加纳医护人员中 COVID-19 感染的风险因素。
Risk factors for COVID-19 infections among health care workers in Ghana.
机构信息
Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana.
出版信息
PLoS One. 2023 Jul 6;18(7):e0288242. doi: 10.1371/journal.pone.0288242. eCollection 2023.
INTRODUCTION
Health care workers (HCWs) are crucial to the fight against COVID-19 and are at risk of being infected. We sought to determine the risk factors and associations of COVID-19 among HCWs in Ghana during the period of the pandemic.
MATERIALS AND METHODS
A case-control study was conducted using the WHO COVID-19 HCWs exposure risk assessment tool. A HCW was categorized as "high risk" for COVID-19 if s/he did not respond "always, as recommended" to adherence to Infection Prevention and Control (IPC) measures during a healthcare interaction. A HCW was categorized as "low risk" if s/he responded "always, as recommended" to adherence to IPC measures. We used univariate and multiple logistic regression models to determine associated risk factors. Statistical significance was set at 5%.
RESULTS
A total of 2402 HCWs were recruited and the mean age was 33.2±7.1 years. Almost 87% (1525/1745) of HCWs had high risk for COVID-19 infection. Risk factors identified were profession (doctor- aOR: 2.13, 95%CI: 1.54-2.94; radiographer-aOR: 1.16, 95% CI: 0.44-3.09)), presence of comorbidity (aOR: 1.89, 95%CI: 1.29-2.78), community exposure to virus (aOR: 1.26, 95% CI: 1.03-1.55), not performing hand hygiene before and after aseptic procedures performed (aOR: 1.6, 95% CI: 1.05-2.45); not frequently decontaminating high-touch surfaces always as recommended (aOR: 2.31, 95%CI: 1.65-3.22; p = 0.001) and contact with a confirmed COVID-19 patient (aOR: 1.39, 95% CI: 1.15-1.67). Among those who came into any form of contact with confirmed COVID-19 patient, providing direct care (aOR: 2.0, 95%CI: 1.36-2.94), face-to-face contact (aOR: 2.23, 95%CI: 1.41-3.51), contact with environment/materials used by COVID-19 patient (aOR: 2.25, 95%CI: 1.45-3.49) and presence during conduct of aerosol generating procedures (aOR: 2.73, 95%CI: 1.74-4.28) were associated with COVID-19 infection.
CONCLUSION
Non-adherence to IPC guidelines puts HCWs at increased risk of COVID-19 infection thus ensuring IPC adherence is key to reducing this risk.
引言：医护人员是抗击 COVID-19 的关键力量，他们面临着感染的风险。我们旨在确定加纳医护人员在 COVID-19 大流行期间感染 COVID-19 的风险因素和关联。
材料与方法：本研究采用世界卫生组织（WHO）COVID-19 医护人员暴露风险评估工具进行病例对照研究。如果医护人员在医疗互动中未“始终按照建议”遵守感染预防和控制（IPC）措施，则将其归类为 COVID-19 高风险；如果医护人员“始终按照建议”遵守 IPC 措施，则将其归类为低风险。我们使用单变量和多变量逻辑回归模型来确定相关的风险因素。统计学显著性水平设定为 5%。
结果：共招募了 2402 名医护人员，平均年龄为 33.2±7.1 岁。几乎 87%（1525/1745）的医护人员感染 COVID-19 的风险较高。确定的风险因素包括职业（医生-aOR：2.13，95%CI：1.54-2.94；放射技师-aOR：1.16，95%CI：0.44-3.09））、共存疾病（aOR：1.89，95%CI：1.29-2.78））、社区接触病毒（aOR：1.26，95%CI：1.03-1.55））、在进行无菌操作前后未进行手部卫生（aOR：1.6，95%CI：1.05-2.45））；未经常按照建议对高频接触表面进行消毒（aOR：2.31，95%CI：1.65-3.22；p=0.001））和接触确诊 COVID-19 患者（aOR：1.39，95%CI：1.15-1.67）。在那些与确诊 COVID-19 患者有任何形式接触的人中，直接护理（aOR：2.0，95%CI：1.36-2.94））、面对面接触（aOR：2.23，95%CI：1.41-3.51））、接触 COVID-19 患者使用的环境/材料（aOR：2.25，95%CI：1.45-3.49））和在进行气溶胶生成程序时（aOR：2.73，95%CI：1.74-4.28））与 COVID-19 感染相关。
结论：不遵守 IPC 指南会使医护人员感染 COVID-19 的风险增加，因此确保遵守 IPC 指南是降低这种风险的关键。
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