Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia
Abstract
:1. Introduction
2. Methods
2.1. Study Subjects
2.2. Screening and Testing of Healthcare Workers
2.3. Standard Operating Procedures for COVID-19 Testing
2.4. Investigation of COVID-19 Infection
2.5. Data Sources
2.6. Data Analysis
3. Results
4. Discussion
5. Conclusions
6. Limitations and Future Research
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Nguyen, L.H.; Drew, D.A.; Graham, M.S.; Joshi, A.D.; Guo, C.-G.; Ma, W.; Mehta, R.S.; Warner, E.T.; Sikavi, D.R.; Lo, C.-H.; et al. Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. Lancet Public Health 2020, 5, e475–e483. [Google Scholar] [CrossRef]
- Thompson, M.G.; Burgess, J.L.; Naleway, A.L.; Tyner, H.L.; Yoon, S.K.; Meece, J.; Olsho, L.E.W.; Caban-Martinez, A.J.; Fowlkes, A.; Lutrick, K.; et al. Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers—Eight U.S. Locations, December 2020–March 2021. MMWR Morb. Mortal. Wkly. Rep. 2021, 70, 495–500. [Google Scholar] [CrossRef] [PubMed]
- Costantino, C.; Cannizzaro, E.; Verso, M.G.; Tramuto, F.; Maida, C.M.; Lacca, G.; Alba, D.; Cimino, L.; Conforto, A.; Cirrincione, L.; et al. SARS-CoV-2 Infection in Healthcare Professionals and General Population During “First Wave” of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy. Front. Public Health 2021, 9, 644008. [Google Scholar] [CrossRef] [PubMed]
- Yassin, A.; Al-Mistarehi, A.H.; El-Salem, K.; Karasneh, R.A.; Al-Azzam, S.; Qarqash, A.A.; Khasawneh, A.G.; Zein Alaabdin, A.M.; Soudah, O. Prevalence Estimates and Risk Factors of Anxiety among Healthcare Workers in Jordan over One Year of the COVID-19 Pandemic: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 2615. [Google Scholar] [CrossRef] [PubMed]
- Lan, F.-Y.; Wei, C.-F.; Hsu, Y.-T.; Christiani, D.C.; Kales, S.N. Work-related COVID-19 transmission in six Asian countries/areas: A follow-up study. PLoS ONE 2020, 15, e0233588. [Google Scholar] [CrossRef] [PubMed]
- Kooli, C. COVID-19: Public health issues and ethical dilemmas. Ethics Med. Public Health 2021, 17, 100635. [Google Scholar] [CrossRef]
- World Health Organization. Keep Health Workers Safe to Keep Patients Safe: WHO; World Health Organization: Geneva, Switzerland, 2020. [Google Scholar]
- Al Maskari, Z.; Al Blushi, A.; Khamis, F.; Al Tai, A.; Al Salmi, I.; Al Harthi, H.; Al Saadi, M.; Al Mughairy, A.; Gutierrez, R.; Al Blushi, Z. Characteristics of healthcare workers infected with COVID-19: A cross-sectional observational study. Int. J. Infect. Dis. 2021, 102, 32–36. [Google Scholar] [CrossRef]
- Jeremias, A.; Nguyen, J.; Levine, J.; Pollack, S.; Engellenner, W.; Thakore, A.; Lucore, C. Prevalence of SARS-CoV-2 Infection Among Health Care Workers in a Tertiary Community Hospital. JAMA Intern. Med. 2020, 180, 1707–1709. [Google Scholar] [CrossRef]
- Fusco, F.M.; Pisaturo, M.; Iodice, V.; Bellopede, R.; Tambaro, O.; Parrella, G.; Di Flumeri, G.; Viglietti, R.; Pisapia, R.; Carleo, M.A.; et al. COVID-19 among healthcare workers in a specialist infectious diseases setting in Naples, Southern Italy: Results of a cross-sectional surveillance study. J. Hosp. Infect. 2020, 105, 596–600. [Google Scholar] [CrossRef]
- Al-zoubi, N.A.; Obeidat, B.R.; Al-Ghazo, M.A.; Hayajneh, W.A.; Alomari, A.H.; Mazahreh, T.S.; Al-Faouri, I.G.; Obeidat, K.; Issa, A.B.; Aleshawi, A. Prevalence of positive COVID-19 among asymptomatic health care workers who care patients infected with the novel coronavirus: A retrospective study. Ann. Med. Surg. 2020, 57, 14–16. [Google Scholar] [CrossRef]
- Papoutsi, E.; Giannakoulis, V.G.; Ntella, V.; Pappa, S.; Katsaounou, P. Global burden of COVID-19 pandemic on healthcare workers. ERJ Open Res. 2020, 6, 00195–02020. [Google Scholar] [CrossRef]
- Hung, L.S. The SARS epidemic in Hong Kong: What lessons have we learned? J. R. Soc. Med. 2003, 96, 374–378. [Google Scholar] [CrossRef]
- Ha, K.M. A lesson learned from the MERS outbreak in South Korea in 2015. J. Hosp. Infect. 2016, 92, 232–234. [Google Scholar] [CrossRef]
- Salim, S. No Healthcare Workers in Malaysia Infected from Handling COVID-19 Patients, Says Health D-G. The Edge Market 8 April 2020. Available online: https://www.theedgemarkets.com/article/no-healthcare-workers-malaysia-infected-handling-COVID-19-patients-says-health-dg (accessed on 9 November 2021).
- Alajmi, J.; Jeremijenko, A.M.; Abraham, J.C.; Alishaq, M.; Concepcion, E.G.; Butt, A.A.; Abou-Samra, A.-B. COVID-19 infection among healthcare workers in a national healthcare system: The Qatar experience. Int. J. Infect. Dis. 2020, 100, 386–389. [Google Scholar] [CrossRef] [PubMed]
- Zhou, P.; Huang, Z.; Xiao, Y.; Huang, X.; Fan, X.-G. Protecting Chinese healthcare workers while combating the 2019 novel coronavirus. Infect. Control Hosp. Epidemiol. 2020, 41, 745–746. [Google Scholar] [CrossRef] [PubMed]
- Helmi, M.; Sari, D.; Sulistyowati, Y.; Meliala, A.; Trisnantoro, L.; Nurrobi, T.; Ratmono, T. The challenge of education and training in the COVID-19 National Emergency Hospital Wisma Atlet Kemayoran in Jakarta. Avicenna 2021, 2021, 2. [Google Scholar] [CrossRef]
- Kim, R.; Nachman, S.; Fernandes, R.; Meyers, K.; Taylor, M.; LeBlanc, D.; Singer, A.J. Comparison of COVID-19 infections among healthcare workers and non-healthcare workers. PLoS ONE 2020, 15, e0241956. [Google Scholar] [CrossRef]
- Mhango, M.; Dzobo, M.; Chitungo, I.; Dzinamarira, T. COVID-19 Risk Factors Among Health Workers: A Rapid Review. Saf. Health Work 2020, 11, 262–265. [Google Scholar] [CrossRef]
- Ministry of Health Malaysia. Management of Healthcare Worker (HCW) during COVID-19 Outbreak; Ministry of Health Malaysia: Putrajaya, Malaysia, 2020.
- Ministry of Health Malaysia. Standard Operating Procedure (SOP) for SARS-CoV-2 Real-Time Rt-PCR Testing Laboratory; Ministry of Health Malaysia: Putrajaya, Malaysia, 2020.
- World Health Organization. Laboratory Testing for Coronavirus Disease (COVID-19) in Suspected Human Cases: Interim Guidance; World Health Organization: Geneva, Switzerland, 2020. [Google Scholar]
- Ministry of Health Malaysia. COVID19—Public. Available online: https://github.com/MoH-Malaysia/covid19-public/blob/main/epidemic/cases_malaysia.csv (accessed on 2 April 2021).
- Gholami, M.; Fawad, I.; Shadan, S.; Rowaiee, R.; Ghanem, H.; Hassan Khamis, A.; Ho, S.B. COVID-19 and healthcare workers: A systematic review and meta-analysis. Int. J. Infect. Dis. 2021, 104, 335–346. [Google Scholar] [CrossRef] [PubMed]
- Dzinamarira, T.; Murewanhema, G.; Mhango, M.; Iradukunda, P.G.; Chitungo, I.; Mashora, M.; Makanda, P.; Atwine, J.; Chimene, M.; Mbunge, E.; et al. COVID-19 Prevalence among Healthcare Workers. A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 19, 146. [Google Scholar] [CrossRef] [PubMed]
- Park, S.S.; Oh, H.Y.; Hong, D.J. Mass screening of healthcare personnel for SARS-CoV-2 in the Northern Emirates. J. Hosp. Infect. 2021, 108, 52–54. [Google Scholar] [CrossRef] [PubMed]
- Muhammad Nur Amir, A.R.; Binti Amer Nordin, A.; Lim, Y.C.; Binti Ahmad Shauki, N.I.; Binti Ibrahim, N.H. Workforce Mobilization from the National Institutes of Health for the Ministry of Health Malaysia: A COVID-19 Pandemic Response. Front. Public Health 2021, 9, 574135. [Google Scholar] [CrossRef]
- Elengoe, A. COVID-19 Outbreak in Malaysia. Osong Public Health Res. Perspect. 2020, 11, 93–100. [Google Scholar] [CrossRef] [PubMed]
- Lim, J.T.; Maung, K.; Tan, S.T.; Ong, S.E.; Lim, J.M.; Koo, J.R.; Sun, H.; Park, M.; Tan, K.W.; Yoong, J.; et al. Estimating direct and spill-over impacts of political elections on COVID-19 transmission using synthetic control methods. PLoS Comput. Biol. 2021, 17, e1008959. [Google Scholar] [CrossRef]
- Tang, A. COVID-19: Over 500 Healthcare Workers Sent to Sabah, Says Health DG. The Star 12 October 2020. Available online: https://www.thestar.com.my/news/nation/2020/10/12/COVID-19-over-500-healthcare-workers-sent-to-sabah-says-health-dg (accessed on 9 November 2021).
- Director General of Health. KPK Press Statement 18 December 2020. Available online: https://kpkesihatan.com/2020/12/18/kenyataan-akhbar-kpk-18-disember-2020-situasi-semasa-jangkitan-penyakit-coronavirus-2019-COVID-19-di-malaysia (accessed on 2 February 2021).
- Batumalai, K. COVID-19 Continues Spreading among Klang Valley Hospital Staff. Available online: https://codeblue.galencentre.org/2021/01/19/COVID-19-continues-spreading-among-klang-valley-hospital-staff (accessed on 2 February 2021).
- Ahmad, S. Serdang Hospital Is Now the COVID-19 Treatment Centre. Berita Harian 30 July 2021. Available online: https://www.bharian.com.my/berita/nasional/2021/07/845122/hospital-serdang-kini-pusat-rawatan-COVID-19 (accessed on 9 November 2021).
- Mohd, H.; Razak, A. COVID-19: Sg Buloh Hospital Warns Staff of Action If Infected after Flouting SOP. Available online: https://malaysia.news.yahoo.com/COVID-19-sg-buloh-hospital-231100887.html (accessed on 2 February 2022).
- Al-Kuwari, M.G.; AbdulMalik, M.A.; Al-Nuaimi, A.A.; Abdulmajeed, J.; Al-Romaihi, H.E.; Semaan, S.; Kandy, M. Epidemiology Characteristics of COVID-19 Infection Amongst Primary Health Care Workers in Qatar: March–October 2020. Front. Public Health 2021, 9, 679254. [Google Scholar] [CrossRef] [PubMed]
- Al Bujayr, A.A.; Aljohar, B.A.; Bin Saleh, G.M.; Alanazi, K.H.; Assiri, A.M. Incidence and epidemiological characteristics of COVID-19 among health care workers in Saudi Arabia: A retrospective cohort study. J. Infect. Public Health 2021, 14, 1174–1178. [Google Scholar] [CrossRef] [PubMed]
- Nienhaus, A.; Hod, R. COVID-19 among Health Workers in Germany and Malaysia. Int. J. Environ. Res. Public Health 2020, 17, 4881. [Google Scholar] [CrossRef]
- Mahajan, N.N.; Mathe, A.; Patokar, G.A.; Bahirat, S.; Lokhande, P.D.; Rakh, V.; Gajbhiye, R.; Rathi, S.; Tilve, A.; Mahajan, K.; et al. Prevalence and Clinical Presentation of COVID-19 among Healthcare Workers at a Dedicated Hospital in India. J. Assoc. Physicians India 2020, 68, 16–21. [Google Scholar] [PubMed]
- Zulaikha, M.R.N.S.; Anita, A.R.; Aisah, M.S.; Valentine, G. Prevalence of COVID-19 Infection and Its Associated Factors Among Government Healthcare Workers (HCWs) in Lahad Datu, Sabah. In Proceedings of the 3rd International Scientific Meeting on Public Health and Sports (ISMOPHS 2021), Virtual Conference via Zoom, 25 January 2022; pp. 32–40. [Google Scholar]
- Cook, T.M. Risk to health from COVID-19 for anaesthetists and intensivists—A narrative review. Anaesthesia 2020, 75, 1494–1508. [Google Scholar] [CrossRef]
Variables | Total Staff a | n | % |
---|---|---|---|
Malaysia | 155,578 | 1608 | 1.03 |
States | |||
Perlis | 2145 | 1 | 0.04 |
Kedah | 10,334 | 25 | 0.24 |
Pulau Pinang | 8861 | 28 | 0.31 |
Perak | 15,052 | 90 | 0.59 |
Selangor b | 20,920 | 442 | 2.11 |
WPKL and Putrajaya c | 13,997 | 108 | 0.77 |
Negeri Sembilan | 6696 | 50 | 0.74 |
Melaka | 4987 | 19 | 0.38 |
Johor | 15,887 | 76 | 0.47 |
Pahang | 9419 | 5 | 0.05 |
Terengganu | 6487 | 2 | 0.03 |
Kelantan | 7604 | 20 | 0.26 |
Sabah | 17,271 | 640 | 3.70 |
Sarawak | 14,240 | 96 | 0.67 |
WP Labuan | 550 | 6 | 1.09 |
Mortality rate | |||
Death | 155,578 | 3 | 0.000019 |
Personal Characteristics | n | % |
---|---|---|
Age Group | ||
≤24 years old | 65 | 4.0 |
25–34 years old | 944 | 58.7 |
35–44 years old | 378 | 23.5 |
45–54 years old | 165 | 10.3 |
≥55 years old | 32 | 2.0 |
Gender | ||
Male | 520 | 32.3 |
Female | 1088 | 67.7 |
Race | ||
Malay | 799 | 49.7 |
Chinese | 74 | 4.6 |
Indian | 92 | 5.7 |
Sabah Indigenous | 604 | 37.6 |
Sarawak Indigenous | 30 | 1.9 |
Others | 9 | 0.5 |
Comorbidity | ||
Single comorbidity | 93 | 5.8 |
Double comorbidities | 29 | 1.8 |
Triple comorbidities | 4 | 0.2 |
>3 comorbidities | 2 | 0.1 |
No comorbidities | 1480 | 92.0 |
Occupational Characteristics | ||
Hospital Department | ||
Medical | 374 | 23.3 |
Emergency | 284 | 17.7 |
Hospital admin and governance | 147 | 9.1 |
Anaesthetic | 138 | 8.6 |
Hospital clinical support services | 128 | 7.9 |
Surgery | 118 | 7.3 |
Pathology | 71 | 4.4 |
Obstetrics and gynaecology | 63 | 3.9 |
Pharmacy | 55 | 3.4 |
Paediatric | 52 | 3.2 |
Ward (multidiscipline) | 43 | 2.7 |
Orthopaedics | 37 | 2.3 |
Radiology | 33 | 2.1 |
Dentistry | 6 | 0.4 |
Unidentified | 59 | 3.7 |
Hospital Category | ||
State hospital | 560 | 34.8 |
Major hospital | 502 | 31.2 |
Minor hospital | 123 | 7.6 |
Non-specialist hospital | 313 | 19.5 |
Institute hospital | 110 | 6.8 |
Occupational Category | Total Staff a | n (%) | Infection Rate (%) |
---|---|---|---|
Environmental health professionals | 90 | 3 (0.2) | 3.33 |
Medical doctor assistants | 8268 | 146 (9.1) | 1.77 |
Food preparation personnel | 1991 | 28 (1.7) | 1.41 |
Medical doctor and specialists | 30,830 | 387 (24.1) | 1.26 |
Hospital drivers | 2565 | 29 (2.3) | 1.13 |
Dentists and assistants | 555 | 6 (0.4) | 1.08 |
Healthcare assistants | 19,232 | 156 (9.7) | 1.08 |
Nursing professionals | 61,480 | 652 (40.5) | 1.06 |
Radiographer | 2324 | 20 (1.2) | 0.86 |
Pharmacists and assistants | 6248 | 49 (3.0) | 0.78 |
Laboratory personnel | 4951 | 37 (2.3) | 0.75 |
Other Clinical personnel | 602 | 4 (0.2) | 0.66 |
Administrative personnel | 12,031 | 74 (4.6) | 0.62 |
Occupational and physiotherapists | 1981 | 10 (0.6) | 0.50 |
Support services personnel | 1876 | 6 (0.4) | 0.32 |
Dieticians and nutritionists | 352 | 1 (0.1) | 0.28 |
Total (average infection rate) | 155,376 | 1608 | 1.03 |
Occupational Category | n | Source of Infection | |||
---|---|---|---|---|---|
Work, n (%) | Community, n (%) | Undetermined, n (%) | |||
Staff to Staff | Patient to Staff | ||||
Nursing professionals | 652 | 237 (36.3) | 116 (17.8) | 276 (42.3) | 23 (3.5) |
Medical doctor and specialists | 387 | 137 (35.4) | 101 (26.1) | 135 (34.9) | 14 (3.6) |
Healthcare assistants | 156 | 55 (35.3) | 20 (12.8) | 73 (46.8) | 8 (5.1) |
Medical doctor assistants | 146 | 55 (37.7) | 30 (20.5) | 58 (39.7) | 3 (2.1) |
Administrative personnel | 72 | 26 (36.1) | 0 (0.0) | 44 (61.1) | 2 (2.8) |
Pharmacists and assistants | 49 | 19 (38.8) | 4 (8.2) | 26 (53.1) | 0 (0.0) |
Laboratory personnel | 37 | 17 (45.9) | 0 (0.0) | 18 (48.6) | 2 (5.4) |
Hospital drivers | 29 | 13 (44.8) | 1 (3.4) | 15 (51.7) | 0 (0.0) |
Food preparation personnel | 28 | 16 (57.1) | 0 (0.0) | 11 (39.3) | 1 (3.6) |
Radiographer | 20 | 1 (5.0) | 0 (0.0) | 17 (2.4) | 2 (10.0) |
Occupational and physiotherapists | 10 | 3 (30.0) | 0 (0.0) | 7 (85.0) | 0 (0.0) |
Support services personnel | 7 | 3 (42.9) | 0 (0.0) | 4 (57.1) | 0 (0.0) |
Dentists and assistants | 7 | 0 (0.0) | 0 (0.0) | 6 (85.7) | 1 (14.3) |
Other clinical personnel | 4 | 2 (50.0) | 1 (25.0) | 1 (25.0) | 0 (0.0) |
Environmental health professionals | 3 | 0 (0.0) | 0 (0.0) | 3 (100) | 0 (0.0) |
Total | 1608 (100) | 584 (36.3) | 273 (17.0) | 695 (43.2) | 56 (3.5) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Harith, A.A.; Ab Gani, M.H.; Griffiths, R.; Abdul Hadi, A.; Abu Bakar, N.A.; Myers, J.; Mahjom, M.; Robat, R.M.; Zubir, M.Z. Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia. Int. J. Environ. Res. Public Health 2022, 19, 12485. https://doi.org/10.3390/ijerph191912485
Harith AA, Ab Gani MH, Griffiths R, Abdul Hadi A, Abu Bakar NA, Myers J, Mahjom M, Robat RM, Zubir MZ. Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia. International Journal of Environmental Research and Public Health. 2022; 19(19):12485. https://doi.org/10.3390/ijerph191912485
Chicago/Turabian StyleHarith, Abdul Aziz, Mohd Hafiz Ab Gani, Robin Griffiths, Azlihanis Abdul Hadi, Nor Aishah Abu Bakar, Julia Myers, Maznieda Mahjom, Rosnawati Muhamad Robat, and Muhammad Zulfakhar Zubir. 2022. "Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia" International Journal of Environmental Research and Public Health 19, no. 19: 12485. https://doi.org/10.3390/ijerph191912485