Uptake and Perceptions of Covid-19 Testing by Health Care Workers at Harare City Health Facilities, Harare, Zimbabwe

Abstract

The World Health Organization highlighted the importance of testing for COVID-19 surveillance to limit the spread of the disease, enable public health authorities to manage its risk, and thereby restoring normal economic and social activities. Health care workers (HCWs) are more at risk of becoming infected with COVID-19 thereby transmitting the disease to patients who are already battling with other ailments. There is limited information on COVID-19 testing uptake by HCWs in Harare. An analytical cross-sectional study using a mixed methods approach was conducted at Mbare, Mabvuku and Warren Park Polyclinics. A checklist was used to collect secondary data from the COVID-19 testing registers for 103 HCWs from January to September 2021 and an in-depth interview guide was used to collect data from participants. Quantitative data analysis was performed using STATA 16. All categorical variables like gender were presented as frequencies and percentages. Logistic regression analysis was performed reporting odds ratios (univariate) and adjusted odds ratios (multivariate analysis). Qualitative interviews were transcribed, interview summaries were written, a coding framework was developed and thematic analysis through NVIVO 11 was used to identify, analyze, and interpret patterns of meaning within the data. Overall, 331 COVID-19 tests were performed among 103 HCWs from January to September 2021 and 71 of them were positive representing 21% of total tests performed. Age ranges of HCWs with positive tests were 28 for 30-39 years (42.4%), 21 for 40-49 years (31.8), 10 for 50-59 years (15.2%). At Mbare polyclinic, 92 tests were negative (36.5%), 34 were positive (47.9) and 8 were invalid, at Mabvuku polyclinic, 97 tests were negative (38.5%) and 21 were positive (29.6%), at Warren Park polyclinic, 63 tests were negative (25.0%) and 16 were positive (22.5%). Among the HCWs that tested positive, the symptoms reported included dry cough (n=12, 14.1%), fever/chills (n=12, 14.1%), runny nose (n=11,12.9%), sore throat (n=9, 10.6%), tiredness/fatigue (n=6, 7.1%). The number of positive results at Mbare compared to Mabvuku and Warren Park polyclinics with borderline odds ratio of OR=0.59 [95% CI: 0.32-1.09, p=0.088] and OR= 0.69 [95% CI: 0.35-1.35, p=0.276]. The multivariate model showed that HCWs who tested because at risk were (OR=3.07, 95% CI:1.28-7.38, p=0.012), and symptomatic were (OR=1.32,95% CI: 0.59-2.96, P=0.497]. Uptake of COVID-19 testing among HCWs was positive with staff being tested at least more than once and testing was largely influenced by the epidemiological waves, being symptomatic, at high risk and known benefits of testing. Barriers to uptake included fear of pain, perceived low severity of disease, inaccessibility, and cost of testing services. The researcher recommends the HCH department to mobilize funds for intense research and provision of COVID-19 self-testing kits.