Knowledge, attitudes and practices towards COVID-19 among young adults with Type 1 Diabetes Mellitus amid the nationwide lockdown in India: A cross-sectional survey

COVID-19-related fear and anxiety in a sample of patients with type 2 diabetes: a cross-sectional study in Iran after several peaks of the pandemic

Purpose

The aim of this study was to assess COVID-19-related anxiety, and fear burden in diabetic patients, as a risk group for severe COVID-19.

Methods

A cross-sectional online survey conducted on 111 type 2 diabetes mellitus (T2DM) patients referred to a Diabetes clinics of Royan institute, and 155 healthy controls recruited from normal population using a snowball sampling technique. Fear of COVID-19 Scale (FCV-19 S) and Coronavirus anxiety scale (CAS) were used.

Results

The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). Correlation matrix between coronavirus anxiety and fear scores in these samples confirmed that in T2DM participants CAS was significantly positively associated with FCV-19 (r = 0.407, p = 0.000). There was also statistically and positively significant correlation between CAS and FCV-19 in healthy subjects (r = 0.495, p = 0.000).

Conclusion

The present study revealed that the level of fear and anxiety from COVID-19 was almost the same in a sample of Iranian T2DM patients and healthy controls. The pandemic with several peaks in the country cannot cause an increased anxiety and fear from COVID-19, especially in patients with diabetes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01353-8.

Exploring Disease Management Experiences of Individuals with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Study

The aim of this study was to investigate the impact of COVID-19 infection on disease management among individuals with type 2 diabetes and to explore their perspectives on COVID-19. This descriptive qualitative study included patients with diabetes, with a sample of 15 patients meeting the study criteria. The data were analyzed using code groups, which were then further categorized into main themes and subthemes. The main themes were: initial contact with the SARS-CoV-2 that is associated with COVID-19 illness changes in diabetes self-management behaviors; attempt at maintaining diabetes selfmanagement behaviors; and problems with accessing diabetes care. The study findings revealed several significant insights. Individuals with diabetes exhibited a fear of contracting SARS-CoV-2, which led to reduced levels of exercise and difficulties in managing blood sugar levels and insulin adjustments. Moreover, due to anxiety about COVID-19 infection, they postponed health check-ups, resulting in experiencing diabetes-related complications.

Systematic review and meta-analysis of knowledge, attitudes, and practices regarding COVID-19 among chronic disease patients: A global perspective

Background

Chronic health conditions were significantly correlated with an increased clinical severity of coronavirus 2019 (COVID-19) and a heightened risk of COVID-19 mortality. This study aims to determine global knowledge, attitudes, and practices (Knowledge Abuse Profile) of the patients with chronic diseases toward COVID-19.

Methods

The study was initiated in December 2019 and extended until April 2023, during which an extensive search for relevant English-language literature was conducted as part of this systematic review and meta-analysis. Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest were utilized for the search. The quality of included studies was assessed using a quality rating checklist created by Joanna Briggs Institute for cross-sectional research. In the STATA software version 14, inverse variance and Cochran Q statistics were used for statistical analysis to assess heterogeneity among the studies. The Dersimonian and Liard random-effects models were applied in cases where heterogeneity existed.

Results

A total of 23 studies involving 14,587 patients contributed to this meta-analysis. These studies comprised 21 studies focused on knowledge, with 6864 participants, 12 studies on attitudes involving 3597 patients, and 12 on practices, encompassing 4126 patients. The pooled estimates for sufficient knowledge, positive attitudes, and COVID-19 preventive behaviors among chronic disease patients were determined as 48.2% (95% confidence interval [95% CI]: 33.9%-62.5%), 60.8% (95% CI: 46.8%-74.8%), and 58.3% (95% CI: 39.5%-77.0%), respectively. Over the years, there was a consistent decrease in adequate knowledge, positive attitudes, and COVID-19 preventive behaviors among the population. Specifically, regarding knowledge, the rates declined from 50.2% in 2020 to 49.7% in 2021 and dropped to 45.1%. Similarly, the percentage of individuals with a positive attitude fell, decreasing from 64.1% in 2020 to 60.3% in 2021 and dropping to 57.9% in 2022. Furthermore, COVID-19 preventive behaviors showed fluctuations, with the rates recorded at 63.7% in 2020, increasing to 75.4% in 2021, and then decreasing to 47% in 2022, in line with the publication dates of included studies.

Conclusion

The findings of meta-analysis show a significant decrease in the levels of knowledge, attitudes, and adherence to preventative interventions for COVID-19 among individuals with chronic diseases. The findings emphasize the need for targeted interventions, and ongoing education to address this trend.

Knowledge, Attitude, and Practices Regarding Covid-19 Outbreak in Turkey: A Cross-Sectional Study

The COVID-19 infection, which has been increasing all over the world since December 2019 and has experienced its second and third waves in 2020 and 2021, has created fear in the society. Despite the fact that this infection has been fought for about 3 years, it is very important to develop the knowledge, attitudes and skills of the society against disease X (i.e. an unidentified future pandemic) epidemic such as COVID-19 in terms of infection control. The research was cross-sectional in the period that we can call the early days of the pandemic. Data were collected from a total of 312 individuals who attended the Ankara City Hospital Blood Collection Unit between November 1 and November 30, 2020 and accepted participation in the study. The patient information, attitude and behavior form prepared based on the literature information was collected face to face. Chi-square test was applied to determine whether there is a systematic relationship between the categorical variables in the data analysis. Ethics committee permissions and consent from the participants were obtained. According to the results of the study, the knowledge levels of the individuals were half sufficient, they were worried about themselves and their relatives in terms of getting COVID 19, and their attitude toward the COVID-19 pandemic was moderate. As a result, it is necessary to improve the knowledge, attitude and practices of individuals in society to combat the pandemic.

Knowledge, attitudes, and practices of chronic disease patients in Bojanala towards COVID-19

BACKGROUND

 COVID-19 is an acute respiratory disease. Its morbidity and mortality in patients with comorbidities have been established. This study evaluated the knowledge, attitude and practices regarding COVID-19 of patients with comorbidities attending primary health care services.

METHODS

 An analytical cross-sectional study was conducted, with data collected from patients using a self-administered questionnaire. Knowledge, attitude and practice scores were calculated. Descriptive and inferential statistical analyses were used, and the level of significance was set at 5%.

RESULTS

 This study enrolled 469 participants aged 18-84 years, and the majority were women. The mean knowledge score was 7.09 ± 1.73 out of 9, the mean attitude score was 2.33 ± 0.86 out of 3, and the mean practices score was 3.79 ± 0.56 out of 4. There was a positive linear relationship between knowledge and attitude scores and between attitude and practices scores; as one score increased, the other also increased significantly.

CONCLUSION

 The level of knowledge was good in general, with optimistic attitudes and good practices by the patients. Those aged 70 years and above need special attention because older persons have poorer knowledge of and practices towards COVID-19, which could lead to higher hospitalisation and mortality rates.Contribution: This study found that patients with chronic diseases had good COVID-19 knowledge, attitudes and practices, while interventions targeting patients aged 70 years and above are needed to improve their COVID-19 awareness and practices.

Impacts of the COVID-19 pandemic on life expectancy at birth in Asia

OBJECTIVE

To investigate the impact of the COVID-19 pandemic on life expectancy at birth (e0) for 51 Asian countries and territories from January 1, 2020 to December 31, 2021.

METHOD

Based on age-sex-specific mortality used for estimating the changes in e0 for years 2019, 2020, and 2021 from the 2022 revision of the World Population Prospects, we employed Arriaga's discrete method to decompose changes in e0 into both absolute and relative contributions of changes in age-specific death rate, and further obtained the age-sex-specific contribution to changes in e0 by country/territory and period (i.e., 2019-2020 and 2020-2021) for Asia.

FINDINGS

The COVID-19 pandemic reduced 1.66 years in e0 of the Asian population from 2019 to 2021, slightly lower than the world average of 1.74 years. South Asia had a high loss of 3.01 years, whereas Eastern Asia had almost no changes. Oman, Lebanon, India, Armenia, Azerbaijan, Indonesia, and the Philippines experienced a high loss of above 2.5 years in e0. Despite significant national and territorial variations, the decline of e0 in Asia was mostly from the age group of 60-79 years, followed by age groups of 80 + and 45-59 years; and age groups of children contributed little (i.e., 0-4 and 5-14 years old). Males suffered more losses than females in this pandemic. Asian nations saw less loss in e0 in the second year of the pandemic, i.e., 2020-2021, than in the first year, i.e., 2019-2020, but this recovery trend was not observed in Southern Asia and South-Eastern Asia. Countries from Central Asia and Western Asia, such as Kazakhstan, Armenia, Azerbaijan, Lebanon, and Oman, had extraordinarily more losses in e0 in the first year at ages around 70.

CONCLUSION

The COVID-19 pandemic had significantly affected e0 of Asian populations, and most contribution to the reduction of e0 came from the three older age groups, 60-79 years, 80 + years, and 45-59 years, with great variations across countries/territories. Our findings could have important implications for development of more resilient public health systems in Asian societies with better policy interventions for vulnerable demographic groups.

Knowledge, attitude, and practice towards COVID-19 among chronic disease patients visiting public hospitals

Background

Corona virus disease 2019 (COVID 19) is a potentially severe acute respiratory infection first reported in December 2019 in Wuhan, China. It is currently a global health issue and a public health emergency for the entire world, including Ethiopia. People with comorbidities of chronic disease are at higher risk for severe disease and death from this virus. Hence, in order to better control the COVID-19 pandemic, their understanding, attitude, and practice of COVID-19 prevention measures should be improved. Therefore, this study aimed to assess the knowledge, attitude, and practice of chronically ill patients toward COVID-19 among chronic disease patients.

Methods

An institutional-based cross-sectional study was employed among patients with chronic diseases visiting public hospitals in Mekelle, Tigray, Ethiopia, from April to June 2021. An interviewer-administered questionnaire was used to retrieve data from systematically selected 319 chronic disease patients. The data were entered using EpiData version 4.4.2.1 and analyzed by SPSS version 23. Both bivariate and multivariate logistic regression analyses were done to identify factors associated with the outcome variables. Significance was determined at a p value of <0.05, and association was described by using an odds ratio at a 95% confidence interval.

Results

A total of 319 patients with chronic diseases participated in this study, with a 100% response rate. Out of 319 study participants, 51.1% had good knowledge, 59.9% had a positive attitude, and about half (49.2%) had good practices toward the COVID-19 pandemic. Multivariate analysis revealed that study participants completed secondary school (AOR = 4.691, 95%CI = 1.846-11.918), had college or higher educational levels (AOR = 4.626, 95%CI = 1.790-11.955) were positively associated with good knowledge towards COVID 19 where as those who aged 50 and up (AOR = 0.415, 95%CI = 0.227-0.759), divorced (AOR = 0.298, 95%CI = 0.116-0.764), and widowed (AOR = 0.115, 95%CI = 0.025-0.528) were negatively associated with it. Positive attitude had a statistically significant association with sex, being male (AOR = 0.471, 95%CI = 0.265-0.837), and occupation, being merchants (AOR = 4.697, 95%CI = 1.174-18.795), private employees (AOR = 4.484, 95%CI = 1.182-17.008) and housewives (AOR = 5.292, 95%CI = 1.372-20.414). Moreover, good knowledge (AOR = 4.047,95%CI = 2.205-7.427) and a positive attitude (AOR = 5.756,95%CI = 3.244-10.211) were factors significantly associated with the good practices of study participants towards COVID-19.

Conclusion

Less than two thirds of the study participants had good knowledge, attitudes, and practices overall about the COVID-19 pandemic. Health professionals and other responsible bodies should provide public education about COVID-19 and its prevention measures to chronic disease patients.

Knowledge about diabetes and its association with adherence to self-care and glycemic control in patients with type 1 diabetes in Southern Brazil

Objective

To evaluate the association between knowledge about the disease, adherence to self-care, and glycemic control in people diagnosed with type 1 diabetes mellitus.

Subjects and methods

A cross-sectional study of patients aged over 18 years diagnosed with type 1 diabetes mellitus, treated at an outpatient clinic of a Brazilian university hospital. Participants with other types of diabetes, cognitive impairment, pregnancy, and outpatient discharge were excluded. Data were collected from January to March 2021 (by telephone call), with questions about the participants' profile, diabetes knowledge questionnaire (DKN-A), and self-care inventory revised (SCI-R) translated into and adapted for Brazilian Portuguese. Data analysis involved chi-square associations, Mann-Whitney U tests, and Poisson regression.

Results

Among 198 adult participants, the mean age was 42 ± 12 years, 53.5% were women, the mean glycated hemoglobin was 8.6 ± 1.6%, 140 (70.8%) had satisfactory knowledge about diabetes, 65 (32.8%) had adherence to self-care, and 46 (23.2%) had adequate glycemic control. We found an association between knowledge and adherence to self-care (p < 0.001). Knowledge was not associated with glycemic control (p = 0.705).

Conclusion

Knowledge about diabetes was associated with greater adherence to self-care in people with type 1 diabetes mellitus, but it did not reflect in better glycemic control.

Global acceptance of COVID-19 vaccine among persons with diabetes: A systematic review and meta-analysis

AIM

This review aimed to estimate the level of acceptance of COVID-19 vaccine among persons with diabetes.

METHODS

A systematic search was conducted on PubMed, MEDLINE, Embase, and CINAHL to identify relevant studies for this review. A random-effects meta-analysis was performed to generate an overall estimate of vaccine acceptance. The I² statistic was used to quantify the degree of variation across studies, and subgroup analysis was conducted to identify the sources of heterogeneity. The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).

RESULTS

This review included 18 studies involving 11,292 diabetes patients. The pooled prevalence of COVID-19 vaccine acceptance among persons with diabetes was 76.1% (95% CI: 66.7% - 83.5%). The pooled prevalence across the continent ranged from 68.9% (95% CI: 47.8% - 84.3%) in Asia to 82.1% (95% CI: 80.2% - 83.8%) in Europe. Barriers to vaccine acceptance included misinformation, lack of information, mistrust, health concerns, and external influences.

CONCLUSION

The barriers to vaccine acceptance identified in this review, could inform the formulation of health policies and public health interventions that are specifically tailored to address the needs of persons with diabetes.

Effect of a health education program about COVID-19 on the knowledge, attitude, and practices of paramedical students in Egypt: an interventional study

Background

In December 2019, an outbreak of novel coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, has been reported in China.

Objective

This study aims to assess the knowledge, attitude, and practices (KAP) of Benha Health Technical Institute (BHTI) students and to evaluate the impact of a health education program about COVID-19 on their KAP.

Methods

This is an interventional study that recruited 398 students from BHTI and was conducted in 3 phases. Firstly, an assessment of students' KAP was done using a structured questionnaire concerning COVID-19. Secondly, an education program about COVID-19 was conducted. Lastly, the reassessment of KAP was carried out using the same questionnaire after one month.

Results

The median knowledge, attitude, and practice scores among the studied students in the pre-interventional stage were 12, 15, and 26 which had significantly increased to 15, 16, and 28 respectively after the intervention. The knowledge score of the participants was significantly affected by students' age and grade of education; the attitude score was affected by age, gender, and grade of education, while the practice score was only affected by participants' age.

Conclusion

The educational program significantly increased the KAP of BHTI students.

Gender Differences in Knowledge, Attitudes, and Practices toward COVID-19 in Saudi Arabia: A Cross-Sectional Study

Days after the World Health Organization (WHO) declared that COVID-19 was a pandemic, Saudi Arabia took preventative and precautionary measures to avoid its spread and to safeguard its citizens. In this study, we investigated the knowledge, attitudes, and practices (KAP) of both men and women toward COVID-19 as well as associated factors. A cross-sectional study was conducted using an online, self-report questionnaire distributed via Google Forms. The overall percentage of correct answers for the knowledge statements was 80.2%, with a higher rate among the female respondents (82.4% vs. 78.5%, p = 0.005). Slightly more than half (i.e., 165: 51.6%) of the participants showed that they did not go to crowded places during the pandemic; however, more female respondents recorded that they avoided crowded places than male respondents (57.7% vs. 46.2%, p = 0.04). Most participants (i.e., 272: 85.0%) reported that they had worn a mask in recent days, and more than two-thirds (84.4%) said that they still follow the strategies recommended by government authorities to prevent the spread of the virus. Again, more female respondents reported this than males (89.9% vs. 79.5%; p = 0.01). Significant correlations (p < 001) were noted between knowledge and practices (r = 0.31), knowledge and attitudes (r = 0.37), and attitudes and practices (r = 0.29). In the multivariate logistic regression analysis, occupation and education were independently associated with knowledge among both the male and female respondents (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.2-7.2; aOR: 5.9; 95% CI: 2.2-15.9). Residence was independently associated with attitudes, but only among the male respondents (aOR: 2.3; 95% CI: 1.1-4.9), and COVID-19 was independently associated with practices among both the male and female respondents (aOR: 4.5; 95% CI: 1.4-14.2; aOR: 9.8; 95% CI: 1.2-81.2). There were significant gender differences in both knowledge and practices toward COVID-19, with the female respondents achieving better scores than the male respondents. Thus, we recommend that health education campaigns are tailored to specifically target males.

Communication inequalities and health disparities among vulnerable groups during the COVID-19 pandemic - a scoping review of qualitative and quantitative evidence

BACKGROUND

The COVID-19 pandemic has exacerbated health disparities in vulnerable groups (e.g., increased infection, hospitalization, and mortality rates in people with lower income, lower education, or ethnic minorities). Communication inequalities can act as mediating factors in this relationship. Understanding this link is vital to prevent communication inequalities and health disparities in public health crises. This study aims to map and summarize the current literature on communication inequalities linked with health disparities (CIHD) in vulnerable groups during the COVID-19 pandemic and to identify research gaps.

METHODS

A scoping review of quantitative and qualitative evidence was conducted. The literature search followed the guidelines of PRISMA extension for scoping reviews and was performed on PubMed and PsycInfo. Findings were summarized using a conceptual framework based on the Structural Influence Model by Viswanath et al. RESULTS: The search yielded 92 studies, mainly assessing low education as a social determinant and knowledge as an indicator for communication inequalities. CIHD in vulnerable groups were identified in 45 studies. The association of low education with insufficient knowledge and inadequate preventive behavior was the most frequently observed. Other studies only found part of the link: communication inequalities (n = 25) or health disparities (n = 5). In 17 studies, neither inequalities nor disparities were found.

CONCLUSIONS

This review supports the findings of studies on past public health crises. Public health institutions should specifically target their communication to people with low education to reduce communication inequalities. More research about CIHD is needed on groups with migrant status, financial hardship, not speaking the language in the country of residence, sexual minorities, and living in deprived neighborhoods. Future research should also assess communication input factors to derive specific communication strategies for public health institutions to overcome CIHD in public health crises.

The COVID-19 pandemic: knowledge, attitudes and practices of coronavirus (COVID-19) among patients with type 2 diabetes

BACKGROUND

It is necessary to evaluate COVID-19 data on Knowledge, Attitudes and Practices (KAP) to confirm effective protective practice and to reduce risk in society. Hence, the study was carried out to determine KAP towards COVID-19 and the factors associated with knowledge and practices among patients with type 2 diabetes (T2D).

METHODS

In this cross-sectional (descriptive-analytical) study, 357 patients with diabetes in Izeh participated in the study. The sampling method used was convenience sampling method. Data collection tool was a researcher-made questionnaire of demographic information and KAP of patients with T2D in relation to the new coronavirus. The validity and reliability of the research tool was confirmed using the content validity and test-retest. Data analysis was done in Stata.14.2 and Smartpls 3.2.8 using descriptive and analytical statistical tests.

RESULTS

The mean score of participants' KAP towards Covid-19 was 74.22 (16.30), 72.88 (14.87), and 70.51 (19.70), respectively. The lowest and the highest score of the patients' knowledge was in the field of transmission (56.60 (20.96)) and care and prevention of the COVID-19 (88.58 (21.88)), respectively. Residence was the most important factor predicting the practice of diabetic patients with an explanatory coefficient ([SMD 1.08 (95% CI 0.85 to 1.30), P < 0.001] and R² = 0.87%).

CONCLUSION

Despite the good level of KAP of people towards the COVID-19 disease, there were answers showing poor knowledge, incorrect beliefs and attitudes, and insufficient practice regarding different aspects of the COVID-19 in some cases in our study. Residence was a strong predictor of type 2 diabetes mellitus (T2DM) patients' practice in terms of protective behaviors against Covid-19. Hence, educational needs evaluation based on residence is recommended, especially in rural T2DM patients.

Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait

OBJECTIVES

To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients.

METHODS

A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics.

RESULTS

A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%).

CONCLUSIONS

Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.

Knowledge, Attitudes and Practices of the General Population in Yemen Regarding COVID-19: A Cross-Sectional Study

BACKGROUND

Following the World Health Organization declaration of COVID-19 as a pandemic, Yemen has taken preventive and precautionary measures against COVID-19 to control its spread. This study evaluated the knowledge, attitudes, and practices (KAP) of the Yemeni public regarding COVID-19.

METHODS

A cross-sectional study using an online survey was conducted during the period from September 2021 to October 2021.

RESULTS

The mean total knowledge score was 9.50 ± 2.12. The majority of the participants (93.4%) were aware that to prevent infection by the COVID-19 virus, going to crowded places and gatherings should be avoided. Approximately two thirds of the participants (69.4%) believed COVID-19 is a health threat to their community. However, in terms of actual behavior, only 23.1% of the participants reported that they did not go to any crowded places during the pandemic, and only 23.8% had worn a mask in recent days. Moreover, only about half (49.9%) reported that they were following the strategies recommended by the authorities to prevent the spread of the virus.

CONCLUSION

The findings suggest that the general public has good knowledge and positive attitudes regarding COVID-19, but that their practices are poor.

Knowledge, attitude and practices regarding COVID-19 and their associated factors in patients with type 2 diabetes attending Abdullah-Khalil diabetes center, Omdurman: A cross-sectional study

Novel corona virus disease 2019 is the major threat for human life nowadays worldwide. This study aims to assess the knowledge, attitude and practices regarding COVID-19 among patients with type 2 diabetes attending Abdullah Khalil diabetes center (Omdurman Teaching Hospital). A facility-based observational descriptive cross-sectional study was carried out between January and February 2021, using non-probability quota sampling technique in Abdullah-Khalil diabetes center via the use of a structured close-ended interview questionnaire. It consisted of 19, 10, and 10 questions pertaining to knowledge, attitude and practices towards COVID-19 respectively. A total of 249 patients with type 2 diabetes were included. Of them, 132 (53.0%) were females and the majority (53.0%) aged between 41 and 60 years old. Concerning their education and marital status, 70 (28.1%) were primary school level and 208 (83.5%) were married. 89.6% of participants reported mass media as main source of information regarding COVID-19. Patients with type 2 diabetes attending Abdullah-Khalil diabetes center have good knowledge, positive attitude and good prevention practices towards COVID-19. Most respondents had good knowledge, positive attitude and good practices as 78.7%, 97.6%, and 69.9%, respectively. Educational level and source of information showed statistically significant association with the knowledge, attitude. However, the practice showed only statistical association with the mass media as a source of information (P = .006).

Knowledge, attitudes, and behaviors regarding COVID-19 among hospitalized patients in Taizhou, China

Objection

This study investigated the relationship between the knowledge, attitudes, and behaviors among hospitalized patients regarding the prevention and control of COVID-19.

Method

An online cross-sectional survey was conducted among hospitalized patients between July 8 and August 11, 2021, at a tertiary hospital in Taizhou, China. We performed descriptive analysis, t test, ANOVA (analysis of variance), and generalized linear regression modeling on the exported data. All data were analyzed using R software, version 4.1.0.

Results

A total of 1185 valid questionnaires were returned. The average score of the participants on COVID-19 behaviors was 69.3 (SD = 15.6, with a full score of 87), indicating that most inpatients had good COVID-19 prevention and control behaviors. In addition, we found that inpatients with higher COVID-19 awareness also behaved better (B (95%CI) = 1.00 (0.73-1.27)) and were more willing to recommend vaccination to other people (OR (95%CI) = 1.11 (1.06-1.17)). Moreover, hospitalized patients who had positive attitudes toward implementing COVID-19 prevention and control measures had better practices (B (95%CI) = 2.50 (2.24-2.76)) and more willingness to recommend vaccinations (OR (95%CI) = 1.20 (1.14-1.26)).

Conclusion

The research showed that the COVID-19 behaviors of hospitalized patients were positively associated with their knowledge and attitudes. These findings suggested that, for inpatients, hospitals should focus on teaching basic prevention knowledge of COVID-19. Targeted education initiatives should also be developed for patients from rural areas, especially those over 60 years of age, to help improve their knowledge and cultivate good prevention and control behaviors.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-022-01796-y.

Knowledge, attitudes, practice of people toward the COVID-19 pandemics, and its impact in Afghanistan

COVID-19 pandemic disrupted the social and economic norms. Knowledge, Attitude and Practices studies are used to address the information gap for further strategic decision making to control the pandemic. This study aimed to find the level of Knowledge, Awareness, Attitudes, and behavioral practices of the people of Afghanistan about the COVID-19 and its impact on health and socio-economic dimension of their routine lives. We used a cross-sectional method with two stage sampling design. Data analysis was performed using SPSS v.20. The survey focused on adults including men and women all over the country to represent the country, including the urban and rural areas. Most of the respondents are in the age group of 21-30 years (46.5%); 60.15% of the participants are married. Almost 75% of females and 84% of males were literate and most participants have a bachelor's degree (34%). More than 80% of participants knew they can prevent themselves from contacting COVID-19 through hand washing frequently with soap and water and wearing a mask. More than 80% of participants responded that they would go for a lab test for detection of the virus as well as COVID-19 vaccination if it is available. Almost 35% reported always wearing a mask to prevent COVID-19 transmission; more than half of participants always wash their hands, more than 60% of them do not touch their eyes, nose, and mouth frequently. Nearly 60% of participants indicated that their household had problems satisfying food needs partly during the COVID-19 pandemic. Nearly half of participants believed that the government was successful in applying lockdown measures and in awareness rising (56.8 and 69.8%). The study findings provide some useful insight about the KAP of communities in Afghanistan, which could assist policy makers in public health to design and implement interventions based on the information gaps reported.

Knowledge, Attitudes, and Practices Toward COVID-19 Among Rural Residents of Hebei Province: A Cross-Sectional Survey

OBJECTIVE

Coronavirus disease (COVID-19) has spread worldwide due to high infectivity. The social sexual environment in rural areas of China and the weak basic medical facilities may affect the treatment and transmission of the disease. The aim of this study was to understand the knowledge, attitudes, and practices (KAP) related to COVID-19 among residents in rural areas experiencing the epidemic and the factors, to provide a basis for further epidemic prevention and control.

METHODS

The COVID-19 KAP of rural residents in Hebei Province was collected by the snowball sampling method. The COVID-19 KAP questionnaire was distributed on social platforms such as WeChat and QQ through a network questionnaire.

RESULTS

The overall level of COVID-19 KAP in rural residents was good, but in terms of knowledge, the correct rate of isolation was 73.2%, the correct rates of 2 disinfection items were 72.3% and 77.4%, and the correct rate of hand-washing was 70.7%; 54.5% residents felt panic; 81.0% disinfected household items; and 84.9% washed their hands correctly. Residents still needed to strengthen these aspects. A binary logistic analysis showed that age, education, and participation in training were factors affecting the level of COVID-19 KAP.

CONCLUSIONS

This study found that rural residents had good levels of COVID-19 KAP, but there were gaps in specific issues that warrant attention. We advocate training on COVID-19 for rural residents.

Assisting individuals with diabetes in the COVID-19 pandemic period: Examining the role of religious factors and faith communities

With the onset of the coronavirus disease 2019 (COVID-19) pandemic, diabetes management has become more challenging than it has ever been. Studies on the management of diabetes during this time are required. Unfortunately, the lack of information on the potential role of religious factors and faith communities in diabetes management during the COVID-19 era prevents us from fully understanding the issue of diabetes management during the COVID-19 pandemic period. People with chronic conditions such as diabetes may benefit from some form of religious support from faith communities and their ability to cope could be fostered by some religious factors. It is unclear how religious factors and faith communities contribute to diabetes management. In this article, the authors examine how people with diabetes can be aided in the COVID-19 pandemic period from the perspective of religious factors and faith communities. Based on the studies identified, it appears that religious factors and faith communities play an important role in managing diabetes among patients during the COVID-19 pandemic.

Knowledge, Attitudes, and Practices of COVID-19 Safety Measures Among Type 1 Diabetes Mellitus Patients at King Abdulaziz University Hospital: A Cross-Sectional Study

Background: Coronavirus disease 2019 (COVID-19), an infectious disease caused by an enveloped RNA beta coronavirus, has become a pandemic, with a mortality rate ranging from 0.7% to 10.8%. Although older adults with comorbidity are more likely to suffer severe disease and eventual mortality, diabetes mellitus (DM) is one of the most frequently reported noncommunicable diseases shown to predict poor prognosis in COVID-19 patients.

Aim: To determine the knowledge, attitudes, and practices (KAP) of COVID-19 safety measures and factors associated with poor knowledge and practice among type 1 diabetes mellitus (T1DM) patients at King Abdulaziz University Hospital (KAUH), Jeddah.

Methodology: This cross-sectional study included 267 patients with T1DM aged 18-65, admitted to the hospital from January to June 2020. Data were collected via phone interviews during September 2020. The questionnaire consisted of 15 questions for knowledge, five for attitude, and eight concerning practices, and some questions were based on diabetes and COVID-19 specifically.

Results: Overall, 64 participants with a median age of 53 years were studied. The median COVID-19 knowledge score showed poor (11.50%), average (43.75%), and good knowledge (6.25%). Most of the participants practiced precautionary measures outside their homes.

Conclusion: In conclusion, half of the population had poor COVID-19 knowledge, 60.9% of the participants felt anxious, and most of them performed precautionary measures, including wearing a facemask, maintaining a 1-m distance, and washing their hands regularly.

Practice Level and Associated Factors Towards the Preventive Measures of COVID-19 Among the General Population; A Systematic Review and Meta-Analysis

Background

Studies conducted on the practice of COVID-19 preventive methods across the world are highly inconsistent and inconclusive. Hence, this study intended to estimate the pooled preventive practice and its determinants among the general population.

Methods

This study was conducted using online databases (PubMed, HINARI, Scopus, EMBASE, Science Direct, and Cochrane library database), African Journals online, Google Scholar, open gray and online repository accessed studies. The quality of the included studies was assessed using Newcastle-Ottawa Quality Assessment Scale (NOS). STATA 14.0 software for analysis. The existence of heterogeneity between studies was checked using Cochran Q test and I2 test statistics and then, the presence of publication bias was detected using both funnel plot and Egger's test.

Results

51 studies were included and the pooled level of practice toward the preventive measures of COVID-19 was 74.4% (95% CI: 70.2-78.6%, I2 = 99.7%, P < 0.001] using a random effects model. Being female [OR = 1.97: 95% CI 1.75, 2.23; I2 = 0.0%, P < 0.698], rural residence [OR = 0.53: 95% CI 0.44, 0.65; I2 = 73.5%, P < 0.013], attending higher education level [OR = 1.47: 95% CI 1.18, 1.83; I2 = 75.4%, P < 0.001], being employed [OR = 2.12: 95% CI 1.44, 3.12; I2 = 91.8%, P < 0.001], age < 30 [OR = 0.73: 95% CI 0.60, 0.89; I2 = 73.9%, P < 0.001], and knowledgeable [OR = 1.22: 95% CI 1.09, 1.36; I2 = 47.3%, P < 0.077] were the independent predictors of adequate practice level.

Conclusions

nearly three-fourths of the general population has an adequate preventive practice level toward COVID-19. Thus, the global, regional, national, and local governments need to establish policies and strategies to address the identified factors.

Brazilians' level of knowledge, attitudes and practices towards COVID-19: a cross-sectional study

BACKGROUND

Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease.

OBJECTIVE

To determine the knowledge, attitudes and practices of the Brazilian population regarding COVID-19.

DESIGN AND SETTING

Cross-sectional survey-type study, conducted using a population sample from different Brazilian states.

METHODS

A quantitative, descriptive and analytical approach was used. Sampling was done according to convenience and via snowballing. The data collection instrument was a knowledge, attitudes and practices system.

RESULTS

1,655 people from all over Brazil participated in the survey; 80% were living in the southern region and 70.15% were female. More than 90% had knowledge and good attitudes relating to the means of transmission, preventive care and symptoms associated with COVID-19, although their knowledge and attitudes were not fully reflected in daily practices, for which there was lower adherence (80%). Greater knowledge was correlated with older participants, larger number of children, female sex and marital status; better attitude, with female sex and complete higher education; and better practices, with greater age, larger number of children and female sex.

CONCLUSION

A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.

Evaluation of the Knowledge, Attitude, and Practice of COVID-19 Prevention Methods Among Hypertensive Patients in North Shoa, Ethiopia

Introduction

The occurrence of coronavirus diseases 2019 (COVID-19) has affected more than 247 million populations around the world. People with comorbidities such as hypertension, diabetes mellitus, congestive heart failure, kidney disease, elderly people, and people with weak immunity develop severe types of COVID-19 if exposed to the disease. Therefore, this study aimed to assess knowledge, attitude, and practice of COVID-19 prevention methods among hypertensive patients in North Shoa, Oromia region, Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from May 5/2020 to June 5/2020 in public hospitals in the North Shoa zone, Ethiopia. Data were collected using a structured questionnaire and study participants were recruited using a simple random sampling technique. The data were checked for completeness and entered into the EpiData manager version 4.4.1 and transferred to SPSS version 23 for analysis purposes. Bivariate and multivariate logistic regression were computed and a significant association was declared with a p-value less than 0.05.

Results

A total of 360 (97.0%) hypertension patients responded. This study revealed that 210 (58.3%) study participants had good knowledge of COVID-19 prevention methods, 199 (55.3%) had a favorable attitude towards COVID-19 prevention methods, and 210 (58.3%) hypertension patients at follow-up practiced COVID-19 prevention methods. Respondents who received less than two thousand Ethiopian birrs monthly and respondents who followed electronic news media were significantly associated with the use of sanitizer, respondents who had a favorable attitude towards the COVID-19 prevention method were significantly associated with mask-wearing, and respondents who received less than two thousand Ethiopian birrs monthly were significantly associated with maintaining a physical distance.

Conclusion

Generally, this study finding revealed that the level of knowledge, attitude, and practice towards COVID-19 prevention among hypertension patients was low. Therefore, increasing knowledge, attitude, and practice on COVID-19 among hypertension patients requires a coordinated effort from the government, non-government, and health professionals.

Assessment of COVID-19-related awareness, knowledge, prevention practices and challenges faced by truck drivers in major transport cities of India: a cross-sectional survey

OBJECTIVES

To assess COVID-19-related awareness and knowledge among truck drivers across India and report prevention practices followed, and challenges faced, by them during the COVID-19 lockdown.

DESIGN

Cross-sectional study.

SETTING

Delhi, Kanpur, Kolkata and Bangalore from July to September 2020.

PARTICIPANTS

Data were collected in Hindi using a structured questionnaire via telephonic interviews. Minimum 200 drivers were included from each location.

OUTCOME MEASURES

Sociodemographic profile, awareness regarding COVID-19, knowledge regarding infection sources, disease spread and vulnerable populations, prevention practices followed and challenges faced. Information sources were also assessed.

RESULTS

Fisher's exact test and Analysis of variance (ANOVA) test were used to check for significant differences across proportions. P value less than 0.05 was considered significant. Overall, 1246 drivers were included, with 72% response rate. Of 1246 drivers, 65% were 30-50 years of age. A majority correctly answered knowledge questions regarding communicability (95%) and fatality (66%). Fifty per cent drivers were aware of treatability of the disease, while only 43% and 24% correctly reported all signs and symptoms and routes of transmission, respectively. No driver was aware of all high-risk populations. Overall Knowledge Score is significantly associated with region. Mobile phones were the primary source of information across all regions. Over two-third drivers follow all prevention practices regularly, which differed significantly across regions. Following standard prevention practices was positively correlated with higher knowledge scores and was significantly correlated with mask use. Worry about the disease was common. Less than 40% drivers received full payment for work during this period, while 25% drivers were unable to return home due to the pandemic. Seven per cent and 26% drivers had either limited or no access to food and health services, respectively.

CONCLUSIONS

Awareness activities and employer provisioned social security/health insurance might safeguard this vulnerable population till the pandemic fully abates as well as in similar situations in the future.

Knowledge, Attitude, and Practice (KAP) toward COVID-19 Pandemic among the Public in Taiwan: A Cross-Sectional Study

Purpose: Knowledge, attitude, and practice (KAP) models are often used by researchers in the field of public health to explore people’s healthy behaviors. Therefore, this study mainly explored the relationships among participants’ sociodemographic status, COVID-19 knowledge, affective attitudes, and preventive behaviors. Method: This study adopted an online survey, involving a total of 136 males and 204 females, and used a cross-sectional study to investigate the relationships between variables including gender, age, COVID-19 knowledge, positive affective attitudes (emotional wellbeing, psychological wellbeing, and social wellbeing), negative affective attitudes (negative self-perception and negative perceptions of life), and preventive behaviors (hygiene habits, reducing public activities, and helping others to prevent the epidemic). Results: The majority of participants in the study were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 12.86 (SD = 1.34, range: 7−15 with a full score of 15), indicating a high level of knowledge. However, the key to decide whether participants adopt COVID-19 preventive behaviors was mainly their affective attitudes, especially positive affective attitudes (β = 0.18−0.25, p< 0.01), rather than COVID-19 disease knowledge (β = −0.01−0.08, p > 0.05). In addition, the sociodemographic status of the participants revealed obvious differences in the preventive behaviors; females had better preventive behaviors than males such as cooperating with the epidemic prevention hygiene habits (t = −5.08, p< 0.01), reducing public activities (t = −3.00, p< 0.01), and helping others to prevent the epidemic (t = −1.97, p< 0.05), while the older participants were more inclined to adopt preventive behaviors including epidemic prevention hygiene habits (β = 0.18, p = 0.001, R2 = 0.03), reducing public activities (β = 0.35, p< 0.001, R2 = 0.13), and helping others to prevent the epidemic (β = 0.27, p< 0.001, R2 = 0.07). Conclusions: Having adequate COVID-19 knowledge was not linked to higher involvement in precautionary behaviors. Attitudes toward COVID-19 may play a more critical function in prompting individuals to undertake preventive behaviors, and different positive affective attitudes had different predictive relationships with preventive behaviors.

Adherence to COVID-19 protective behaviours in India from May to December 2020: evidence from a nationally representative longitudinal survey

OBJECTIVES

Since the onset of the COVID-19 pandemic, behavioural interventions to reduce disease transmission have been central to public health policy worldwide. Sustaining individual protective behaviour is especially important in low-income and middle-income settings, where health systems have fewer resources and access to vaccination is limited. This study seeks to assess time trends in COVID-19 protective behaviour in India.

DESIGN

Nationally representative, panel-based, longitudinal study.

SETTING

We conducted a panel survey of Indian households to understand how the adoption of COVID-19 protective behaviours has changed over time. Our data span peaks and valleys of disease transmission over May-December 2020.

PARTICIPANTS

Respondents included 3719 adults from 1766 Indian households enrolled in the Harmonised Diagnostic Assessment of Dementia for the Longitudinal Ageing Study in India.

ANALYSIS

We used ordinary least squares regression analysis to quantify time trends in protective behaviours.

RESULTS

We find a 30.6 percentage point (95% CI (26.7 to 34.5); p<0.01) decline in protective behaviours related to social distancing over the observation period. Mask wearing and handwashing, in contrast, decreased by only 4.3 percentage points (95% CI (0.97 to 7.6); p<0.05) from a high base. Our conclusions are unchanged after adjusting for recorded COVID-19 caseload and nationwide COVID-19 containment policy; we also observe significant declines across socioeconomic strata spanning age, gender, education and urbanicity.

CONCLUSION

We argue that these changes reflect, at least in part, 'COVID-19 fatigue,' where adherence to social distancing becomes more difficult over time irrespective of the surrounding disease environment.

Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations Towards COVID-19: A Systematic Scoping Review

Objectives: The COVID-19 pandemic represents a major crisis for governments and populations. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-risk adult populations towards COVID-19.

Methods: A systematic scoping review was conducted of peer-reviewed articles in five databases on studies conducted during the early stages of COVID-19. Thirty-one studies meeting the inclusion criteria were appraised and analyzed.

Results: The levels of risk perceptions, knowledge, and behaviors towards COVID-19 were moderate to high in both general and high-risk adult populations. Adults were knowledgeable about preventive behaviors. Our review identified hand-washing and avoiding crowded places as dominant preventive behaviors. Being a female, older, more educated, and living in urban areas was associated with better knowledge of COVID-19 and appropriate preventive behaviors.

Conclusion: This review offers a first understanding of risk perceptions, knowledge and behaviors of adult populations during the early stages of the COVID-19 pandemic.

Planning for pandemic resilience: COVID-19 experience from urban slums in Khulna, Bangladesh

COVID-19 worsened urban slum dwellers' pre-existing vulnerabilities. Maintaining WHO-suggested physical distancing/isolation made planning more challenging in slums. The scenarios hint at the urgency to investigate whether these resource-scarce communities – already susceptible to climate change, poverty, health services, infrastructure, and space constraints, could build resilience against COVID-19. What lack of resources/assets made communities vulnerable there, and what adaptation measures were taken? What planning/management practices were adopted there, and to what extent could WHO's IPC guidelines (on transmission prevention and control) be followed? Findings show that pre-COVID economic, infrastructural, and health-related issues had affected slum dwellers' COVID-time vulnerabilities. While poor infrastructure and sanitation, informal employment, livelihood diversity, superstition, and comorbidities remained the key ‘internal’ issues, lack of institutional preparedness and safety-net programs, discontinued municipal services and inaccessible/untrustworthy healthcare services and corruption/bias/non-coordination in beneficiary selection remained the key ‘external’ issues. Information sharing, openness to pandemic knowledge, and active participation in awareness/training programs have been the most adopted measures. Aid schemes, despite criticisms, saved dwellers from starvation. Therefore, this proved to be a critical coping element. However, NGOs systematic monetary aid gave dwellers the most flexibility in spending. On top, NGOs proved to be the most vital external stakeholder in all sectors except for built environment/planning. To increase adaptive capacity, scopes remain in maximizing the use of community infrastructure in future events. Simultaneously, spatial aspects, alongside the non-spatial, seemed crucial in tackling complex poverty profiles, resource-scarcity, and vulnerabilities of slums. Findings are based on NGO BRAC's existing dataset and fieldwork between April–August 2020 on 29 slums in Khulna, Bangladesh, using a qualitative methodology. The study contributes to a growing body of knowledge and practice on resilient planning for COVID-19 (and similar future pandemics), especially for slums, while addressing its overlooked spatial dimensions.

Impact of Coronavirus Disease 2019 Outbreak on Children and Adolescents with Type 1 Diabetes Mellitus

BACKGROUND

This study aimed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on daily routines and health of patients with type 1 diabetes mellitus (T1DM).

STUDY DESIGN

A cross-sectional study.

METHODS

This study included 98 children and adolescents with type 1 diabetes who were regularly followed up in the Endocrinology outpatient clinic of Besat Hospital, Hamadan, Iran, in 2020. The primary measurements included body mass index, glycemic control, number of hypoglycemic events, number of hospitalizations, as well as bedtime and availability of insulin six months pre and post COVID-19 outbreak. The obtained data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant.

RESULTS

Out of 98 participants (mean±SD age: 13.5±49), 51% of the cases were male, and %81.6 of the patients were urban residents. Furthermore, most participants (43.9%) were in the age group of 11-15 years, and the mean±SD duration of diabetes was 4.64±3.31 years. In addition, 2.04% of the participants developed COVID-19. There was a statistically significant difference among average duration of night sleep (P<0.001), bedtime (P<0.001), time of waking up (P<0.001), amount of insulin intake (P=0.003), daily exercise (P<0.001), and availability of the insulin (P<0.001) before and during COVID-19 crisis. The frequencies of hospitalizations and hypoglycemic events were lower after the COVID-19 outbreak (P=0.005 and P=0.034, respectively). Morning insulin dose was omitted in 22.2% of participants. No differences were found between hemoglobin A1c and daytime sleep pre and post COVID-19 outbreak.

CONCLUSIONS

The key challenges due to COVID-19 pandemic restrictions for Iranian T1DM patients were the need to take more insulin, lower physical activity, non-availability of insulin, and missed morning insulin dose. However, it is worth mentioning that the patients' blood glucose control did not worsen in this period.

Evaluation of the Knowledge, Attitude and Practice of Patients on Immunosuppressive Drugs Towards COVID-19 Attending Dermatology Department- A Multicentric Cross-Section Study

Background:

The deadly COVID-19 (Coronavirus Disease 2019) or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was identified for the first time in December 2019 from Wuhan, China, and by the beginning of March 2020, it was declared a pandemic by the World Health Organization (WHO). Despite so many government regulations and awareness measures, there is still a lacuna between the gravity of illness and the knowledge of the average person toward it.

Objective:

We aimed at assessing the knowledge, attitude, and behavioral practice (KAP) of patients on immunosuppressive medication attending the dermatology department toward, COVID-19.

Material and Methods:

A self-designed printed/digital questionnaire consisting of 30 questions (Hindi and English) was supplied to patients being treated with any systemic immunosuppressives (for at least 3 weeks), for any dermatological ailment. The questionnaire consisted of 12 questions assessing the knowledge, 11 for attitude, and 7 for practices of patients toward COVID-19.

Results:

The study included 237 patients with a mean age of 44.57 ± 13.72 years. The correct knowledge toward COVID-19 was present in 126 (53.16%) patients with a mean score of 7.79 ± 3.08 out of 13. The mean attitude score was 8.35 ± 2.16 (out of 11) while the mean score of practice was 5.64 ± 2.03 (out of 8). Increased hygiene levels were seen in 220 (92.83%) patients. Sixty-six (27.85%) patients admitted to stopping their prescribed immunosuppressives by themselves during COVID-19 and a significant proportion agreed to the use of alternative medicines with questionable efficacy (n = 91; 38.39%). A significant difference in KAP was found across various strata of society like gender, age, socioeconomic status, literacy, and residence (P < 0.001).

Limitations:

Our study was limited by small sample size, absence of a control group with healthy individuals, and short duration of the study.

Conclusions:

Most of the participants had poor knowledge, a positive attitude, and good practices toward COVID-19. Proper counseling of patients and the use of telemedicine could help combat the gap in KAP without compromising the healthcare facilities needed for the management of such patients.

Altered Sleep Duration and Poor Quality of Sleep Among Pharmacy Students Amidst COVID-19 Lockdown: A South-Indian Study

Introduction/background

The nationwide lockdown enforced due to the spread of coronavirus disease-2019 had a definite impact on sleep.

Objective

To observe any changes in the duration, pattern and quality of sleep among pharmacy students due to the lockdown.

Methods

A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the ethical committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analyzed using STATA version 16.0.

Results and Discussion

Out of 310 participants, the study revealed an increase in the time needed to fall asleep (p value < 0.001) and in the total duration of sleep (p value < 0.001). A delay in the time of sleep in the morning (p value < 0.001) and at night (p value < 0.001) was also one among the many significant results. The incidences of jerky leg movements (p value < 0.001), snoring (p value < 0.001), frequent nightmares (p value < 0.001) and anxiety (p value < 0.001) were also increased as a direct effect of the lockdown.

Conclusion

The study has confirmed the detrimental impact of the lockdown on sleep among pharmacy students. All attributes of sleep duration and sleep quality have achieved statistical significance signifying the need to develop cognitive behavioral interventions and prevent the worsening of mental health amidst the COVID-19 era.

Stigma toward people with COVID-19 among the Lebanese population: a cross-sectional study of correlates and mediating effects

INTRODUCTION

Stigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma.

METHODS

A cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19.

RESULTS

More than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta =  -.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score.

CONCLUSION

Our main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.

Analysis of change in knowledge, attitude, and practices about COVID-19 following and awareness session in rural population of Western India

BACKGROUND

Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup.

AIM

The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population.

MATERIALS AND METHODS

A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire.

RESULTS

Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%-100%), maintaining social distancing (44%-64%), frequent handwashing (52%-64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%-28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%.

CONCLUSION

A single, short awareness session led to significant change in KAP about COVID-19 in rural population.

A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety

Background

The COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying.

Methods

A cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, recruited 405 Lebanese adults using a snowball sampling technique. The CBS-11, an 11-item tool specifically created for this study, was used to measure bullying behaviors towards COVID-19 patients.

Results

All items of the CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach’s alpha (.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa = 1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa = 1.18), higher stigma discrimination scores (ORa = 1.09), and having a health professional family member (ORa = 2.42) were significantly associated with bullying.

Conclusion

Our main findings showed that the CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00643-1.

Investigating the resilience of refugee camps to COVID-19: A case of Rohingya settlements in Bangladesh

Bangladesh Rohingya camps have hosted 65,000 refugees fled from Myanmar only since 2017. Their compromised living environment and limited physical and socioeconomic facilities make them highly sensitive to COVID-19. The Government of Bangladesh and international aid agencies have applied WHO's IPC (Infection, Prevention, and Control) guidelines to mitigate the transmission of COVID-19 outbreaks and enhance their resilience. However, Rohingyas often disregard these guidelines or become reluctant to follow them. Building on 10 in-depth interviews, 66 questionnaires, and observation, the study investigates the limitations and challenges of implementing these guidelines toward building community resilience. It assesses their resilience, focusingon Kutupalong camp, Cox's Bazar-one of the world's largest refugee camps. Findings reveal that Rohingya's past experience associated with their psychological trauma largely influences their current actions and demotivates them fromfollowing the health guidelines. Their deep mistrust of and disrespect to healthcare providers and aid agencies discourage them to follow the IPC. Also, insufficient built infrastructure and unhygienic living conditions, including improper WASH management, increase their risk to COVID-19. The study highlights a need for understanding their socio-psychological values and cultural narratives and recommends a set of guidelines for policymakers and aid agencies to build community resilience to COVID -19.

The Knowledge, Attitude and Practice about Public Emergencies and the Response Capability of Residents in Shanghai after the Outbreak of Coronavirus Disease 2019 (COVID-19): A Cross-Sectional Study

People’s knowledge, attitude and practice (KAP) are a part of the public’s emergency response capability and play an important role in controlling public health emergencies. This study aims to evaluate Shanghai residents’ KAP and the response ability regarding public health emergency events in China. An anonymous questionnaire investigation including demographics, socioeconomic characteristics and KAP was conducted through the online survey system from April 19 to April 30 2020. Of the 1243 people who completed the questionnaire, 1122 respondents (90.3%) had a good, positive attitude, while only 46.8% of participants had good knowledge, 46.2% performed well in the aspect of practice and 19.5% of residents had good response capability. It was found that men (OR:1.57,95% CI: 1.16–2.13), and people with 10 to 12 years or longer than 12 years of education (OR: 2.08,95% CI: 1.14–3.92; OR: 3.56,95% CI: 1.96–6.72) had the best public emergency response capability. Positive attitudes may be significantly associated with good practice (OR: 1.76, 95% CI: 1.18–2.64). Internet and television were the major media for people to acquire knowledge and skills. A lack of knowledge, poor perception and poor emergency response ability were found in Shanghai residents. Target intervention should be developed and implemented to improve the knowledge and skills of people for dealing with public emergency events.

Efficacy and safety of hydroxychloroquine as add-on therapy in uncontrolled type 2 diabetes patients who were using two oral antidiabetic drugs

OBJECTIVE

To evaluate the Safety and Efficacy of Hydroxychloroquine as add-on therapy in uncontrolled type 2 diabetes patients who were using two oral antidiabetic drugs.

MATERIALS AND METHODS

This was a double blind, placebo controlled, parallel group study in 304 inadequately controlled type 2 diabetes (T2DM) subjects with two oral antidiabetic drugs (glimepiride 4 mg and metformin 500 mg) were randomised to hydroxychloroquine (HCQ) 200 mg, 300 mg, 400 mg once daily (OD) or placebo. Dose of hydroxychloroquine was selected as per body weight of the subject. Primary end point was glycated haemoglobin (HbA1c) change at week 12 from baseline. Secondary endpoint was change in fasting plasma glucose (FPG), post prandial plasma glucose (PPG), body weight and any adverse reaction including no of hypoglycemic events, as well as a change in the percentage of subjects with A1C < 7.0% and > 6.5% after 12 weeks of treatment.. In follow-up of 400 mg once daily was once again divided to 200 mg twice daily (BD) to study the effect on tolerability profile for further 12 weeks.

RESULTS

Hydroxychloroquine was associated with significant reduction in HbA1c from baseline (7-8.5%) in 12 weeks -0.78%, -0.91% and 1.2% for hydroxychloroquine 200 mg, 300 mg and 400 mg OD, respectively, versus 0.13% with placebo (P < 0.005). FPG and PPG were reduced by -25 to -38 mg/dl and 34-53 mg/dl, respectively. Body weight also reduced in each group of HCQ. Hypoglycemia was reported only with 300 mg (1.2%) and 400 mg (2.1%) group of HCQ. It was observed that patients who complains with mild GI disturbance with HCQ 400 mg glycemic efficacy was maintained with 200 mg BD with significant relief of the symptoms.

CONCLUSION

Hydroxychloroquine added to sulphonylurea and metformin, improves glycemic control significantly in T2DM patients. Glycemic effect of different dose of hydroxychloroquine is dose dependent. The safety/tolerability profile of hydroxychloroquine was favourable except GI disturbance which is more frequent with 400 mg. This can be avoided with 200 mg BD without compromise on efficacy.

Knowledge, Attitude and Practice About Coronavirus Disease (COVID-19) Pandemic and Its Psychological Impact on Students and Their Studies: A Cross-Sectional Study Among Pharmacy Students in Saudi Arabia

Background

Individuals’ knowledge, attitude and practice towards preventive and precautionary measures of COVID-19 are essential to control the spread of the disease. Consequently, the aims of the study were to evaluate knowledge, attitude and practice of pharmacy students towards the pandemic and to assess its psychological impact on them to provide future guidance.

Methods

A cross-sectional, questionnaire-based study was conducted via a web-based survey in May 2020. All pharmacy students enrolled at Unaizah College of Pharmacy, Qassim University, were invited to take part in the study.

Results

A total of 232 out of 460 students took part in the study, giving a response rate of 50.43%. The mean total knowledge score was 9.87 ± 2.04 (maximum attainable score, 12). The majority of the participants (n=163; 70.3%) believed COVID-19 is a health threat to their community in the early months of the pandemic. Moreover, the majority (93%) also believed that the lockdown at the beginning of the pandemic was necessary to contain the pandemic. Encouragingly, 86.6% reported that they did not go to any crowded places during the pandemic with more female students avoiding crowded places compared to male students (91.6% versus 78.7%, respectively, P = 0.005). The majority (91%) also reported that they were following the strategies recommended by the authorities to prevent the spread of the virus. Encouragingly, 54.3% reported that the pandemic either had no effect or just a limited effect on their studies. However, 38.5% reported that they always felt or frequently felt nervous or anxious during the pandemic.

Conclusion

The study showed that pharmacy students had good knowledge as well as positive attitudes and good practices towards COVID-19 and the preventive measures. However, during the early months, the pandemic did have a negative psychological impact on a number of students. Consequently, proactive psychological and social support services to the students should be considered during the current and future pandemics. In addition, it is important to consider and proactively address key issues that could cause stress and anxiety among students when shifting to distance learning and assessments.

A Typology of Poles' Attitudes toward COVID-19 during the First Wave of the Pandemic

(1) Objective: To explore Poles' attitudes during the first wave of COVID-19 pandemic in 2020 as a contribution toward the creation of effective health policies. (2) Method: Computer-assisted web interviewing (CAWI) was used to survey a sample of 1001 Poles selected using quota sampling. (3) Results: Using cluster analysis, three types of attitudes were distinguished, people being classified as "involved" (48.1%), "cautious" (27.4%), or "indifferent" (24.6%). The result of greatest interest was the absence of any attitude indicating an extremely dismissive posture toward COVID-19. Three logistic regression analyses, comparing people displaying each attitude with those comparing the other two attitudes combined, showed that an involved attitude was likely to be associated with being female, being in a poorer financial situation, but having relatively high life satisfaction. A cautious attitude was more likely to appear in places with fewer residents and among people in a favorable financial situation, and that an indifferent attitude was more likely to be associated with being male and having lower life satisfaction. (4) Conclusions: The attitudes identified may help to explain why, during the spring of 2020, the virus was spreading slightly more slowly, and on a narrower scale, in Poland than in other countries.

COVID-19 and the public response: Knowledge, attitude and practice of the public in mitigating the pandemic in Addis Ababa, Ethiopia

BACKGROUND

The COVID-19 pandemic is impacting the global community in many ways. Combating the COVID-19 pandemic requires a coordinated effort through engaging public and service providers in preventive measures. The government of Ethiopia had already announced prevention guidelines for the public. However, there is a scarcity of evidence-based data on the public knowledge, attitude, and practice (KAP) and response of the service providers regarding COVID-19.

OBJECTIVE

This study aimed to assess the public KAP and service providers' preparedness towards the pandemic in Addis Ababa, Ethiopia.

METHODS

A community-based cross-sectional study was conducted in Addis Ababa, Ethiopia, from late March to the first week of April 2020. Participants were conveniently sampled from 10 different city sites. Data collection was performed using a self-administered questionnaire and observational assessment using a checklist. All statistical analysis was performed using SPSS version Descriptive statistics, correlation coefficient and chi-square tests were performed.

RESULT

A total of 839 public participants and 420 service providers enrolled in the study. The mean age was 30.30 (range = 18-72) years. The majority of the respondents (58.6%) had moderate knowledge about COVID-19, whereas 37.2% had good knowledge. Moreover, 60.7% and 59.8% of the participants had a positive attitude towards preventive measures and good practice to mitigate the pandemic, respectively. There was a moderate positive correlation between knowledge and attitude, whereas the correlations between knowledge and practice and attitude and practice were weak. With regard to service providers' preparedness, 70% have made hand-washing facilities available. A large majority of the respondents (84.4%) were using government-owned media followed by social media (46.0%) as a main source of information.

CONCLUSION

The public in Addis Ababa had moderate knowledge, an optimistic attitude and descent practice. The information flow from government and social media seemed successful seeing the majority of the respondents identifying preventive measures, signs and symptoms and transmission route of SARS-CoV-2. Knowledge and attitude was not associated with practice, thus, additional innovative strategies for practice changes are needed. Two thirds of the service provider made available hand washing facilities which seems a first positive step. However, periodic evaluation of the public KAP and assessment of service providers' preparedness is mandatory to combat the pandemic effectively.

COVID-19 Preventive Measure Practices and Knowledge of Pregnant Women in Guraghe Zone Hospitals

BACKGROUND

The COVID-19 pandemic is caused by a severe acute respiratory syndrome coronavirus which emerged in Wuhan. Recently this virus has rapidly spread throughout Ethiopia. The current preventive measure practices and knowledge have gaps. Therefore this study aimed to assess COVID-19 preventive measure practices and knowledge of pregnant women in Guraghe Zone hospitals.

METHODS AND MATERIALS

This cross-sectional study was conducted from July 27-August 27, 2020 among pregnant women in Guraghe zone hospitals. Systematic random sampling technique were employed to select 403 participants. Data were checked manually for completeness, cleaned, and stored in Epi Data and exported to SPSS for further analysis. Variables which have a P-value less than 0.25 on bivariate analysis were taken to multivariate analysis. A P-value of less than 0.05 and 95% confidence level was used as a cut-off point for presence of association in multivariate analysis.

RESULTS

COVID-19 preventive measure practice and knowledge of pregnant women visiting Guraghe Zone hospitals was 76.2% and 54.84%, respectively. Those aged 20-24 (AOR=1.22, 95% CI=1.15-22.24), 25-29 (AOR=1.32, 95% CI=1.20-20.25), and 30-34 (AOR=2.57, 95% CI-2.32-43.38) were more likely to practice COVID-19 preventive measures. Those residing in urban area (AOR=2.16, 95% CI=1.24-3.77) and perceiving that COVID-19 is worst for people with chronic disease (AOR=5.12, 95% CI=1.73-15.17) were more likely to practice COVID-19 preventive measures.

CONCLUSION

COVID-19 preventive measure practices and knowledge were low. Age, residence, and perception of COVID-19 on chronic disease were independent factors associated with preventive measure practices. Pregnant women aged ≥35 need to be counseled on practices of preventing COVID-19 by their healthcare providers.

Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East

BACKGROUND AND AIM

Uncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute's out patient department.

METHOD

A convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10).

RESULT

The study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables.

CONCLUSION

Participants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.

The association between COVID-19 and type 1 diabetes mellitus: A systematic review

BACKGROUND

/Aim: Various reports of the occurrence of type 1 diabetes mellitus (T1DM) in patients with COVID-19 have been published, denoting an association between both diseases. Therefore, we conducted this systematic review to summarize the prevalence of T1DM in COVID-19 patients and to identify the clinical presentations and outcomes in this patient population.

MATERIALS AND METHODS

Up to 10/27/2020, Medline, Embase, cochrane and google scholar databases were searched for original studies investigating the association between COVID-19 and T1DM. A manual search was conducted to identify missing studies. The quality of included studies was analyzed by the National Institute of Health (NIH) risk of bias tool. Outcomes included length of hospital stay, hospitalization, intensive care unit (ICU) admission, diabetic ketoacidosis (DKA), severe hypoglycemia, and death.

RESULTS

Fifteen studies were included in the qualitative analysis. Included studies reported data of both adult and pediatric patients. The prevalence of T1DM in COVID-19 patients ranged from 0.15% to 28.98%, while the rate of COVID-19 in patients with T1DM ranged from 0% to 16.67%. Dry cough, nausea, vomiting, fever and elevated blood glucose levels were the most commonly reported presentations. The investigated outcomes varied widely among studied populations.

CONCLUSIONS

The prevalence of T1DM in patients with COVID-19 ranged from 0.15% to 28.98%. The most common presentation of COVID-19 in patients with T1DM included fever, dry cough, nausea and vomiting, elevated blood glucose and diabetic ketoacidosis. The outcomes of COVID-19 in terms of length of hospital stay, hospitalization, ICU admission, DKA rate, and severe hypoglycemia were reported variably in included studies. Due to the heterogeneous study populations and the presence of many limitations, more studies are still warranted to reach a definitive conclusion.

COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia

BACKGROUND

To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town.

PATIENTS AND METHODS

Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used.

RESULTS

The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge.

CONCLUSION

The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.