Risk factors for SARS-CoV-2 infection among healthcare workers in Rajasthan: A Case-Control Study aligned with WHO UNITY protocol

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Abstract
Background: Understanding the risk factors for healthcare workers (HCWs) involved in COVID-19 care is essential for developing effective infection prevention strategies. Methodology: A case-control study, aligned with the World Health Organization UNITY protocol and using the WHO Go.Data template, was conducted in Rajasthan across three public hospitals to identify factors associated with COVID-19 infection among HCWs. Data were analyzed using SPSS v.23. Descriptive analysis included COVID-19 positivity rates, exposure frequency and duration, and Infection Prevention and Control (IPC) practice scores. Chi-square and Fisher’s exact tests (P < 0.05) were used to assess associations. Results: A total of 196 participants (50 cases and 146 controls) were enrolled. Among the cases, 54% were doctors and 42% were specifically assigned to COVID-19 care, with an average exposure duration of 8.8 ± 4.9 days over the prior 2 weeks. Notably, 36% experienced long-term face-to-face exposure. Of all variables, only hand hygiene before and after patient material contact showed a significant association with infection (P = 0.036). Conclusion: These findings underscore the need for strengthened IPC adherence, particularly hand hygiene, among HCWs in high-exposure settings.