ABSTRACT
Objective: This study sought to determine the factors associated with COVID-19 infection in a recent cluster involving healthcare workers in a district hospital located northwest of Malaysia. Method: We conducted a case-control study on 171 healthcare workers who were epidemiologically linked to the index case of a COVID-19 cluster in a district hospital located in Malaysia. Materials and Methods: Data were collected from district outbreak registry between 15 March 2020 to 15 April 2020. Data from 42 cases and 129 controls were analyzed using simple and multiple logistic regression to identify factors associated with positive RT-PCR for SARS-CoV-2. Result: Final regression model indicates that the factors that were associated with COVID-19 infection among healthcare workers were presence of symptoms (AOR: 5.32, 95%CI: 1.60, 17.73) and direct contact with index case (AOR: 8.09, 95%CI: 3.14, 20.86). Discussion: Symptomatic healthcare workers were more likely to be tested positive compared to those without symptoms suggesting the importance of daily health screening to enable early identification of disease. Infected healthcare workers had higher odds to be directly exposed to index case (primary transmission) compared to those who were infected by secondary transmission, implying that public health measures were able to control secondary transmission in the outbreak. Conclusion: Healthcare workers with any symptom should be isolated and undergo early testing to prevent COVID-19 cluster in hospitals.