The high prevalence of infectious diseases among health workers indicates the need for improving surveillance

Araújo, Tânia Maria de; Souza, Fernanda de Oliveira; Helioterio, Margarete Costa; Andrade, Kaio Vinicius Freitas de; Pinho, Paloma de Sousa; Werneck, Guilherme Loureiro

doi:10.1590/2317-6369/23021en2023v48e17

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Revista Brasileira de Saúde Ocupacional

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Short communication • Rev. bras. saúde ocup. 48 • 2023 • https://doi.org/10.1590/2317-6369/23021en2023v48e17 copy

The high prevalence of infectious diseases among health workers indicates the need for improving surveillance

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to estimate the seroprevalence of arboviruses, syphilis, HIV, and hepatitis B (HBV) in Healthcare Workers (HCW).

Methods:

a survey among HCW among was randomly selected in a city in Bahia-Brazil. The research used a structured questionnaire, which collected sociodemographic, occupational, and health information in 2019. Rapid immunochromatographic tests were used to track infections. Thus, positive results for arboviruses, syphilis, HIV, and HBV indicated seropositivity for the respective infection. In addition, simultaneous detection of antibodies for zika (ZIKV) and dengue (DENV) viruses indicated seropositivity for flavivirus infection.

Results:

a total of 453 HCW were included, 82.8% were women. Most HCW (55.1%) reported contact with biological material; 5.2% reported injuries with biological material. The seroprevalence was 34.7% (95%CI:30.1-39.4) for dengue, 1.7% (95%CI:0.7-3.4) for zika, 9.9% (95%CI:7.2-13.2) for chikungunya, and 39.9% (95%CI:35.2-44.7) for flavivirus (ZIKV+DENV); with 21.9% (95%CI:18.1-26.2) being negative to all arboviruses. Seropositivity to arboviruses increased with age and was higher among endemic disease control agents. Three HCW tested positive for HBV (HBsAg); no HIV cases were detected.

Conclusion:

a high percentage of HCW was exposed to infectious agents (contact with biological material and/or exposure to arboviruses). Among the necessary conditions for preventing infections in the work environment, the following stand out: monitoring of infectious diseases among HCW, surveillance of work environments, and measures to control occupational exposures, such as the availability of repellents.

Keywords:
communicable diseases; health workers; survey; occupational health; occupational health surveillance

*Variables*	*HCW*
*Variables*	n*	%
Sex (n=453)
Men	78	17.2
Women	375	82.8
Age group in years (n=442)
21-30	44	10.0
31-49	292	66.0
50 or more	106	24.0
Ethnicity/Skin color (n=440)
Black	146	33.2
Mixed / Brown	222	50.5
White	53	12.0
Yellow / Indigenous	19	4.3
Level of education (n=440)
Did not complete high school	26	5.9
Completed high school	159	36.1
Technical education	87	19.8
University degree	168	38.2
Occupation (n=444)
Community healthcare workers	111	25.0
Healthcare providers	76	17.1
Administrative employees	99	22.4
Endemic disease control agents	64	14.4
Health technicians	61	13.7
Support services workers	33	7.4
Type of job contract (n=453)
Civil servants	300	66.2
Temporary job contract	153	33.8
Type of healthcare services (n=453)
Primary healthcare services	344	76.0
Medium-complexity healthcare services	109	24.0
Working time in current occupation (n=438)
≤ 5 years	120	27.4
6-10 years	151	34.5
> 10 years	167	38.1

*Exposure*	*HCW (Total=453)*		*Primary services (Total=352)*		*Medium complexity services (Total=101)*
*Exposure*	n*	%	n	%	n	%
Contact with biological material (n=453)*
Never	201	44.9	152	43.7	49	49.0
Rarely	53	11.8	41	11.8	12	12.0
Sometimes	92	20.5	79	22.7	13	13.0
Always	102	22.8	76	21.8	26	26.0
Blood transfusion (n=447)*
Yes	30	6.7	24	6.9	6	5.9
No	417	93.3	322	93.1	95	94.1
Contact with body fluids from HIV or hepatitis patients (n=443)*
Yes	32	7.2	26	7.6	6	6.1
No	411	92.8	318	92.4	93	93.9
Injectable drugs (n=447)*
Yes	17	3.8	10	2.9	7	6.9
No	430	96.2	336	97.1	94	93.1
Three or more sexual partners (n=448)*
Yes	52	11.6	38	11.0	14	13.9
No	396	88.4	309	89.0	87	86.1
Handling of sharp instruments (n=435)*
Yes	214	49.2	170	50.7	44	44.0
No	221	50.8	165	49.3	56	56.0
Tattoo or Piercing (n=447)*
Yes	75	16.8	55	15.9	20	19.8
No	372	83.2	291	84.1	81	80.2
Injuries with biological materials (n=422)*
Yes**	22	5.2	16	4.8	6	6.7
No	399	94.8	315	95.2	84	93.3

*Variables*	*Arbovirus*
		*Dengue (Dengue + / Zika -)*		*Zika (Zika+/Dengue-)*		*Chikungunya*		*Flavivirus (Zika+/Dengue+)*		*Positive to the three arboviruses*		*Negative to all three arboviruses*
	n	%	*95% CI*	%	*95% CI*	%	*95% CI*	%	*95% CI*	%	*95% CI*	%	*95% CI*
Global seroprevalence	424	34.7	30.1;39.4	1.7	0.7;3.4	9.9	7.2;13.2	39.9	35.2;44.7	78.1	73.8;81.9	21.9	18.1;26.2
Age group (years)
21-30	41	24.4	12.4;40.3	4.9	0.6;16.5	7.3	1.5;19.9	34.1	20.1;50.6	65.9	49.4;79.9	34.1	20.0;50.6
31-49	273	33.3	27.8;39.3	1.1	0.2;3.2	9.9	6.6;14.1	39.9	34.1;46.0	76.9	71.5;81.8	23.1	18.2;28.5
50 or more	103	42.7	33.0;52.8	1.9	0.2;6.8	11.7	6.2;19.5	39.8	30.3;49.9	84.5	76.0;90.9	15.5	9.1;24.0
Sex
Men	70	40.0	28.5;52.4	2.9	0.3;9.9	7.1	2.4;15.9	40.0	28.5;52.4	84.3	73.6;91,9	15.7	8.1;26.4
Women	354	33.6	28.7;38.8	1.4	0.5;3.3	10.5	7.5;14.1	39.8	34.7;45.1	76.8	72.1;81.1	23.2	18.9;27.9
Race/skin colour
Black	140	30.0	22.6;38.3	0.7	0.0;3.9	13.6	8.4;20.4	42.3	34.5;51.5	75.7	67.8;82.6	24.3	17.4;32.2
Mixed/Brown	205	34.1	27.7;41.1	2.4	0.8;5.6	8.3	4.9;12.9	38.0	31.4;45.1	75.6	69.1;81.3	24.5	18.7;30.9
White	50	50.0	35.5;64.5	0.0	0.0;7.1	4.0	0.5;13.7	36.0	22.9;50.8	88.0	75.7;95.5	12.0	4.5;24.3
Yellow / Indigenous	17	47.1	22.9;72.1	0.0	0.0;19.5	17.6	3.8;43.4	47.1	22.9;72.1	100.0	80.5;100.0	0.0	0.0;19.5
Level of education
Did not complete high school	24	37.5	18.8;59.4	4.2	0.1;21.1	12.5	2.7;32.4	33.3	15.6;55.3	75.0	53.3;90.2	25.0	9.8;46.7
Completed high school	151	34.4	26.9;42.6	1.3	0.2;4.7	13.2	8.3;19.7	42.4	34.4;50.7	80.8	73.6;86.7	19.2	13.3;26.4
Technical education	85	28.2	19.0;39.0	1.2	0.0;6.4	10.6	5.0;19.2	48.2	37.3;59.3	80.0	69.9;87.9	20.0	12.1;30.1
University degree	151	34.4	26.9;42.6	2.0	0.4;5.7	5.3	2.3;10.2	35.1	27.5;43.3	72.8	65.0;79.8	27.2	20.2;35.0
Occupation
Community healthcare workers	109	31.2	22.7;40.8	0.0	0.0;3.3	11.0	5.8;18.4	44.0	34.5;53.9	78.9	70.0;86.1	21.1	13.9;30.0
Endemic disease control agents	61	36.1	24.2;49.4	1.6	0.0;8.8	14.8	7.0;26.2	44.3	31.5;57.6	85.2	73.8;93.0	14.8	7.0;26.2
Administrative employees	89	37.1	27.1;48.0	1.1	0.0;6.1	12.4	6.3;21.0	36.0	26.1;46.8	75.2	65.0;83.8	24.8	16.2;35.0
Health technicians	59	45.8	32.7;59.2	1.7	0.0;9.1	10.2	3.8;20.8	33.9	22.1;47.4	83.1	71.0;91.6	16.9	8.4;29.0
Healthcare providers	69	27.5	17.5;39.6	1.4	0.0;7.8	1.4	0.0;7.8	42.0	30.2;54.5	71.0	58.8;81.3	29.0	18.7;41.2
Support services workers	30	36.7	19.9;56.1	10.0	2.1;26.5	10.0	2.1;26.5	30.0	14.7;49.4	76.7	57.7;90.1	23.3	9.9;42.3

Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO Rua Capote Valente, 710 , 05409 002 São Paulo/SP Brasil, Tel: (55 11) 3066-6076 - São Paulo - SP - Brazil
E-mail: rbso@fundacentro.gov.br

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[1] Contact: Tânia Maria de Araújo E-mail:araujo.tania@uefs.br