Occupational risk factors associated with Covid-19 among Health Workers in a tertiary referral Hospital, Nairobi Kenya: A case control study

Abstract

Background: Covid-19 disease disproportionately affected health workers (HWs) by worsening the preexisting shortage of HWs in developing countries , thus overwhelming health systems and disrupting health delivery. However, evidence on the predominant sources of Covid-19 exposure among HWs in sub-Saharan Africa remains scarce. This study sought to identify the occupational risk factors associated with Covid-19 disease among HWs in a tertiary hospital in Kenya. Methods: An unmatched case-control study design was used to assess exposure differences between 39 randomly sampled PCR Covid-19 positive HWs (cases) and 108 conveniently sampled PCR Covid-19 negative and asymptomatic HWs(controls). An adapted WHO risk assessment questionnaire was administered via phone interviews to measure occupational exposure in the last two weeks before each participant’s PCR Covid-19 test between November 2021 and December 2021. Multivariable logistic regression was applied to identify the statistically significant risk factors and the results on adjusted Odds Ratio (aOR) were reported at 95% Confidence Intervals (P<0.05). Results: Controlling for the sex and the clinical status, sub-optimal adherence to face shields ((aOR 4,p<0.05), suboptimal infection prevention control (IPC) adherence in common staff dining rooms (aOR 8,p<0.05), working in medium risk departments (aOR 7,p<0.05) in the last 2 weeks before PCR Covid-19 testing were the significant occupational risk factors to Covid-19 disease among HWs. Conclusions: Reinforcing adherence to facial protective gears together with other personal protective equipment and promoting adherence to infection prevention protocols among HWs in occupational areas with perceived lower risk of infectious disease such as common hospital rooms can reduce the spread of Covid-19 among HWs. Future validation of occupational exposure risk assessment tool across different hospital and health delivery settings can improve comparability and generalizability of findings to inform policies for optimal protection of HWs during SARSCoV2 and similar infectious disease pandemics.