Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]

Background Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the...

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Main Authors: Rony Zachariah, Luke Bawo, Pruthu Thekkur, Benjamin T. Vonhm, Emmanuel Dwalu, Louis Ako-Egbe, Darius B. Lehyen
Format: Article
Language:English
Published: F1000 Research Ltd 2024-11-01
Series:F1000Research
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Online Access:https://f1000research.com/articles/13-656/v2
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author Rony Zachariah
Luke Bawo
Pruthu Thekkur
Benjamin T. Vonhm
Emmanuel Dwalu
Louis Ako-Egbe
Darius B. Lehyen
author_facet Rony Zachariah
Luke Bawo
Pruthu Thekkur
Benjamin T. Vonhm
Emmanuel Dwalu
Louis Ako-Egbe
Darius B. Lehyen
author_sort Rony Zachariah
collection DOAJ
description Background Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, (P<0.001) with the highest rates in 2020 (24/1,000 health care workers) and 2021 (14/1,000 health care workers). Case fatality was 2% in both 2020 and 2021 with no deaths thereafter. Among those hospitalized, the highest proportions were nursing cadres with 191(45%), physicians with 63 (15%) and laboratory technicians with 42 (10%). The most frequent reported site for COVID-19 infection was the health facility (326, 89%). COVID-19 vaccination coverage in health care workers was 20%. The majority (91%) of hospitalizations were for mild symptomatic infections. Even in referral centres (n-52), 18 (35%) were for mild infections. Of the 424 who were hospitalized, 412 (97%) recovered, 9 (2%) died and 3 (1%) either left against medical advice or absconded. Of the nine deaths, none were vaccinated, seven had moderate-to-severe disease but were not referred to specialized COVID-19 treatment centers. Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.
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spelling doaj-art-a2e25826e8ce4a16ad2c35056a7c208a2024-11-19T01:00:01ZengF1000 Research LtdF1000Research2046-14022024-11-0113174181Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]Rony Zachariah0https://orcid.org/0000-0002-2915-9328Luke Bawo1Pruthu Thekkur2Benjamin T. Vonhm3Emmanuel Dwalu4https://orcid.org/0000-0003-2875-4130Louis Ako-Egbe5https://orcid.org/0000-0002-3269-8509Darius B. Lehyen6https://orcid.org/0009-0008-9894-7409Implementation Research Department, UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, 1211, SwitzerlandHealth Information, Monitoring & Evaluation and Research Department, Ministry of Health, Monrovia, 1000, LiberiaOperational Research Department, Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, 75001, FranceDepartment of Infectious Diseases and Epidemiology, National Public Health Institute of Liberia, Monrovia, 1000, LiberiaDepartment of Infectious Diseases and Epidemiology, National Public Health Institute of Liberia, Monrovia, 1000, LiberiaHealth System Strengthening Department, World Health Organization, Country Office, Monrovia, 1000, LiberiaDepartment of Infectious Diseases and Epidemiology, National Public Health Institute of Liberia, Monrovia, 1000, LiberiaBackground Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, (P<0.001) with the highest rates in 2020 (24/1,000 health care workers) and 2021 (14/1,000 health care workers). Case fatality was 2% in both 2020 and 2021 with no deaths thereafter. Among those hospitalized, the highest proportions were nursing cadres with 191(45%), physicians with 63 (15%) and laboratory technicians with 42 (10%). The most frequent reported site for COVID-19 infection was the health facility (326, 89%). COVID-19 vaccination coverage in health care workers was 20%. The majority (91%) of hospitalizations were for mild symptomatic infections. Even in referral centres (n-52), 18 (35%) were for mild infections. Of the 424 who were hospitalized, 412 (97%) recovered, 9 (2%) died and 3 (1%) either left against medical advice or absconded. Of the nine deaths, none were vaccinated, seven had moderate-to-severe disease but were not referred to specialized COVID-19 treatment centers. Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.https://f1000research.com/articles/13-656/v2SORT IT Universal Health Coverage Health Systems Strengthening Infection Prevention Control Pandemics Operational Researcheng
spellingShingle Rony Zachariah
Luke Bawo
Pruthu Thekkur
Benjamin T. Vonhm
Emmanuel Dwalu
Louis Ako-Egbe
Darius B. Lehyen
Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
F1000Research
SORT IT
Universal Health Coverage
Health Systems Strengthening
Infection Prevention Control
Pandemics
Operational Research
eng
title Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
title_full Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
title_fullStr Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
title_full_unstemmed Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
title_short Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes? [version 2; peer review: 2 approved]
title_sort health care workers hospitalized for covid 19 in liberia who were they and what were their outcomes version 2 peer review 2 approved
topic SORT IT
Universal Health Coverage
Health Systems Strengthening
Infection Prevention Control
Pandemics
Operational Research
eng
url https://f1000research.com/articles/13-656/v2
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