HEALTH WORK FORCE EXPOSURE RISK ASSESSMENT AND MANAGEMENT FOR COVID-19 IN ADDIS ABABA, ETHIOPIA

Background: Coronavirus diseases 2019 (COVID-19) is highly contagious emerging pandemic with no drugs available. Health Work Force (HWF) exposure to COVID-19 is expected to be higher than the general population because of their work environment, use of aerosol generating procedures (AGPs) and the routine duties.

Objective: This study investigated Health Work Force COVID-19 exposure risk and its management. It determine the risk categorization of each HWF after exposure to a COVID-19 patient,  assessed adherence to Infection Prevention and Control (IPC) during patient to health Work Force interactions/ procedures and  risk management practices based on the risk category.

Method: Cross-sectional study was conducted in Addis Ababa COVID-19 treatment, and diagnostic centers. Thirty-two facilities were included in the study for the exposure risk assessment and 25 facilities were involved in exposed case management practice assessment comprising a total of 732 HWF. Eligible HWF based on proportion of Health professionals to support staffs were involved. Among the HWF 76.6% were Health professionals; while 23.4% were support staffs. Participants for exposed case management checklist assessment were 25 eligible individuals from their respective COVID 19 facility. Categorization of COVID 19 exposure risk was done based on WHO classification, into “High exposure risk level” and “Low exposure risk level” by grouping the professions in to 4 groups to use similar denominator for the variables used. The analysis for case management practice categorization (Good/Poor practice) based on exposure risk level (High/low) was done by computing check list assessments questions for exposure risk level.

Result: Four hundred forty (62.1%) of the HWF have high exposure risk level to COVID 19.  Poor adherence (62.1%) to Infection Prevention and Control among HWF were observed.  Poor case management practice (40%) for low and (56%) for high exposure risk categories of HWF have been observed. Exposure risk of support staffs is higher than all HWF, Health professionals in general and Health professionals present during AGP in particular.

Conclusion and recommendation: HWF COVID-19 exposure risk is extremely higher. Support staffs need special follow up regarding IPC and Personal Protective Equipment (PPE) utilization. Electronic prescriptions and lab requests are important to minimize paper based contacts. Refresher IPC training for the high exposure risk HWF at return to work is mandatory to all with high exposure risk.