Assessing Risk Factors Associated With Covid19 Disease Among Health Workers at Kenyatta National Hospital: a Case Control Study

Abstract

The spread of Covid19 disease among health workers (HWs) has been associated with worsening acute shortage of HWs and overwhelmed health systems. Contextual evidence on the predominant source of Covid19 exposure among HWs remains scarce. Therefore, this study identifies the social-demographic, community, occupational, and health systems’ risk factors associated with Covid19 disease among HWs in a tertiary hospital in Kenya. Using a hospital-based, unmatched case-control study design and with an ethical approval obtained from KNH-UoN ethics committee and informed consent given by the participants, exposure differences between randomly sampled 39 Covid19 disease-positive HWs and conveniently sampled 108 Covid19 disease-negative and asymptomatic HWs were interviewed between November 2021 and December 2021. Adapting the WHO Covid19 risk assessment protocol, the socio-demographic, occupational, community and health systems characteristics were examined via phone interviews. At 95% Confidence Interval and applying multiple imputations for missing data at random, a multivariable logistic regression was applied to identify the statistically significant independent variables associated with the covid19 disease outcomes of a HW. Controlling for the sex and clinical status, sub-optimal adherence to face shield (p<0.05), suboptimal infection prevention control (IPC) adherence in tea rooms (p<0.05), working in medium risk departments (p<0.05), being on leave (p<0.05), history of exposure to a Covid19 suspect or case (p<0.05), and symptomatic PCR Covid19 testing (p<0.05) before PCR Covid19 testing were risk factors to Covid19 disease among HWs. In conclusion, the protection of HWs from further spread of Covid19 can be optimized by reinforcing optimal adherence to face protective gears as part of personal protective equipment and infection prevention protocol in places where HWs may lower their guard against Covid19 disease such as when dining with colleagues at work, in departments where perception of risk may be low and in extra-occupational setups such at the household or community. Prompt Covid19 testing for symptomatic HWs as vulnerable and priority groups should be sustained.