Factors Contributing to Risk of SARS-CoV-2 Transmission in Two Specialized Centres in the Southern Province, Sri Lanka

Abstract

Introduction and objectives: COVID-19 has had uneven impacts on health and well-being. Focusing on the experience of the Southern Province of Sri Lanka, this study describes the main factors influencing the transmission of SARS-CoV-2 among patients admitted to the New District General Hospital (NDGH) Kamburugamuwa and District General Hospital (DGH), Matara. Methods: A prospective, cross-sectional descriptive study was conducted among 423 patients aged 18 years or older who were confirmed as COVID-19 positive by rRT-PCR test or rapid antigen test. Critically ill patients or oxygen-dependent patients at the time of data collection were excluded. Data were collected via phones using an interviewer-administered questionnaire. The categorical variables were analysed and presented as frequency distributions. The chi-squared test used to identify the association and p<0.05 was considered statistically significant. Results: The response rate was 70.0% (296/ 423). A majority of the patients were in the age range of 36–55-years (n=92, 31.1%) and females (n=159, 53.7%). Most of the patients reported cough (n=191, 64.5%) followed by fever (n=176, 59.5%) and shortness of breath (SOB) (n=171, 57.8%). Cough (n=138, 46.6%), SOB (n=123, 41.6%) and runny nose (n=46, 15.5%) were more common in aged above 35 years compared to the aged 35 years or below (p>0.05). Most (n=211, 71.3%) consulted a healthcare provider following symptoms. A majority (n=77, 35.5%) of patients hardly practiced hand washing with soap and water for at least 20 seconds and maintained social distancing (n=75, 35.9%). Hypertension (n=52, 17.6%), diabetes mellitus (n=55, 18.6%) and cardiovascular disease (n=20, 6.8%) were more frequent in the?>?35-year-olds patients. Increased risk of disease transmission was associated with contacts with an immediate family member (p=0.000), being a female (p=0.001), alcohol users (p=0.013) and active smoking (p=0.005). Conclusions and recommendations: The advanced age, alcohol use, smoking, contact with an immediate family member and poor practice of protective measures increased the transmission of the disease. Therefore, it is essential to increase health literacy on hygienic practices in all communities.