Abstract
Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and an important cause of morbidity and mortality in developing countries. Umzingwane district in Matabeleland South province is one of the districts with high reported cases of TB in Zimbabwe. There is scarcity of published data on TB risk perception, related risk and mitigation strategies employed by health-care workers (HCWs) in this region. Therefore, the aim of this study was to determine the risk perception of TB among HCWs and to assess the risk management practices in relation to perceived risk, by HCWs in Umzingwane District. Methods: A cross-section study was conducted and used stratified random sampling to enrol a total of 127 participants from both clinical and non-clinical settings. Pre-coded questionnaires and an electronic data collection form similar were used to collect data to achieve the study objectives. Data were analysed using SPSS version 26 and Epi-Info version 7. Univariate and multivariate analysis were conducted to investigate the relationship between study variables and to satisfy each of the study objectives. Results: The modal age of participants was 31 to 40 years. Based on analysis of sociodemographic variables, participants aged between 20 and 30 years were less likely to feel at risk of TB in the occupational environment (OR 0.33 CI: 0.11 – 0.98). Participants with their highest qualification as a diploma were more likely to feel at significant risk of TB (AOR 4.52 CI: 1.38 – 14.8). Health care workers offering non-clinical or supporting roles were less likely to feel at risk (AOR 0.07 CI: 0.01 – 0.52). Staff in combined medical and surgical departments perceived a higher risk (OR 3.43 CI: 1.09 – 10.79). Health care workers who did not know any other health worker diagnosed of TB were less likely to feel at risk of TB (OR 0.34 CI: 0.14 – 0.85). Compared to those who were never in contact with TB patients, HCWs with contact of any frequency with TB patients were more likely to feel at risk of TB. Health care workers who did not implement any mitigation strategies were less likely to feel at risk (OR 0.18 CI:0.06 – 0.60) as were those who did not implement open area patient waiting (OR 0.18 CI: 0.06 – 0.53) and those who did not implement patient triage and fast tracking (OR 0.27 CI: 0.10 – 0.76). Staff who did not use TB Preventive Therapy (TPT) when it was an applicable intervention were more likely to feel at significant risk of TB in the occupational environment (AOR 4.36 CI:1.10 – 17.23). Conclusion: This study highlighted important incongruencies between perceived risk and actual risk as highlighted in previous studies or existing evidence. The identified gaps in the implementation of v mitigation strategies commensurate with perceived levels of risk. There is a need for training of HCWs on TB infection control with emphasis of the importance of the various mitigation strategies to enable HCWs to apply mitigation strategies commensurate with their perceived risk. Key terms: Tuberculosis, TB, significant risk, perceived risk, occupational environment, mitigation strategies, risk management, Umzingwane District.
M.A. (Public Health)