Adherence of healthcare workers to COVID-19 infection prevention practices and its relationship with SARS-CoV-2 seropositivity

Abstract

Background Infection prevention and control (IPC) practices against COVID-19 should be adopted by healthcare workers (HCWs) at their workplaces to protect themselves, their patients, and their families from infection. Purpose This study aimed to describe the relationship between the healthcare-related COVID-19 infection prevention measures adopted by HCWs and their SARS-CoV-2 seropositivity. Research Design This cross-sectional study was conducted during the second and third COVID-19 waves in Egypt. Study Sample The study included 416 unvaccinated HCWs from 39 hospitals in Egypt. Data Collection Sociodemographic data, as well as COVID-19 IPC measures done at work, and protective measures performed by their healthcare facilities were collected. SARS-CoV-2 spike protein antibodies were measured by ELISA. Results 58.2% of participants were seropositive for SARS-CoV-2. Among the previously undiagnosed HCWs, 125/271 (46.1%) were seropositive. Predictors of seropositivity were rural residence (aOR = 5.096; 95% CI: 1.583–16.403, p = 0.006), previous COVID-19 infection (aOR = 4.848, 95% CI: 2.933–8.015, p = 0.000), and examining 10–20 suspected COVID-19 patients daily (aOR = 2.329; 95% CI: 1.331–4.077, p = 0.003. Reporting low satisfaction (25–50%) with infection control implementation, working more than 40 h per week, reporting to “sometimes abiding by hand hygiene” compared to those who reported to “always” adhere to hand hygiene and shorter duration of hand washing (<20 s) were associated with significantly higher odds of seropositivity. Conclusions Poor infection control measures and the high workload of HCWs (longer working hours and examining more patients) were modifiable risk factors for SARS-CoV-2 seropositivity among HCWs. Hand hygiene was better among HCWs working in urban versus rural areas.