were no statistically significant differences in exposures between HCWs with confirmed COVID-19 and those without (OR 0.96; 95% CI 0.4-2.5). The WHO five moments of hand hygiene recommended for health workers were practiced by (64%). Non availability of Personal Protective Equipment was reported by 70% of HCWs and this was similar among the cases of COVID-19 and the non-cases. Conclusion: Given the critical role HCWs play in looking after the sick, continued protection of this population at work, at home, and in the community through surveillance should be a national priority.