PLoS ONE (Jan 2021)

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

  • 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

DOI
https://doi.org/10.1371/journal.pone.0260261
Journal volume & issue
Vol. 16, no. 11
p. e0260261

Abstract

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BackgroundHealthcare 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.MethodsIn 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.ResultsBetween 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.ConclusionsCases 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.