Abstract
Background: The COVID-19 pandemic imposed substantial challenges on healthcare workers (HCWs), leading to the reallocation and reprioritisation of resources, potentially elevating the risk of tuberculosis (TB) among them. This study, conducted in the Ekurhuleni Health District, aimed to assess TB risk among HCWs before and during the pandemic.
Methods: A total of 343 participants, predominantly females (81.1%) and mainly nurses (64.2%) completed the questionnaire. Descriptive analysis, multivariate logistic regression, and bivariate analysis were used to identify factors contributing to TB risk and their effects, with significance set at P <0.05.
Results: The findings indicated that HCWs' exposure to TB remained high, with 80.0% exposed before COVID-19 (2018 to 2019) and 79.0% during the pandemic (2020 to 2021). The study highlighted a significant association between resource reprioritisation and reallocation during the COVID-19 first wave and HCWs' TB exposure, χ2 (11) = 69.133, p < 0.05. Additionally, it was observed that the number of HCWs contracting TB decreased during and after the first COVID-19 wave. Patient TB diagnoses in 2020 to 2021 were identified as a predictive factor (OR = 10.38, p<0.001, 95% CI: 2.51 - 43.01) for the impact of resource reprioritisation and reallocation on HCWs' TB risk.
Conclusion: This study underscores the persistent high risk of TB among HCWs in the Ekurhuleni Health District. Although resource reprioritisation during the initial COVID-19 wave was linked to increased HCW TB exposure, a subsequent decline in TB cases suggests improved infection control measures. Patient TB diagnoses emerged as a predictive factor in the impact of resource reallocation on HCWs' TB risk. Ongoing vigilance and comprehensive HCW protection measures are imperative.
Keywords: COVID-19, reprioritisation and reallocation of resources, TB exposure, TB Risk, infection prevention and control, occupational health.