Comprehensive occupational health services for healthcare workers in Zimbabwe during the SARS-CoV-2 pandemic.

Abstract

BACKGROUND:

Healthcare workers are disproportionately affected by COVID-19. In low- and middle- income countries, they may be particularly impacted by underfunded health systems, lack of personal protective equipment, challenging working conditions and barriers in accessing personal healthcare.

METHODS:

In this cross-sectional study, occupational health screening was implemented at the largest public sector medical centre in Harare, Zimbabwe, during the "first wave" of the country's COVID-19 epidemic. Clients were voluntarily screened for symptoms of COVID-19, and if present, offered a SARS-CoV-2 nucleic acid detection assay. In addition, measurement of height, weight, blood pressure and HbA1c, HIV and TB testing, and mental health screening using the Shona Symptom Questionnaire (SSQ-14) were offered. An interviewer-administered questionnaire ascertained client knowledge and experiences related to COVID-19.

RESULTS:

Between 27th July and 30th October 2020, 951 healthcare workers accessed the service; 210 (22%) were tested for SARS-CoV-2, of whom 12 (5.7%) tested positive. Clients reported high levels of concern about COVID-19 which declined with time, and faced barriers including lack of resources for infection prevention and control. There was a high prevalence of largely undiagnosed non-communicable disease: 61% were overweight or obese, 34% had a blood pressure of 140/90mmHg or above, 10% had an HbA1c diagnostic of diabetes, and 7% had an SSQ-14 score consistent with a common mental disorder. Overall 8% were HIV-positive, with 97% previously diagnosed and on treatment.

CONCLUSIONS:

Cases of SARS-CoV-2 in healthcare workers mirrored the national epidemic curve. Implementation of comprehensive occupational health services during a pandemic was feasible, and uptake was high. Other comorbidities were highly prevalent, which may be risk factors for severe COVID-19 but are also important independent causes of morbidity and mortality. Healthcare workers are critical to combatting COVID-19; it is essential to support their physical and psychological wellbeing during the pandemic and beyond.

• Authors: Fungai Kavenga, Hannah M Rickman, Rudo Chingono, Tinotenda Taruvinga, Takudzwa Marembo, Justen Manasa, Edson Marambire, Grace McHugh, Celia L Gregson, Tsitsi Bandason, Nicol Redzo, Aspect Maunganidze, Tsitsi Magure, Chiratidzo Ndhlovu, Hilda Mujuru, Simbarashe Rusakaniko, Portia Manangazira, Rashida A Ferrand, Katharina Kranzer
• Journal: PloS one (PLoS One) Vol. 16 Issue 11 Pg. e0260261 ( 2021) ISSN: 1932-6203 [Electronic] United States
• PMID: 34813627 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• COVID-19 (epidemiology, prevention & control, transmission, virology)
• Cross-Sectional Studies
• Delivery of Health Care (standards)
• Female
• Health Personnel (statistics & numerical data)
• Humans
• Male
• Occupational Health (standards)
• Occupational Health Services (standards)
• Personal Protective Equipment (standards)
• SARS-CoV-2
• Zimbabwe (epidemiology)