Prevalence and Associated Factors of Chronic Fatigue Among Healthcare Professionals: A Cross-Sectional Study at a University Hospital in North Africa

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Abstract
Background: Chronic fatigue constitutes a critical occupational health challenge among healthcare workers with substantial implications for individual well-being and patient safety. Empirical evidence regarding chronic fatigue among healthcare professionals in North Africa remains limited, particularly in contexts where healthcare systems contend with resource constraints and elevated workload demands. Objective: This study aimed to determine the prevalence of chronic fatigue and chronic fatigue syndrome (myalgic encephalomyelitis (CFS/ME)) among healthcare professionals without severe chronic diseases at a university hospital in Tunisia and identify independent associations of chronic fatigue. Methods: We conducted a cross-sectional analysis of 205 healthcare professionals at University Hospital Farhat Hached, Sousse, Tunisia, from October to December 2021. Data were collected using a pre-test questionnaire to collect data about sociodemographic characteristics, chronic fatigue, quality of life, and lifestyle habits. A vitamin D3 test was also performed, as it is identified as an associated factor and potential biological modulator of chronic fatigue. Results: Chronic fatigue prevalence was 37.1%, with chronic fatigue syndrome (myalgic encephalomyelitis (CFS/ME)) prevalence of 11.2%. Multivariate analysis revealed good physical health-related quality of life (adjusted Odds Ratio (OR) = 0.08, p < 0.001) and good mental health-related quality of life (adjusted OR = 0.10, p < 0.001) as protective factors. Moderate-to-severe depression (adjusted OR = 5.84, p < 0.001) and obesity (adjusted OR = 2.50, p = 0.021) independently increased chronic fatigue risk. No independent association was detected between vitamin D levels and chronic fatigue. Conclusions: Chronic fatigue affects more than one-third of healthcare professionals in this resource-limited setting. Comprehensive occupational health interventions addressing psychological and metabolic health factors are needed to protect healthcare workers’ well-being and maintain the quality of care delivery.

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