title: Diabetes, HIV and other health determinants associated with absenteeism among formal sector workers in Namibia.
abstract: BACKGROUND
  As countries in sub-Saharan Africa develop their economies, it is important to understand the health of employees and its impact on productivity and absenteeism. While previous studies have assessed the impact of single conditions on absenteeism, the current study evaluates multiple health factors associated with absenteeism in a large worker population across several sectors in Namibia.
  
  
  METHODS
  From March 2009 to June 2010, PharmAccess Namibia conducted a series of cross-sectional surveys of 7,666 employees in 7 sectors of industry in Namibia. These included a self-reported health questionnaire and biomedical screenings for certain infectious diseases and non-communicable disease (NCD) risk factors. Data were collected on demographics, absenteeism over a 90-day period, smoking behavior, alcohol use, hemoglobin, blood pressure, blood glucose, cholesterol, waist circumference, body mass index (BMI), HIV status, and presence of hepatitis B antigens and syphilis antibodies. The associations of these factors to absenteeism were ascertained using negative binomial regression.
  
  
  RESULTS
  Controlling for demographic and job-related factors, high blood glucose and diabetes had the largest effect on absenteeism (IRR: 3.67, 95%CI: 2.06-6.55). This was followed by anemia (IRR: 1.59, 95%CI: 1.17-2.18) and being HIV positive (IRR: 1.47; 95%CI: 1.12-1.95). In addition, working in the fishing or services sectors was associated with an increased incidence of sick days (IRR: 1.53, 95%CI: 1.23-1.90; and IRR: 1.70, 95%CI: 1.32-2.20 respectively). The highest prevalence of diabetes was in the services sector (3.6%, 95%CI:-2.5-4.7). The highest prevalence of HIV was found in the fishing sector (14.3%, 95%CI: 10.1-18.5).
  
  
  CONCLUSIONS
  Both NCD risk factors and infectious diseases are associated with increased rates of short-term absenteeism of formal sector employees in Namibia. Programs to manage these conditions could help employers avoid costs associated with absenteeism. These programs could include basic health care insurance including regular wellness screenings.
authors.affiliation: PharmAccess Foundation, Pietersbergweg 17, 1105, BM Amsterdam, Zuidoost, the Netherlands. leonor.guariguata@gmail.com
authors.forename: Leonor
authors.initials: L
authors.lastname: Guariguata
authors.forename: Ingrid
authors.initials: I
authors.lastname: de Beer
authors.forename: Rina
authors.initials: R
authors.lastname: Hough
authors.forename: Els
authors.initials: E
authors.lastname: Bindels
authors.forename: Delia
authors.initials: D
authors.lastname: Weimers-Maasdorp
authors.forename: Frank G
authors.initials: FG
authors.lastname: Feeley
authors.forename: Tobias F Rinke
authors.initials: TF
authors.lastname: de Wit
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007221:Industry / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009276:Namibia / Q000453:epidemiology; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D055815:Young Adult