Clinical Presentation and Risk Factors for COVID-19 among Health Care Workers in Nairobi Metropolis, Kenya, 2021

  • Respiratory Diseases
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As of March 31, 2021, COVID-19 cases were 126,372,442 with 2,769,696 deaths globally. Kenya had 134,058 cases and 2153 deaths, with the infection rate among Healthcare Workers (HCWs) increasing from 2.9% in early June 2020 to 11.2% by March 31, 2021. The factors contributing to the increase were unknown. We sought to identify factors associated with COVID-19 (SARS-Cov-2) infections among HCWs in Nairobi to guide control measures.

We conducted an unmatched case-control study at a ratio of 1 case to 2 controls. A case was as any HCW with laboratory-confirmed COVID-19 infection irrespective of clinical presentation, while controls were those who tested negative. Simple random sampling was used to select the participants who were interviewed using a structured questionnaire. We calculated univariate and multivariate statistics to determine risk factors for infection.

We enrolled 148 cases and 296 controls. The median age among cases was 35 years (IQR: 23–42.5) and for controls was 36 years (IQR: 30–44). Females were 95 (64.2%) among the cases and 215 (72.6%) among controls. Cough (71.6%) was the most reported symptom.Working in the isolation centers (aOR=5.9; 95% CI:1.835–19.036, p<0.05), working in a level 2 facility (aOR=25.1; 95% CI: 5.025–124.955, p<0.05), not always wearing Personal Protective Equipment (PPEs) (aOR=7.3; 95%CI:1.399–37.747, p<0.05), and occasionally practicing hand hygiene (aOR=77.5; 95% CI: 11.546–443.332, p<0.05), were risk factors whereas Infection Prevention Control (IPC) training (aOR=0.1; 95% CI: 0.060–0.345, p<0.05) and IPC availability (aOR=0.5; 95% CI: 0.264–0.773, p<0.05), were protective.

Infection control training, PPE use and supply, and poor hand hygiene practices were associated with infection risk. Following dissemination of these findings, the authorities enforced proper use of PPEs and IPC implementation to curb the spread of COVID-19 among HCWs, especially those working in isolation centers in level 2 facilities.

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