Adherence to Infection Prevention Control and occurrence of COVID-19 Infection among Health Care Workers in Harare City, 2021

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Healthcare workers (HCWs) play a critical role in fighting COVID-19. Prevention remains the best weapon for protecting HCWs against the COVID-19 pandemic. Of the 506 health workers routinely tested for SARS-COV-2 infection in Harare City facilities between December 2020 and February 2021, 128/506(25%) tested positive. As a result, there was significant service disruptions. We investigated factors associated with COVID-19 infection among HCWs in Harare City.

We conducted a cross-sectional study among 467 health workers to determine behavioural, occupational and non-occupational factors and vaccination status associated with COVID-19 infection. Thirteen health facilities who reported COVID-19 HCW infection from June 2020 to June 2021 were included. Adherence to infection prevention and control (IPC) measures was assessed using standards adopted from WHO. Univariate, bivariate and stepwise logistic regression analysis was performed using Epi-info. Statistical significance was considered at a p-value <0.05.

Among the 467 HCWs interviewed, 166/467(35.5%) had a history of COVID-19 infection. Of the 166 workers with history of COVID-19, 66/166(39.8%) were nurses. Independent factors associated with contracting COVID-19 infection were: no IPC training in the past six months (aOR=2.13;95%CI 1.06-4.27), not properly wearing face masks (aOR=16.68;95%CI9.39-29.61), not observing social distance at mealtimes (aOR=6.33;95%CI3.36-11.89;p<0.01), and a COVID-19 case at home (aOR=9.03;95%CI3.93-20.76;p<0.01). Of the 378 HCWs fully vaccinated, 39/378(10.3%) had breakthrough infections. Most who had breakthrough infections, 33/39(84.6%) had asymptomatic or mild disease. One death of a female who had uncontrolled diabetes and was not vaccinated was recorded.

Predictors of COVID-19 infection among health care workers were training on IPC measures, social distancing at meal times, proper use of personal protective equipment (PPE) and having a COVID-19 case at household level. We recommended refresher training to strengthen on adherence to infection control and proper use of PPE.

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