Self-Reported COVID-19 Diagnosis and Workplace Preparedness Indicators Among Primary Healthcare Workers in King Sabatha Dalindyebo, South Africa

Background/Objectives: Primary healthcare (PHC) workers played a central role in the COVID-19 response, yet evidence on self-reported COVID-19 diagnosis and workplace preparedness in resource-constrained PHC settings remains limited. This study assessed the frequency and distribution of self-reported COVID-19 diagnosis among PHC workers in King Sabatha Dalindyebo, South Africa, and examined its associations with occupational category and selected workplace preparedness indicators. Methods: A cross-sectional analytical study was conducted among 268 PHC workers in King Sabatha Dalindyebo sub-district, Eastern Cape Province, South Africa, from January 2022 to April 2022. A structured self-administered questionnaire measured demographic and occupational characteristics, COVID-19 history, and individual preventive behaviours and workplace preparedness indicators. The primary outcome was self-reported COVID-19 diagnosis during 2020–2022. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used. The principal model included age and occupational role; an extended model additionally included sex and selected preparedness indicators (PPE use, COVID-19 policy availability, workplace risk assessment and N95 fit testing). Results: Of 266 participants with valid outcome data, 103 (38.7%) reported a COVID-19 diagnosis. Age ≥ 46 years (adjusted odds ratio [aOR] 1.86, 95% confidence interval [CI] 1.10–3.16) and professional nurse/facility manager status (aOR 2.73, 95% CI 1.61–4.61) were independently associated with diagnosis in the principal model. In the extended model (n = 263; 101 reported diagnoses), the associations persisted (age ≥ 46 years: aOR 1.83, 95% CI 1.06–3.19; nurse/facility manager: aOR 3.22, 95% CI 1.84–5.64), whereas self-reported consistent PPE use, policy availability, workplace risk assessment, and N95 fit testing were not statistically significantly associated after adjustment with reported diagnosis. The corresponding occupational-category adjusted prevalence ratios (aPRs) were 1.82 (principal model) and 1.98 (extended model). Conclusions: Self-reported COVID-19 diagnosis was common among PHC workers in this South African setting and was associated with older age and professional nurse/facility manager status. The measured preventive behaviour and workplace preparedness indicators were not statistically significantly associated with diagnosis in the extended model. However, the cross-sectional design, uncertain temporality and reliance on self-reported measures limit interpretation. These findings support further role-sensitive occupational surveillance and prospective evaluation of infection-prevention implementation in PHC settings.