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

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. M...

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Main Authors: Kavenga, Fungai, Rickman, Hannah M., Chingono, Rudo, Marembo, Takudzwa, Taruvinga, Tinotenda, Manasa, Justen, Marambire, Edson, McHugh, Grace, Gregson, Celia L., Bandason, Tsitsi, Redzo, Nicol, Maunganidze, Aspect, Magure, Tsitsi, Ndhlovu, Chiratidzo, Mujuru, Hilda, Rusakaniko, Simbarashe, Manangazira, Portia, Ferrand, Rashida A., Kranzer, Katharina
Format: Article
Language:English
Published: Public Library of Science 2022
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Online Access:https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260261
http://hdl.handle.net/11408/4760
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Summary: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.