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. 2021 Nov 23;16(11):e0260261.
doi: 10.1371/journal.pone.0260261. eCollection 2021.

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

Fungai Kavenga  1 , Hannah M Rickman  2 , Rudo Chingono  1 , Tinotenda Taruvinga  1   3 , Takudzwa Marembo  4 , Justen Manasa  4 , Edson Marambire  1 , Grace McHugh  1 , Celia L Gregson  5 , Tsitsi Bandason  1 , Nicol Redzo  1 , Aspect Maunganidze  6 , Tsitsi Magure  7 , Chiratidzo Ndhlovu  8 , Hilda Mujuru  9 , Simbarashe Rusakaniko  10 , Portia Manangazira  11 , Rashida A Ferrand  1   2 , Katharina Kranzer  1   2   11   12
Affiliations

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

Fungai Kavenga et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Numbers of healthcare workers (clients) enrolled and tested for SARS-CoV-2, overlain with weekly national case reports from Zimbabwe (all dates—2020).
Fig 2
Fig 2. Healthcare workers’ responses to the question “On a scale of 1–10, how serious is the COVID-19 situation” by week of enrolment in the study.
Higher scores indicate higher severity. (All dates—2020).
See this image and copyright information in PMC

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