A cross-sectional survey of knowledge, attitude and practice (KAP) towards COVID-19 pandemic among the Syrian residents

Residents' KABP and Social Support Statuses Under Normalized COVID-19 Pandemic Prevention and Control: A Cross-Sectional Study

OBJECTIVES

To investigate the status quo of residents' knowledge, attitude, belief, and practice (KABP) and social support and the correlation of KABP with social support under normalized coronavirus disease (COVID-19) pandemic prevention and control.

METHODS

A questionnaire was designed based on the KABP model, and an online survey was conducted among residents in September 2022. SPSS software (version 25.0) was used to analyze the data. Two independent sample t-tests, one-way analysis of variance (ANOVA), multivariate linear regression analysis, and Pearson's correlation analysis were conducted.

RESULTS

In total, 326 valid questionnaires were obtained. The scoring rates of residents' KABP and social support were 68.1%, 92.2%, 89.3%, 75.3%, and 62.6%, respectively. Main factors influencing residents' knowledge included gender, nationality, education level, practice, and social support; those influencing attitude were belief and practice; those influencing belief were place of residence, attitude, and practice; those influencing practice were knowledge, attitude, belief, and social support; and those influencing social support were marital status, place of residence, knowledge, and practice. Social support was positively correlated with knowledge and practice.

CONCLUSIONS

This study provides a scientific foundation for the current normalized prevention and control of COVID-19 and is conducive to health managers to better carry out prevention and control related health education for specific groups.

Cracking the code: uncovering the factors that drive COVID-19 standard operating procedures compliance among school management in Malaysia

Malaysia's government's decision to reopen schools during the COVID-19 outbreak, especially for students taking important exams, has alarmed the public. However, the Ministry of Education has implemented a COVID-19 Standard Operating Procedure (SOP) for educational institutions. The school management's ability to protect children from COVID-19 rests on their understanding, attitudes, and practices regarding COVID-19 SOP compliance. This study investigated Selangor, Kuala Lumpur, and Putrajaya school management's COVID-19 SOP compliance determinants. Multistage sampling was used to sample 740 school management from Kuala Lumpur, Putrajaya, and Selangor. A self-administered questionnaire collected sociodemographic, occupational, and lifestyle data, knowledge, attitude, and practice of COVID-19 SOP compliance. The school management had good knowledge, attitude, and practice toward COVID-19 SOP. Monthly income, school location, smoking status, and physical activity differed significantly from KAP (p < 0.05). The correlation between KAP showed a significant relationship with the values (r = 0.348, p < 0.001) and (r = 0.358, p = 0.003). Nine independent variables strongly predicted SOPs compliance practice in multiple linear regression: knowledge, attitude, age, source of knowledge; Ministry of Health, physical activities, type of infectious disease exposed; Tuberculosis and Measles (p < 0.05). The data indicate that school management exhibits good knowledge, attitude, and compliance with SOPs during the pandemic. School management oversees SOPs, and to keep schools safe, management must analyse hazards and take action. Therefore, knowledge and attitude are expected to determine factors of practice toward COVID-19 SOP compliance.

The impact of education level on Knowledge, Attitudes and Practices towards COVID-19 in Edo State, Nigeria

BACKGROUND

For effective Public Health measures, factors that influence Knowledge, Attitudes and Practices (KAP) need to be understood. In this paper, we document the relationship between levels of education on the KAP towards COVID-19 among the population of Edo State, Nigeria.

METHODS

A cross-sectional KAP questionnaire was delivered across 13 communities. The study population was dichotomized into those who had or had not completed secondary education. Chi-square tests were conducted to determine statistical significance.

RESULTS

Of the 538 participants, 30% had completed secondary education. Those with secondary education were significantly more likely to recognize symptoms of COVID-19 (P < 0.001). For attitudes, only one option showed a statistically significant association with 78.4% of those who did not complete secondary education having a high confidence in the church compared with 66% of those who had (P = 0.022). For practices, those who have completed secondary education practiced all of the supplied measures more than those who had not, except for taking herbal supplements.

DISCUSSION

Higher levels of education impacts on knowledge and practices but has less impact on attitudes regarding how well certain individuals/organizations can handle the pandemic. Findings highlighted the importance of tailoring public health communication and strategies to local populations to improve the efficacy.

Understanding olfactory dysfunction in the COVID-19 era: insights from a cross-sectional survey of the Saudi community

Background and objectives

COVID-19 has emerged as a public health emergency caused by the coronavirus 2 (SARS-CoV2). However, only a few studies have reported that anosmia is an early predictor of COVID-19. Therefore, this study aimed to assess the current level of knowledge regarding smell dysfunction in COVID-19 era in Saudi community.

Materials and methods

An online survey was conducted using Survey Monkeys in Saudi Arabia. The survey was distributed through Twitter and WhatsApp. The questionnaire included individuals' demographic information, such as sex, age, residence, income, and qualifications, as well as their knowledge of the early symptoms of COVID-19. ANOVA and Mann-Whitney U-test were conducted to analyze the data. There were twelve items on knowledge dimensions which were assessed through five-point Likert scale.

Results

In total, 809 respondents completed the questionnaire. Among them, 658 (81.3%) had no knowledge of how sudden loss of or change in the sense of smell can be the only symptom of COVID-19. However, most participants, 738 (91.2%), knew that fever was a symptom of COVID-19. Similarly, 707 (87.4%) and 772 (95.5%) participants knew that cough and shortness of breath were the major symptoms of COVID-19, respectively. In addition, 395 (48.3%) participants had no information regarding taste changes as a symptom of COVID-19. Notably, participants who were female, married, or diagnosed with COVID-19 had significantly greater knowledge of smell-related issues due to COVID-19 than males, unmarried, and healthy/those without COVID-19.

Conclusion

This study revealed that the Saudi population has an fairly good level of knowledge regarding common COVID-19 symptoms as more than 90% of the participants understood symptoms of COVID-19, but less acceptable knowledge regarding smell and taste dysfunction as more than 80% had no knowledge of change in olfactory and taste function was due to COVID-19.

Fear of COVID-19: the mediation role between the COVID-19 diagnosis and KAP in Spanish university students

BACKGROUND

Although health public services recommend prevention strategies for COVID-19 some of these recommendations have not been taken seriously by young people. Understanding why some people comply with these recommendations and others do not seem to be crucial in helping public health services to predict behavior and compliance with rules, especially for young people. Previous studies suggest that knowledge, attitudes, and practices (KAP) are useful to assess compliance with the preventive measures and public health policies. Being afraid has also been found to correlate with more engagement with preventive measures. This study aims to assess the KAP and fear of COVID-19 of Spanish university students and to understand the relation between diagnosis, KAP and the level of fear.

METHOD

Participants of this cross-sectional study were 598 college students (69.4% women) from different Spanish Universities. Data were collected for a month using an online questionnaire through Sphinx iQ2.

RESULTS

Levels of KAP among Spanish students were satisfactory and results suggest the presence of fear among them. More importantly, fear of COVID-19 mediated the impact of the diagnosis on the KAP.

CONCLUSIONS

Feeling fear seems to be the mechanism underlying the relationship between diagnosis and KAP. Diagnosis is associated with KAP when the diagnosis it is accompanied by measures of fear. KAP, diagnosis, or perceived fear of COVID must be taken together in consideration for health interventions and public health campaigns design.

Lessons learnt from the first wave of COVID-19 in Damascus, Syria: a multicentre retrospective cohort study

OBJECTIVES

The decade-long Syrian war led to fragile health infrastructures lacking in personal and physical resources. The public health of the Syrian population was, therefore, vulnerable to the COVID-19 pandemic, which devastated even well-resourced healthcare systems. Nevertheless, the officially reported incidence and fatality rates were significantly lower than the forecasted numbers.

DESIGN

A retrospective cohort study.

SETTING

The four main responding hospitals in Damascus, which received most of the cases during the first pandemic wave in Syria (i.e., June-August 2020).

PARTICIPANTS

One thousand one hundred eighty-four patients who were managed as inpatient COVID-19 cases.

PRIMARY AND SECONDARY OUTCOME MEASURES

The records of hospitalised patients were screened for clinical history, vital signs, diagnosis modality, major interventions and status at discharge.

RESULTS

The diagnostic and therapeutic preparedness for COVID-19 was significantly heterogeneous among the different centres and depleted rapidly after the arrival of the first wave. Only 32% of the patients were diagnosed based on positive reverse transcription-PCR tests. Five hundred twenty-six patients had an indication for intensive care unit admission, but only 82% of them received it. Two hundred fifty-seven patients needed mechanical ventilation, but ventilators were not available to 14% of them, all of whom died. Overall mortality during hospitalisation reached 46% and no significant difference was found in fatality between those who received and did not receive these care options.

CONCLUSIONS

The Syrian healthcare system expressed minor resilience in facing the COVID-19 pandemic, as its assets vanished swiftly with a limited number of cases. This forced physicians to reserve resources (e.g., ventilators) for the most severe cases, which led to poor outcomes of in-hospital management and limited the admission capacity for milder cases. The overwhelmed system additionally suffered from constrained coordination, suboptimal allocation of the accessible resources and a severe inability to informatively report on the catastrophic pandemic course in Syria.

Knowledge, attitudes, and practices toward COVID-19 prevention in Yemen: a community-based cross-sectional study

Background

Pandemics, especially in fragile war-torn countries like Yemen, challenge their already strained health systems. Community adherence to pandemic prevention measures is necessary to curb the severity and spread of emerging pandemics - which is influenced by factors, such as people's knowledge and attitudes toward the pandemic. No studies in Aden have been published on the communities' knowledge, attitudes, and practices (KAP) toward COVID-19 prevention to date. To understand adherence to pandemic prevention measures in contexts with fragile health systems, this study investigated KAP of Yemeni participants toward the COVID-19 pandemic.

Methods

We conducted face-to-face semi-structured questionnaires among 400 eligible participants whom were identified for participation in this study through systematic household sampling from eight districts in Aden, Yemen. Eligible participants were Yemeni community members who were ≥ 18 years, living for more than 10 years in Yemen, and were willing to voluntarily participate in the study. The questionnaire included questions surrounding the participants' COVID-19 knowledge (e.g., awareness of spread and prevention), attitudes (e.g., willingness to accept the vaccine or other prevention measures), and prevention practices during the pandemic (e.g., mask wearing, social distancing, vaccine uptake). Total KAP scores were calculated. Univariate and bivariate statistical analyses were conducted using STATA 13 software.

Results

From January to May 2021 we conducted 400 questionnaires with Yemeni community members. The average age was 41.5 ± 14.5 years (range 18-86 years). The results demonstrated that the participants in this study had an intermediate knowledge (53%) and fair attitude (58%) scores. However, participants reported very poor COVID-19 prevention practices- with only 11% demonstrating these practices. Only 25% (100/400) practiced social distancing, 25% (98/400) wore a mask, and only 6% (27/400) of participants accepted (at least one dose of) the COVID-19 vaccine. Factors associated with increased knowledge were being male, married, and surprisingly those having a primary and middle school education levels (p < 0.05). Also participants who were diagnosed with COVID-19 or had a family member diagnosed with COVID-19 (vs. those not diagnosed OR = 2.08, 95% CI 1.07-3.78, p < 0.05) were more likely to know that the vaccine protects against severe COVID-19 infection and were more likely to apply good practices such as accepting the vaccine (OR = 2.65, 95% CI 1.17-6.00, p < 0.05) compared to those who were not.

Conclusion

These findings raise awareness for the need of community-oriented education programs for COVID-19 which considers associated factors to improve the level of public knowledge, attitudes, and practices.

Knowledge, Attitude and Practice towards COVID-19 Pandemic among Patients Attending Dental Outpatient Department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India

Background

The 2019 coronavirus disease (COVID-19) is an extremely contagious illness that spreads mostly via the dentistry practice. Patients in need of dental care are at a higher risk of becoming infected with and becoming carriers of the illness.

Aim

To assess the COVID-19-related knowledge, attitude, and practice (KAP) of patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India.

Materials and Methods

In this cross-sectional study, patients visiting dental outpatient department of M.G.M. Medical College and Hospital, Jamshedpur, Jharkhand, India were included. The questionnaire had four sections including demographic information, knowledge, attitudes, and practice in relation to COVID-19. Along with computation of descriptive statistics, data analysis was performed using unpaired t-test.

Results

A total of 332 people took part in the research. The female respondents were higher in number (53.01%) and the highest percentage of the respondents belongs to the age group 18-40 years (55.72%). Nearly, 98% of respondents were vaccinated. The highest percentage of KAP level was recorded for knowledge (74.95%) followed by that of attitude (50.84%) and practices (37.05%).

Conclusion

While respondents' overall knowledge was high but their enthusiasm for taking preventative measures was low, and their efforts to stem the pandemic were lagging at best. Future campaigns should focus more on reaching out to marginalized populations, such as those with less education or higher poverty rates.

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, attitude, and perception regarding COVID-19-related prevention practice among residents in Vietnam: a cross-sectional study

Background

Vietnam was one of the countries pursuing the goal of "Zero-COVID" and had effectively achieved it in the first three waves of the pandemic. However, the spread of the Delta variant was outbreak first in Vietnam in late April 2021, in which Ho Chi Minh City was the worst affected. This study surveyed the public's knowledge, attitude, perception, and practice (KAPP) toward COVID-19 during the rapid rise course of the outbreak in Ho Chi Minh City.

Methods

This cross-sectional survey was conducted from 30th September to 16th November 2021, involving 963 residents across the city. We asked residents a series of 21 questions. The response rate was 76.6%. We set a priori level of significance at α = 0.05 for all statistical tests.

Results

The residents' KAPP scores were 68.67% ± 17.16, 77.33% ± 18.71, 74.7% ± 26.25, and 72.31% ± 31, respectively. KAPP scores of the medical staff were higher than the non-medical group. Our study showed positive, medium-strong Pearson correlations between knowledge and practice (r = 0.337), attitude and practice (r = 0.405), and perception and practice (r = 0.671; p < 0.05). We found 16 rules to estimate the conditional probabilities among KAPP scores via the association rule mining method. Mainly, 94% confident probability of participants had {Knowledge=Good, Attitude=Good, Perception=Good}, as well as {Practice=Good} (in rule 9 with support of 17.6%). In opposition to around 86% to 90% of the times, participants had levels of {Perception=Fair, Practice=Poor} given with either {Attitude=Fair} or {Knowledge=Fair} (according to rules 1, 2, and rules 15, 16 with a support of 7-8%).

Conclusion

In addition to the government's directives and policies, citizens' knowledge, attitude, perception, and practice are considered one of the critical preventive measures during the COVID-19 pandemic. The results affirmed the good internal relationship among K, A, P, and P scores creating a hierarchy of healthcare educational goals and health behavior among residents.

Preventive Behaviors and Influencing Factors among Thai Residents in Endemic Areas during the Highest Epidemic Peak of the COVID-19 Outbreak

This research aims to investigate COVID-19 preventive behavior and influencing factors among Thai residents during the highest epidemic peak of COVID-19. Nine hundred and forty-six residents in five districts with high COVID-19 infection cases in Thailand were systematically included in this cross-sectional survey. The results showed that 87.2% and 65.2% of the residents had a high level of general knowledge and preventive measures, respectively. As to COVID-19 attitudes, poor levels of attitude among Thai residents were found in risk perception (53.6%) and mistrust issues (70.4%). Moreover, this study presents good preventive behavior (77.0%) among Thai residents. Multiple logistic regression showed that the influence factors of COVID-19 preventive behavior were the young age group (AOR 2.97, 95% CI 1.68-5.25), high income (AOR 1.38, 95% CI 1.03-1.86), and high level of general COVID-19 knowledge (AOR 2.21, 95% CI 1.64-2.96). The conclusion was that providing information on COVID-19 via social media was the key mechanism of policy action for increasing the level of COVID-19 preventive behavior during the highest epidemic peak in Thailand. In addition, the pandemic preparedness and response policy, with resident participation and involvement, could be recommended for the resilience of pandemic preparedness.

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, attitude, practice and associated factors towards COVID-19 and its prevention measures among residents of Mekelle City, Tigray Region, Northern Ethiopia: a community-based cross sectional study

Aim

The emerging respiratory disease known as the novel coronavirus disease (COVID-19) became a global concern and was declared as a global health emergency by the World Health Organization (WHO) on March 11, 2022. This study aimed to assess knowledge, attitude, and practice and associated factors toward COVID-19 and its prevention measures among residents of Mekelle city, Tigray, Northern Ethiopia.

Subject and methods

A community-based cross-sectional study was conducted among 604 residents of selected kebelles in Mekelle city, Tigray region from April to February 2022. A structured questionnaire and observation check list were used to collect the data. Multivariable logistic regression analysis was used with SPSS version 25 to identify factors associated with the outcome variables.

Results

A total of 604 residents were participated in the study with 100% response. Among the total study participants (n = 604), 74.2%, 58.8%, and 39.2%, of them had good knowledge, a positive attitude, and good practice toward COVID-19 and its preventive measures, respectively. Results from the multivariate analysis showed that age, level of education, and family size were found to be significantly associated with good knowledge of study participants toward COVID-19. Additionally, occupation, family size, income level, and having knowledge about COVID-19 were significant factors associated with the attitude of the study participants toward COVID-19. Moreover, practice of study participants to prevent COVID-19 was also significantly associated with educational status, occupation status, income level, and having a positive attitude about the practice toward COVID-19 prevention.

Conclusion

This study result revealed that the study participants' knowledge and attitude regarding COVID-19 were good. However, their practice toward COVID-19 and its preventive measure was poor, which will affect combating the pandemic. Therefore, continuous and effective public health education programs, community mobilization, law enforcements, and breaking siege and allowing all types of humanitarian aids in the region are urgently needed to improve knowledge, attitude, and practices toward COVID-19 and its preventive measures among the residents.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01826-3.

Associated factors with adherence to preventive behaviors related to COVID-19 among medical students in the university of Monastir, Tunisia

INTRODUCTION

Medical students should act as a model for the community in terms of compliance with preventive practices toward COVID-19. The aim of this study was to assess adherence to preventive behaviors related to COVID-19 among medical students and to identify its associated factors.

POPULATION AND METHODS

We conducted a cross-sectional survey in October 2020 in the faculty of medicine of Monastir. We included a representative sample of medical students during registration days for the 2020-2021 academic year. The data were collected through a self-administered anonymous questionnaire. Eleven items related to preventive practices against COVID-19 were assessed (respiratory hygiene practices (Six Item), hand hygiene practices (Three Items) and social distancing (two items)). Items were evaluated using a Likert scale of five points (from 0: (Never) to 4: (Always)). The score obtained from the sum of these items allowed to classify students into two categories: "Good compliance" if the score was ≥ 80% and "Poor compliance" if the score was less than 80%. Scores were compared according to the study population characteristics. Multivariate analysis was used to identify associated factors with good practices. The threshold of statistical significance was set at p < 0.05.

RESULTS

We included 678 medical students. The average age was 21.76 (SD = 1.89 years) with a sex ratio of 0.40. The protection measures most respected by the participants were related to the respiratory hygiene: correct coverage of the nose and mouth with the mask (80%), wearing masks regardless of the presence of symptoms (73.3%) and coverage of the mouth during coughing or sneezing (76.6%). Adherence to hand hygiene measures ranged from 51.4% to 66.3%. The least respected measures were related to social distancing: distancing of at least one meter from others (31.2%) and avoiding crowded places (42.5%). An overall score ≥ 80% was obtained among 61.5% of students. Referring to multivariate analysis, variables that positively affected the overall score of preventive measures related to COVID-19 were the female sex and living alone, with Beta coefficients of 3.82 and 1.37 respectively. The perceived level of stress, E-cigarette and Chicha consumption negatively affected the score with Beta coefficients of (-0.13), (-5.11) and (-2.33) respectively.

CONCLUSION

The level of adherence to good practice among medical students was overall moderate. Awareness programs would be needed in this population, especially for men and those who smoke and vape.

Parents' concerns and attitudes towards school reopening during COVID-19 pandemic: a cross-sectional survey-Tripoli, Libya, 2021

The issue of school reopening has raised several concerns; therefore, the parent's opinion is essential to consider. This study aimed to evaluate the parent's attitudes and concerns toward school reopening in the COVID-19 era. A cross-sectional survey was performed using in-person self-administered questionnaires, the data was collected in the period between January and April 2021 covering parents' concerns and attitudes toward school reopening. A total of 402 parents participated in the survey. Analysis showed that 56.7% of parents have agreed with school reopening, but 54% have raised some legitimate concerns. Importantly, there was a strong correlation between parents' opinions towards school reopening and their level of education, and their concerns about their children's safety if the school was reopened. Despite parents' concerns, it does seem that slightly over half were in favour of school reopening and would send their children to school only if the schools did apply strict precautions and restriction measures. Sharing parents' views toward school reopening with school leaders and decision-makers is important to assess the feasibility and effectiveness of return to schools and to improve existing prevention programs.

Knowledge, attitude and behaviour of general practitioners in Shanghai during the pandemic of COVID-19: a cross-sectional study

OBJECTIVES

To understand the knowledge, attitude and behaviour of general practitioners (GPs) towards COVID-19 and to provide evidence for improved prevention and control measures against the pandemic.

STUDY DESIGN

A cross-sectional study was conducted with 1018 GPs in Shanghai from 21 February to 2 March 2020 using the WeChat platform.

METHODS

Stratified random cluster sampling was performed according to the regional division of urban, urban-rural fringe and rural areas. This study used a self-designed mobile questionnaire. The questionnaire collected information on knowledge, attitudes and behaviours regarding COVID-19 prevention and control.

RESULTS

A total of 989 questionnaires were declared valid. The average scores of GPs' knowledge, attitude and behaviour towards COVID-19 were 6.14±1.42 (range 0-10), 13.59±4.42 (range 0-25) and 7.82±1.53 (range 0-10), respectively. Multiple linear regression analysis showed that the knowledge score of male GPs was lower than that of female GPs (p=0.002). In addition, the 'attitude' score of female GPs was higher than that of male GPs (p=0.004). The 'behaviour' score of GPs in urban areas was lower than that of GPs in urban-rural fringe areas (p<0.001). The higher the knowledge score, the higher the behavioural score was observed to be (p<0.001).

CONCLUSIONS

The scores of knowledge, attitude and behaviour of Shanghai GPs towards COVID-19 were limited at the beginning of the COVID-19 outbreak. As a hopeful measure, the early implementation of proper training programmes for GPs in times of crisis will contribute to disease control and prevention. Lessons learnt from the current pandemic will hopefully help GPs handle similar future challenges and potential novel pandemics.

COVID-19 preventive practices and associated factors among high school and preparatory school students in Dessie City, Ethiopia

Background

As the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia.

Methods

A cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model.

Results

This study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices.

Conclusion

The prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.

Education-related inequalities in beliefs and behaviors pertaining to COVID-19 non-pharmaceutical interventions

BACKGROUND

The coronavirus pandemic has exposed existing social inequalities in relation to disease preventive behaviors, risk of exposure, testing and healthcare access, and consequences as a result of illness and containment measures across different population groups. However, due to a lack of data, to date there has been limited evidence of the extent of such within-country inequalities globally.

METHODS

We examined education-related inequalities in four COVID-19 prevention and testing indicators within 90 countries, using data from the University of Maryland Social Data Science Center Global COVID-19 Trends and Impact Survey, in partnership with Facebook, over the period 1 June 2021 to 31 December 2021. The overall level of education-related inequalities, as well as how they differ across country income groups and how they have changed over time were analyzed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). We also assessed whether these education-related inequalities were associated with government policies and responses.

RESULTS

Education-related inequalities in beliefs, mask wearing, social distancing and testing varied across the study countries. Mask wearing and beliefs in the effectiveness of social distancing and mask wearing were overall more common among people with a higher level of education. Even after controlling for other sociodemographic and health-related factors, social distancing practice was higher among the most educated in low/lower middle income countries, but was higher overall among the least educated in high income countries. Overall there were low education-related inequalities in COVID-19 testing, though there was variation across countries.

CONCLUSIONS

The study highlights important within-country education-related differences in COVID-19 beliefs, preventive behaviors and testing, as well as differing trends across country income groups. This has implications for considering and targeting specific population groups when designing public health interventions and messaging during the COVID-19 pandemic and future health emergencies.

"They cannot afford to feed their children and the advice is to stay home. How‥?": A qualitative study of community experiences of COVID-19 response efforts across Syria

Introduction

COVID-19 highlighted the importance of meaningful engagement between communities and health authorities. This is particularly challenging in conflict-affected countries such as Syria, where social protection and food security needs can hinder adherence to non-pharmaceutical interventions (NPIs) and vaccine uptake. This study explored community perspectives of COVID-19 and health authority responses across the three main areas of control in Syria, i.e. Syrian government-controlled areas (GCA), autonomous administration-controlled areas (AACA), and opposition-controlled areas (OCA).

Methods

We conducted a qualitative study, interviewing 22 purposively-sampled Syrians accessing health services in AACA, GCA, or OCA in 2021 to provide approximately equal representation by governance area and gender. We analysed data thematically using deductive and inductive coding.

Findings

Interviewees in all areas described how their fears of COVID-19 and willingness to adhere to NPIs decreased as their local COVID-19 epidemics progressed and NPIs disrupted access to household essentials such as work and food. Community-level responses were minimal and ad hoc, so most people focused on personal or household protective efforts and many mentioned relying on their faith for comfort. Misinformation and vaccine hesitancy were common in all areas, linked to lack of transparency from and mistrust of local health authorities and information sources.

Conclusions

The COVID-19 pandemic has increased health actors’ need to engage with communities to control disease spread, yet most NPIs implemented in Syria were inappropriate and adherence decreased as the pandemic progressed. This was exemplified by lockdowns and requirements to self-isolate, despite precarious reliance on daily wages, no subsidies for lost income, individual self-reliance, and mistrust/weak communication between communities and health authorities. We found minimal community engagement efforts, consisting entirely of informing with no efforts to consult, involve, collaborate, or empower. This contributed to failures of health actors to contextualise interventions in ways that respected community understandings and needs.

COVID-19-related knowledge influences mental health, self-care behaviors, and quality of life among elderly with non-communicable diseases in Northern Thailand

Background

A growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand.

Methods

In this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF.

Results

Almost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = -0.85), mental health (r = -0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45-13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17-0.31) were associated with mental health problem (p < 0.05).

Discussion

The findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.

COVID-19 Vaccine Acceptance Level in Ethiopia: A Systematic Review and Meta-Analysis

Background

The coronavirus disease 2019 pandemic has had a devastating impact on the everyday lives of the world's population and to this end, the development of curative vaccines was upheld as a welcome panacea. Despite the undeniable negative impact of the disease on human beings, lower than expected proportions of people have taken up the vaccines, particularly in the developing non-Western world. Ethiopia represents an interesting case example, of a nation where COVID-19 vaccine acceptance levels have not been well investigated and a need exists to assess the overall level of vaccine acceptance.

Methods

A systematic multidatabase search for relevant articles was carried out across Google Scholar, Web of Science, Science Direct, Hinari, EMBASE, Boolean operator, and PubMed. Two reviewers independently selected, reviewed, screened, and extracted data by using a Microsoft Excel spreadsheet. The Joanna Briggs Institute prevalence critical appraisal tools and the modified NewcastleOttawa Scale (NOS) were used to assess the quality of evidence. All studies conducted in Ethiopia, reporting vaccine acceptance rates were incorporated. The extracted data were imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was confirmed using Higgins's method, and publication bias was checked by using Beggs and Eggers tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area and sample size was done. Results and Conclusion. After reviewing 67 sources, 18 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 57.8% (95% CI: 47.2%–67.8%). The level of COVID-19 vaccine acceptance in Ethiopia was at a lower rate than necessary to achieve herd immunity. The highest level of vaccine acceptance rate was reported via online or telephone surveys followed by the southern region of Ethiopia. The lowest vaccine acceptance patterns were reported in Addis Ababa.

The quality of Syrian healthcare services during COVID-19: A HEALTHQUAL approach

Syria is a developing country that face enormous healthcare challenges that aggravated with the outbreak of COVID-19. In the study, we evaluate the perceived healthcare service quality based on hospital type, public and private, using five HEALTHQUAL dimensions. We find that service quality in Syrian private hospitals is perceived better that in public hospitals. However, neither type of hospitals scores exceptionally high in any of the examined HEALTHQUAL dimensions. On the contrary, both hospitals score extremely low in the Improvement dimension. We argue that crowdedness environment, medical staff availability and their low salaries, pricing policies as well as the health insurance system, are to blame for such low perceived quality.

Knowledge, Attitudes, and Practices of COVID-19 Vaccination among Adults in Singapore: A Cross-Sectional Study

Public health measures promoting compliance of COVID-19 vaccination requires understanding of knowledge, attitudes, and practices (KAP). This study explored the KAP and risk factors influencing COVID-19 vaccination, including changes in preventive practices before and after vaccination in a high-income country, Singapore. An online cross-sectional study among Singaporeans and permanent residents aged 21 years and older was conducted from July to August 2021. Univariate and multivariable logistic regressions using RStudio version 1.4.1106 was performed to assess associations between demographic factors, KAP, and vaccination status. P values < 0.05 were considered statistically significant. A total of 869 respondents completed the survey. Individuals with higher knowledge (adjusted odds ratio [aOR] = 2.00, P = 0.024), perceived efficacy (aOR = 1.19, P = 0.004), perceived safety (aOR = 1.20, P = 0.005), and willingness to uptake (aOR = 1.55, P < 0.001) scores were more likely to be vaccinated. There was a significant increase in the use of proper handwashing techniques among the vaccinated group before and after vaccinations. The governmental risk communication approaches have been useful in instilling high levels of vaccine knowledge. High levels of good attitudes about and knowledge of COVID-19 vaccination were associated with a high level of vaccination practices. Good perceived vaccine efficacy and confidence in government were also associated with positive vaccine uptake. This study paves the way for more targeted government measures to be implemented to improve vaccination rates of COVID-19 booster vaccines in a high-income country like Singapore.

Knowledge, Attitudes, and Practices Regarding “New Normal” Guidelines and Quality of Life Among Thai People During the COVID-19 Outbreak: An Online Cross-Sectional Survey

In Thailand, strict prevention and control strategies have been implemented to mitigate the rapid spread of coronavirus disease 2019 (COVID-19). “New normal” guidelines and a series of mobile health applications have been introduced by the healthcare sector and implemented to aid the disease control monitoring and prevention of widespread outbreaks. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding “new normal” guidelines and quality of life (QOL) among Thai people during the COVID-19 outbreak, and to determine the association between KA, QOL, and practices. An online cross-sectional survey was conducted from 7 June to 12 September 2021 among Thai people in Public Health Region 6 aged ≥ 18 years old. Of the 506 survey participants, 80.3% were female, and 65.0% were 25–59 years old. The survey revealed that 52.2% of participants were classified as having more accurate knowledge, 58.9% were classified as having more positive attitudes, and 80.8% were classified as having more frequent practices regarding “new normal” guidelines, and 54.7% had high QOL. Of the participants, 93.7% agreed that “people who have been fully vaccinated should wear a mask while outside,” and 95.5% wore a face mask outdoors in crowded places. However, 60.9% of participants misunderstood some details regarding online applications for contact tracing and vaccination services, 44.2% felt that these applications were difficult to use, and 33.4% rarely or never downloaded or used these applications. In logistic regression analyses, accurate knowledge of COVID-19 was associated with higher education, being a government employee, monthly family income &gt; 30,000 Thai Baht, and regular use of social media. More positive attitudes regarding “new normal” guidelines and high QOL were associated with positive practices. High QOL was associated with older age, and higher education. Enhancement of attitudes and QOL is also important for improving practices in the general population during the COVID-19 pandemic. Significant factors identified in KAP will be crucial for developing effective prevention and control programs to mitigate the spread of COVID-19. To implement mobile health applications effectively, more work is required to improve the ease of use and promotion strategies.

Knowledge, Attitude, Practices, and Sources of Information (KAPS) Toward COVID-19 During the Second Wave Pandemic Among University Population in Qatar: A Cross-Sectional Study

Background

The World Health Organization (WHO) declared COVID-19 as a pandemic on 11 March 2020. Many efforts were performed to contain the virus worldwide. People's knowledge and attitude should be directed toward strict preventive practices to halt the spread of the virus. We aimed to assess the knowledge, attitude, practices, and sources of information (KAPS) used by Qatar University (QU) attendees.

Methods

A cross-sectional web-based questionnaire was answered by 500 employees and students in the QU community. It included questions on KAPS toward COVID-19. Information on sociodemographics was collected and analyzed. This study was conducted during the second wave of COVID-18 in the state of Qatar (April-May 2021).

Results

A total of 475 participants aged between 18 and 68 years old consented to complete the survey questionnaire. The study involved 279 (58.7%) non-Qatari nationals and 196 (41.3%) natives, with 254 (53.5%) participants pursuing postgraduate studies and 221 (46.5%) undergraduates. Approximately two-thirds of the sample were employed (64.8%), while one-third were unemployed (35.2%). Knowledge scores on average were 66.4% (M = 5.31, SD = 1.45, and range: 0-8), with only significant differences were noted between nationalities (natives and non-natives) Participants' average score in practices was 69.72% (M = 4.18, SD = 1.7, and range 0-6) with a significant difference in safe COVID-19 practice scores based on the educational level. Adherence with COVID-19 policies and rules were 82% (M = 2.46, SD = 0.7, and range: 0-3) with no differences noted between groups. In addition, the population reported relying on governmental press conferences (76.0%) as their primary source of gaining details concerning COVID-19, followed by social media (64.4%). The least popular resources were information gained from family, relatives, friends, and coworkers (47.4%) and the news channels on TV (46.7%).

Conclusion

Overall, this study provides insights into Qatar's KAPS toward COVID-19 during the quarantine of the second wave of this pandemic. This study, being the first of its kind to be conducted in the state of Qatar, is expected to help the ministry of public health and the government communication office to establish a suitable measurement of response to the spread of COVID-19 and develop the best practices for any future epidemics that might occur.

Knowledge, attitudes, and practices towards COVID-19 among college students in China: A systematic review and meta-analysis

Background

Since the outbreak of the respiratory infectious disease caused by the novel coronavirus in 2019, the COVID-19 epidemic has posed a serious threat to the life and safety of the public, and has also seriously affected the normal study and life of college students in China. Although a series of studies have been conducted on college students’ knowledge, attitudes and practices of COVID-19, the results vary widely. This study aimed to evaluate the pooled estimated level of knowledge, attitudes, and practices (KAP) about COVID-19 among college students in China.

Methods

We conducted a comprehensive search on Scopus, ProQuest, PubMed, EMbase, Web of Science, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP Database and Wanfang Database up to 13 February 2022. We then assessed the quality of included studies using a checklist developed by the Joanna Briggs Institute (JBI) for cross-sectional studies and analyzed using STATA.15 after two researchers independently extracted relevant data and entered them into Microsoft Excel. Funnel plots and Egger’s regression tests were used to check for publication bias, and sensitivity analysis was performed to assess the robustness of the results. A random-effects model was used for the meta-analysis, on the basis of which subgroup analyses were performed by time of investigation (study period) and by gender and major of the subjects.

Result

A total of 42 studies including 174,440 subjects were included in this review, and the quality of the included studies was mainly intermediate and advanced. The findings of the meta-analysis showed that the overall levels of Chinese college students’ knowledge, positive and negative attitudes, and practice of preventive measures towards COVID-19 were 74% (95%CI: 69%-79%), 84% (95%CI: 80%-88%), 31% (95%CI: 23%-38%) and 82% (95%CI: 77%-86%), respectively. The results of subgroup analysis showed that female and medical college students had higher levels of knowledge and practice on COVID-19.

Conclusion

The study findings showed that the overall KAP level of college students in China included in the study was relatively optimistic. Influenced by gender, major and time, there were differences in the KAP level of college students. In order to promote the effective prophylaxis and control of pandemic, we recommend implementing targeted measures to improve the awareness rate of COVID-19-related knowledge among this group and the implementation rate of COVID-19 preventive measures among male and non-medical college students.

Hospitals early challenges and interventions combatting COVID-19 in the Eastern Mediterranean Region

BACKGROUND

During rapidly evolving outbreaks, health services and essential medical care are interrupted as facilities have become overwhelmed responding to COVID-19. In the Eastern Mediterranean Region (EMR), more than half of countries are affected by emergencies, hospitals face complex challenges as they respond to humanitarian crises, maintain essential services, and fight the pandemic. While hospitals in the EMR have adapted to combat COVID-19, evidence-based and context-specific recommendations are needed to guide policymakers and hospital managers on best practices to strengthen hospitals' readiness, limit the impact of the pandemic, and create lasting hospital sector improvements towards recovery and resilience.

AIM

Guided by the WHO/EMR's "Hospital readiness checklist for COVID-19", this study presents the experiences of EMR hospitals in combatting COVID-19 across the 22 EMR countries, including their challenges and interventions across the checklist domains, to inform improvements to pandemic preparedness, response, policy, and practice.

METHODS

To collect in-depth and comprehensive information on hospital experiences, qualitative and descriptive quantitative data was collected between May-October 2020. To increase breadth of responses, this comprehensive qualitative study triangulated findings from a regional literature review with the findings of an open-ended online survey (n = 139), and virtual in-depth key informant interviews with 46 policymakers and hospital managers from 18 out of 22 EMR countries. Purposeful sampling supported by snowballing was used and continued until reaching data saturation, measures were taken to increase the trustworthiness of the results. Led by the checklist domains, qualitative data was thematically analyzed using MAXQDA.

FINDINGS

Hospitals faced continuously changing challenges and needed to adapt to maintain operations and provide essential services. This thematic analysis revealed major themes for the challenges and interventions utilized by hospitals for each of hospital readiness domains: Preparedness, Leadership, Operational support, logistics, supply management, Communications and Information, Human Resources, Continuity of Essential Services and Surge Capacity, Rapid Identification and Diagnosis, Isolation and Case Management, and Infection, Prevention and Control.

CONCLUSION

Hospitals are the backbone of COVID-19 response, and their resilience is essential for achieving universal health coverage. Multi-pronged (across each of the hospitals readiness domains) and multi-level policies are required to strengthen hospitals resilience and prepare health systems for future outbreaks and shocks.

COVID-19 vaccine acceptance among cold-chain workers in Shenzhen, China: A cross-sectional survey

Given the high level of exposure to SARS-CoV-2, cold-chain workers are considered priority vaccination groups. To date, many studies have reported on the willingness within distinct populations to be vaccinated against COVID-19, whereas it has not been reported among cold-chain workers worldwide. To address this void, we conducted a cross-sectional survey to gather general information, COVID-19-related knowledge, attitudes, and practices (KAP), and willingness to receive a COVID-19 vaccine among cold-chain workers in Shenzhen, China. Binary logistic analyses were conducted to explore the associations between COVID-19-related KAP factors and the willingness for COVID-19 vaccination. Among 244 cold-chain workers, 76% indicated that they were willing to be vaccinated. Knowledge about SARS-CoV-2, comprehending the most effective prevention, understanding the transmission routes, and recognizing the priority vaccination groups were positively associated with willingness to be vaccinated against COVID-19. Regarding attitude factors, perceiving the social harmfulness and severity of COVID-19 were related to a higher willingness to vaccination. Participants considering themselves a priority group for COVID-19 vaccination were more likely to get vaccinated. For practice factors, attaining more knowledge and higher self-reported compliance with maintaining adequate ventilation were also positively associated with the dependent variable. Agreement on the importance of COVID-19 vaccination was the most frequent reason for accepting the COVID-19 vaccine; additionally, concerns about side effects and insufficient understanding of efficacy were the main factors contributing to vaccine refusal. Enhancing KAP levels related to COVID-19 helps promote vaccine acceptance. Health authorities should promptly implement educational activities following the updated vaccine status among cold-chain workers.

Knowledge, attitudes, and practices related to the COVID-19 pandemic among pregnant women in Bangkok, Thailand

BACKGROUND

Pregnancy is associated with increased risk for severe COVID-19. Few studies have examined knowledge, attitudes, and practices (KAP) related to pregnancy during the pandemic. This study investigated the association between socio-demographic characteristics and KAP related to COVID-19 among pregnant women in an urban community in Thailand.

METHODS

A cross-sectional online survey was distributed among pregnant women in Bangkok, Thailand from July-August 2021. Binary logistic regression was conducted to test the association between socio-demographic characteristics and KAP related to COVID-19, and a Spearman's analysis tested correlations between KAP scores.

RESULTS

A total of 150 pregnancy survey responses were received. Most participants were third trimester (27-40 weeks gestation; 68.0%). Pregnancy had never been risked contracting COVID-19 (84.7%). Most expressed concerns about being infected with COVID-19 during pregnancy and following birth (94.0 and 70.0%, respectively). The results of binary logistic regression analysis found associations between knowledge and marital status (OR = 4.983, 95%CI 1.894-13.107). In addition, having a bachelor's degree or higher was associated with higher attitude scores (OR = 2.733, 95%CI 1.045-7.149), as was being aged 26-30 (OR = 2.413 95%CI 0.882-6.602) and 31-35 years of age (OR = 2.518-2.664, 95%CI 0.841-8.442). Higher practice scores were associated with having a bachelor's degree or higher (OR = 2.285 95%CI 1.110-6.146), and income ≥15,001 bath (OR = 4.747 95%CI 1.588-14.192). Correlation analysis found a weak positive correlation between knowledge and practice scores (r = 0.210, p-value = 0.01).

CONCLUSION

Participants overall had high KAP scores. This study can guide public health strategies regarding pregnant women and COVID-19. We recommend that interventions to improve and attitude and practice scores. Knowledge on pregnancy and COVID-19 should focus on reducing fear and improving attitudes toward the care of patients as well as the promotion of preventive practices.

COVID-19 related knowledge, attitudes, and practices in Indian Population: An online national cross-sectional survey

Introduction

This highly contagious zoonotic corona virus (SARS-CoV-2) spread to most parts of the world (200 countries) and created a public health emergency. Due to its novel nature and indistinctness, different sources of information and suggestions were developed to guide the individuals about its transmission and prevent its infection. Responses to the active intervention efforts have posed some relevant questions on population understanding and attitudes toward COVID-19. The present study is aims to assess the COVID-19 related knowledge, attitude, and practices (KAP) in a heterogeneous Indian population.

Material and methods

501 respondents across India participated in a questionnaire-based online survey from April 2020 to May 2020. The questionnaire incorporated 56 questions about demographic characteristics and KAP dimensions. The mixed (quantitative and qualitative) methods were employed to evaluate KAP dimensions. Descriptive analysis was estimated as means, SD, and proportion. The bivariate (χ²), correlation, and regression analysis were utilized for the response analysis. In addition, qualitative analysis, including content and thematic analysis were done for open-ended questions.

Result

High knowledge and positive attitude were reported in more than half of the study population, with a proportion of 58.6% and 62.1%, respectively. Education shows a significant difference in the knowledge and attitude dimensions. The good practice (50.5% of the total population) reported a significant difference in age and gender categories with the test of independence (χ2). Prevention (56.89%) in knowledge domain and risk (17.56%), information-seeking (45.51%), prevention (51.50%), and treatment-seeking (54.29%) in attitude domains recorded low proportion. KAP variables were found in association in Pearson correlation analysis. In logistic regression analysis, knowledge was the strongest predictor for the positive attitude, whereas attitude was reported as the best predictor for good practice outcome.

Conclusion

The study presents a moderate level of covid related knowledge, Attitudes, and Practices in Indian population.

Knowledge, Attitude, and Practices Among the General Population During the Later Stage of the COVID-19 Pandemic in Malaysia: A Cross-Sectional Study

Purpose

Patients and Methods

Results

Conclusion

COVID-19 infected patients' experiences in Syria, and the role of the pharmacists during their infection

Background

Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection.

Objective

To assess the experience of individuals who have been infected with coronavirus and the roles played by pharmacists to meet their new needs.

Methods

This descriptive cross-sectional survey was developed based on previous literature, validated, and conducted in Syria. The survey included items related to participants' COVID-19 experiences, and items concerning the roles played by pharmacists when participants were infected. Items were tested for face validity. Data collection was conducted in May and June 2021. Data was analyzed using the Statistical Package for the Social Sciences (SPSS).

Results

The study participants (n=576) had a mean age of 37.99 years. Fatigue was the most reported symptom by the participants. Vitamin C was the most used supplement (76.4%), and 66.5% of the participants used herbs during their infection. More than 60.0% of the participants stated that their anxiety and stress levels increased during their infection. Around 40.0% of the participants needed to visit a specialist doctor. Only 5.4% needed to use an artificial respiration apparatus. The mean of the participants' infection severity was 4.97 (SD=2.30) out of 10. The severity of the infection was significantly affected by being older, female, smoking, and having a chronic condition. Doctors followed by pharmacists were the healthcare providers who advised participants to take certain medications/herbs. More than one-third of the participants strongly agreed/agreed that the pharmacist played important and effective roles during their infection.

Conclusion

Patients' experiences indicated that fatigue was the most reported symptom by the participants diagnosed with coronavirus infection, while vitamin C was the most used supplement. Pharmacists have a major role in helping participants manage their infection and are considered a vital pillar in patients' experiences since they provided patients with the needed medications.

Knowledge into the Practice against COVID-19: A Cross-Sectional Study from Ghana

The COVID-19 pandemic has affected populations globally, including Ghana. Knowledge of the COVID-19 disease, and the application of preventive public health interventions are pivotal to its control. Besides a lockdown, measures taken against the spread of the virus include the wearing of face masks, social distancing, regular hand washing with soap and, more recently, vaccination against the virus. In order to establish a possible link between the knowledge of the disease and compliance with preventive measures, including vaccination, a cross-sectional study employing an interview-structured questionnaire was conducted in six regions of Ghana (n = 1560). An adequate level of knowledge of COVID-19 (69.9%) was reported. The linear multiple regression analysis further explicated the differences in the knowledge of COVID-19 among the respondents by their knowledge of cholera and influenza (adjusted R-Square = 0.643). Despite this profound knowledge of the illness, two thirds of the respondents were unwilling to follow basic preventive measures and only 35.3% were willing to be vaccinated. Amazingly, neither knowledge of COVID-19 nor the socio-demographic characteristics had any meaningful influence on the practice of preventive measures. Personal attitude leading to efficient public compliance with preventive measures, therefore, is a critical issue demanding special attention and effective interventions by the government and locals with authority to curb the spread of the pandemic which surpasses the traditional channels of public health communication. This includes a roll-out of persuasion, possibly including public figures and influencers, and in any case, a balanced and open discussion addressing the acceptance of the COVID-19 vaccine in order to avoid new variants and comparable problems currently facing many countries of Western Europe. Indeed, a profound hesitancy against vaccination may turn African countries such as Ghana for many years into hotspots of new viral variants.

COVID-19 Knowledge and Pandemic-Associated Distress Among the Hospital Pharmacist Workforce in China

BACKGROUND

The unprecedented disruption brought about by the global coronavirus disease 2019 (COVID-19) pandemic had produced tremendous influence on the practice of pharmacy. Sufficient knowledge of pharmacists was needed to deal with the epidemic situation; however, outbreak also aggravated psychological distress among health-care professionals. Therefore, this study aimed to determine knowledge about the pandemic and related factors, prevalence and factors associated with psychological distress among hospital pharmacists of Xinjiang Province, China.

METHODS

An anonymous online questionnaire-based cross-sectional study was conducted by means of WeChat, a popular social media platform in China, February 23-27, 2020, during the COVID-19 outbreak. The survey questionnaire consisted of 4 parts, including informed consent section, demographic section, knowledge about COVID-19, and assessment of overall mental health through World Health Organization's Self-Reporting Questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cutoff to classify the participant as in psychological distress. SRQ-20 score and related knowledge score were used as dependent variables, demographic characteristics (such as gender, age, monthly income, etc.) were used as independent variables, and univariate binary logistic regression was used to screen out the variables with P < 0.05. Then, the filtered variables were used as independent variables, and multivariate logistic regression models were used to analyze associations with sufficient knowledge of COVID-19 and psychological distress.

RESULTS

A total of 365 pharmacists participated in the survey, fewer than half (35.1%; n = 128) of pharmacists attained a score of 6 or greater (out of 10) in overall disease knowledge, and most were able to select effective disinfectants and isolation or discharge criteria. In the multivariable model, age ages 31-40 (odds ratio [OR] = 3.25; P < 0.05), ages 41-50 (OR = 2.96; P < 0.05) versus >50 (referent); primary place of practice in hospitals: drug supply (OR = 4.00; P < 0.01), inpatient pharmacy (OR = 2.06, P < 0.01), clinical pharmacy (OR = 2.17, P < 0.05) versus outpatient pharmacy (referent); monthly income Renminbi (RMB, China's legal currency) 5000-10,000 (OR = 1.77; P < 0.05) versus < 5000 (referent); contact with COVID-19 patients or suspected cases (OR = 2.27; P < 0.01); access to COVID-19 knowledge remote work+ on-site work (OR = 6.07; P < 0.05), single on-site work (OR = 6.90; P < 0.01) versus remote work (referent) were related to better knowledge of COVID-19. Research found that 18.4% of pharmacists surveyed met the SRQ-20 threshold for distress. Self-reported history of mental illness (OR = 3.56; P < 0.05) and working and living in hospital versus delay in work resumption (OR = 2.87; P < 0.01) were found to be risk factors of psychological distress.

CONCLUSIONS

Further training of COVID-19 knowledge was required for pharmacists. As specific pharmacist groups were prone to psychological distress, it was important for individual hospitals and government to consider and identify pharmacists' needs and take steps to meet their needs with regard to pandemic and other work-related distress.

COVID-19 vaccination acceptance among Syrian population: a nationwide cross-sectional study

Background

Severe Acute Respiratory Syndrome Coronavirus 2 continues to spread globally and in the absence of an effective treatment, the vaccine remains the best hope for controlling this disease. In this study, we seek to find out the extent to which people in Syria accept the Corona vaccine and what are the factors that affect their decision.

Methods

This cross-sectional study was conducted in Syria during the period from January 3 to March 17, 2021. A structured self-administered questionnaire was distributed in two phases: The first phase included distributing the questionnaire as a Google Form on social media platforms. In the second phase, a paper version of the questionnaire was handed to patients, their companions, and workers in public hospitals. SPSS v.25 and R v.4.1.1 were used to analyze the data. Pearson Chi-square test and Logistic Regression were used to study the associations between categorical groups.

Results

Of 7531 respondents, 3505 (46.5%) were males and 4026 (53.5%) were females. 3124 (41.5%) were 18–24 years old. Healthcare workers were participants’ main sources of information (50.9%), followed by Social Media users (46.3%). 2790 (37%) of the participant are willing to be vaccinated, and 2334 (31%) were uncertain about it. Fear of possible side effects was the main reason for the reluctance to take the vaccine 1615 (62.4%), followed by mistrust of the vaccine formula 1522 (58.8%). 2218 (29.5%) participants think COVID-19 poses a major risk to them personally. Vaccination intention was significantly associated with gender, residence, financial status, educational level, and geographic origin.

Conclusion

This study showed very negatively important results. The study participants Vaccination acceptance rate is almost the lowest when compared to its peers. A Lot of efforts should be made to correct misinformation about the vaccine and answer all questions about it, especially with a health system that has been ravaged by war for 10 years.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12186-6.

Health Literacy and Disparities in Knowledge, Attitude and Practice Regarding COVID-19 Among College Students During the COVID-19 Outbreak in China: A Cross-Sectional Study

Purpose

This study aimed to assess the knowledge, attitude and practice (KAP) towards COVID-19 of Chinese college students during the COVID-19 outbreak and identify the determinants considerably associated with KAP.

Methods

An online cross-sectional questionnaire survey was conducted in February 2020 in China to recruit participants on the Wen-Juan-Xing online platform. A self-made questionnaire was used to assess the KAP towards COVID-19.

Results

The average scores of COVID-19-related KAP among college students were 32.16 ± 4.09, 16.84 ± 3.18 and 15.36 ± 1.83, respectively. The average correct response rate of COVID-19-related knowledge was 84.62%. 94.59% of the respondents believed China could control and conquer the pandemic; 98.92% of the respondents wore a mask when they went out. The multiple linear regression showed that the female students had higher scores of COVID-19-related knowledge than male students (β = 0.79, P = 0.01), and the students from 985 or 211 universities (β = -2.22, P < 0.01) were significantly associated with higher knowledge scores. Furthermore, a significantly positive correlation was found between the scores of COVID-19-related KAP among students.

Conclusion

The college students had a good KAP towards the COVID-19 pandemic. The present study was able to access the COVID-19-related KAP among college students during the pandemic and identify their weaknesses in pandemic prevention. Consequently, the results of this study provide theoretical basis for implementing precision health education among college students and reference for campuses to conduct scientific prevention and control during a pandemic. Results also provide beneficial experience to curb similar major public health emergencies in the future.

Knowledge, Attitude, and Behavior of Parents toward School Reopening Amidst Coronavirus Disease 2019 Pandemic in Indonesia

Objectives: Recently, the subject of reopening schools has raised several concerns, especially on the possibility of new COVID-19 cluster cases. The parent's role is essential in this matter. Therefore, this study aims to understand the parents' knowledge, attitude, and behavior toward COVID-19 in Indonesia. Methods:  A cross-sectional study was conducted on 206 Indonesian parents. A 55-items questionnaire was used to assess the knowledge, attitude, and behavior of subjects. In this study, median split tests, Kruskal-Wallis, Cronbach's α, and Pearson correlation test were used. Results:  Subjects were found to have high levels of knowledge, especially in the knowledge of COVID-19 as a contagious viral disease (98.5%), and the necessity for children to maintain personal hygiene to prevent COVID-19 (98.5%). Subjects' attitudes were highest at understanding how to prevent COVID-19 (95.1%) and teaching children how to avoid COVID-19 (98.1%). Subjects' attitude was lowest at hearing the news of the death of COVID-19 scares them (72.8%), and on how their child(ren) are getting bored at home because of COVID-19 (69.9%). Subjects' are shown to have high levels of behavior in every question. This study found a significant correlation between socioeconomic status and subjects' knowledge (p = 0.007). Conclusion:  This study revealed a lack of understanding of prevention strategies among low-income households. Hence, there is a need for targeted messaging and health education in low-income settings that consider the challenges they may face when attempting their children to practice COVID-19 prevention if schools reopen. Keywords: COVID-19, Knowledge, Attitude, Behavior, Parents, Indonesia

Public health consequences after ten years of the Syrian crisis: a literature review

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.

Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID − 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.

Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.

Global epidemiology of COVID-19 knowledge, attitude and practice: a systematic review and meta-analysis

OBJECTIVE

To assess the knowledge, attitude and practice (KAP) of the global general population regarding COVID-19.

DESIGN

Systematic review and meta-analysis.

METHODS

MEDLINE, Embase, CINAHL and PsycINFO were used to identify articles published between 1 January and 30 June 2021 assessing KAP regarding COVID-19 in the global general population. The quality of eligible studies was assessed. Random effects model was used to obtain the pooled proportion of each component of KAP of COVID-19. Heterogeneity (I2) was tested, and subgroup and correlation analyses were performed.

RESULTS

Out of 3099 records, 84 studies from 45 countries across all continents assessing 215 731 participants' COVID-19 KAP were included in this study. The estimated overall correct answers for knowledge, good attitude and good practice in this review were 75% (95% CI 72% to 77%), 74% (95% CI 71% to 77%) and 70% (95% CI 66% to 74%), respectively. Low-income countries, men, people aged below 30 years and people with 12 years of education or less had the lowest practice scores. Practice scores were below 60% in Africa and Europe/Oceania. Overall heterogeneity was high (I2 ≥98%), and publication bias was present (Egger's regression test, p<0.01). A positive significant correlation between knowledge and practice (r=0.314, p=0.006), and attitude and practice (r=0.348, p=0.004) was observed.

CONCLUSIONS

This study's findings call for community-based awareness programmes to provide a simple, clear and understandable message to reinforce knowledge especially regarding efficacy of the preventive measures in low and lower middle-income countries, and in Africa and Europe/Oceania, which will translate into good practice. Targeted intervention for men, people with low education, unemployed people and people aged below 30 years should be recommended. As most of the included studies were online surveys, underprivileged and remote rural people may have been missed out. Additional studies are needed to cover heterogeneous populations.

PROSPERO REGISTRATION NUMBER

CRD42020203476.

Knowledge, Attitudes, and Practices Toward COVID-19 Among Chinese Teachers, Shenzhen: An Online Cross-sectional Study During the Global Outbreak of COVID-19

Background: Adequate understanding and precautionary behaviors are of vital importance to contain the spread of coronavirus disease 2019 (COVID-19). To date, the knowledge, attitudes, and practices (KAP) toward COVID-19 among different populations have been reported, whereas such information is unavailable in teachers. We aimed to investigate the KAP of teachers associated with COVID-19 during the global outbreak. Methods: A large-scale population-based survey was conducted to gather information on COVID-19-related KAP among Chinese teachers using a self-administered questionnaire. We received 10,658 responses in April 2020, out of which 8,248 were enrolled in the final analysis. Participants responded to a self-administered questionnaire concerning demographic characteristics and KAP associated with COVID-19. Results: This work included 4,252 (51.6%) teachers in kindergartens, 2,644 (32.1%) teachers in primary schools, and 1,352 (16.4%) teachers in secondary schools. The knowledge level (mean: 4.46 out of seven points) was relatively lower than the levels of attitudes (mean: 3.27 out of four points) and practices (mean: 4.29 out of five points) toward COVID-19. Knowledge scores significantly varied by the collected demographic variables except education worksite (p < 0.05), whereas practice scores significantly differed in age groups (p < 0.05), education level (p < 0.001), education worksite (p < 0.001), and years of teaching (p < 0.001). The multivariate logistic analysis indicated that poor knowledge related to COVID-19 was common among men, younger, and less-educated teachers. In contrast, female teachers and those with higher education levels tend to have good practices against COVID-19. Conclusion: The present work suggested the knowledge gaps regarding COVID-19 were needed to be corrected immediately in teachers. Given the critical role of teachers in the education system, health authorities should take gender, age, and education level into account when developing suitable health interventions.

Knowledge, Attitudes, and Risk Perception Toward Avian Influenza Virus Exposure Among Cuban Hunters

A critical step for decreasing zoonotic disease threats is to have a good understanding of the associated risks. Hunters frequently handle potentially infected birds, so they are more at risk of being exposed to zoonotic avian pathogens, including avian influenza viruses (AIVs). The objective of the current study was to gain a better understanding of Cuban hunters' general hunting practices, focusing on their knowledge and risk perception on avian influenza. An anonymous and voluntary semi-structured questionnaire was designed and applied to 398 hunters. Multiple correspondence analyses found relationships with potential exposure of AIVs to people and domestic animals. The main associated risks factors identified were not taking the annual flu vaccine (60.1%) and not cleaning hunting knives (26.3%); Direct contact with water (32.1%), cleaning wild birds at home (33.2%); receiving assistance during bird cleaning (41.9%), keeping poultry at home (56.5%) and feeding domestic animals with wild bird leftovers (30.3%) were also identified as significant risk factors. The lack of use of some protective measures reported by hunters had no relationship with their awareness on avian influenza, which may imply a lack of such knowledge. The results evidenced that more effective risk communication strategies about the consequences of AIVs infecting human or other animals, and the importance of reducing such risks, are urgently needed.

Symbolic annihilation of Syrian refugees by Turkish news media during the COVID-19 pandemic

BACKGROUND

This article presents a discussion about the representation of Syrian refugees in Turkish news media during the COVID-19 pandemic. Media play a critical role during pandemics by affecting values, opinions, public knowledge about stigmatized groups. When media ignore and stereotypically represent a social group, the social value of the group decreases, and their problems are trivialized.

METHOD

I analyzed data provided by Media Monitoring Center which is an independent media company in Turkey. Sample was selected to reveal news representation of Syrian refugees between March 11, 2020 (the first confirmed case of COVID-19 in Turkey) and August 20, 2020 (the time of this research). Mostly watched television evening (prime) news, the most widely circulated newspapers, and the most visited online news platforms were analyzed. By using content analysis method, the news stories about Syrian refugees were examined.

RESULTS

It has been revealed that Turkish news media overwhelmingly acclaimed for Turkey's polices on Syrian refugees and the criticized the European Union policies towards refugees in the news stories. Even though almost 4 million Syrian refugees live in Turkey, with the largest refugee population in the world, Turkish news media ignored the plight of Syrian refugees.

CONCLUSION

Results of the study demonstrate that Syrian refugees were symbolically annihilated by Turkish news media during the COVID-19 pandemic. The concealment of information and symbolic annihilation of disadvantaged groups could potentially cause health disparities and irreparable harm to public health. Moreover, inequities exacerbate when predicaments of stigmatized groups are ignored in the news media. Further studies are needed to reveal the impact of the media on health disparities among stigmatized groups during the pandemics.

Willingness to Be Vaccinated against COVID-19 in Spain before the Start of Vaccination: A Cross-Sectional Study

Vaccine hesitancy has increased in the past few years, influenced by the socio-cultural differences, political populism, or concerns related to the effectiveness and safety of some vaccines, resulting a feeling of distrust. This feeling can become a barrier against the achievement of the immunity necessary to stop the expansion of COVID-19. The aim of this study was to evaluate the acceptance of the vaccine against COVID-19 in Spain, as well as to identify the factors that have an influence on the concerns and attitudes of people against accepting the vaccine in the months prior to the start of vaccination on December 2020. An online questionnaire was created to obtain information about (1) sociodemographic characteristics; (2) concerns and sources of information about vaccines; and (3) attitudes about vaccination and state of health. A multivariate logistic regression was performed to identify the influencing factors. Of the 2501 participants, 1207 (48.3%) would accept the COVID-19 vaccine, 623 (24.9%) were hesitant, and 671 (26.8%) would reject it. The logistic regression showed that being male, older than 60, married, retired, with a high level of education, or with a leftist political inclination, could increase the probability of accepting the COVID-19 vaccine. Disinformation and the lack of political consensus were the main sources of distrust. The patients with hypertension, immunodepression, hypercholesterolemia, or respiratory disease, or were overweight, showed a greater acceptance to the vaccine, while those with cancer took the longest to accept it. A low acceptance of the vaccine against COVID-19 was observed among the Spanish population in the phase prior to its availability, and the main fears of the population were identified. It is necessary to offer correct and transparent information about these vaccines to reduce the concerns and increase the trust of the population, to thereby guarantee the success of the vaccination campaigns.

Knowledge, Attitudes, and Practices Related to COVID-19 Among Malawi Adults: A Community-Based Survey

Introduction: It is well-recognized that containing COVID-19 successfully is determined by people’s prevention measures which are related to their knowledge, attitudes, and practices (KAP). This perception has attracted attention in low- and middle-income countries (LMIC) due to their fragile health systems and economies. The objective of this study was to understand how residents in Malawi perceived COVID-19, to determine the factors related to KAP. Methods: A semi-structured questionnaire was used for the data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistic, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. Results: A total of 580 questionnaires were involved. The mean knowledge, attitude, and practice (KAP) scores were 10 (SD = ±3, range: 3–19), 16 (SD = ±4, range: 5–25), and 2 (SD = ±1, range: 0–5), respectively. Lack of money and resources (39%) was the biggest challenge for people who practice prevention measures. Among the participants, the radio (70%) and friends/family (56%) were the main sources of information. A higher economic status was associated with better KAP. Conclusions: A low level of KAP was detected among the population. The people faced challenges regarding a lack of necessary preventive resources and formal information channels. The situation was worse considering vulnerable population who had low economic status. Further all-round health education is urgently needed along with providing adequate health supplies and ensuring proper information management.

Public KAP towards COVID-19 and Antibiotics Resistance: A Malaysian Survey of Knowledge and Awareness

This study aimed to assess the knowledge of the Malaysian public on the coronavirus disease 2019 (COVID-19) and antibiotics, the practice of preventive measures and attitude towards the new norms. The web-based questionnaire was disseminated online from 1 to 31 October 2020. Out of 2117 respondents, 1405 (66.4%) knew that transmission of COVID-19 virus could happen in asymptomatic people. In term of antibiotics knowledge, 779 (36.8%) respondents were aware that taking antibiotics could not speed up the recovery process of all infections. Less than half of the respondents (49.0%) knew that antibiotics are effective against bacterial infection only. Majority (92.3%) practiced good preventive measures. Majority of the respondents strongly agreed that quarantine should be made mandatory for all arrival from overseas (97.2%) and wearing face masks should be made mandatory in all public areas (94.0%). Respondents of Chinese ethnicity (p = 0.008), middle-aged (p = 0.002), with tertiary education (p = 0.015) and healthcare related education (p < 0.001), from the higher income groups (p = 0.001) were more likely to have better knowledge on COVID-19. The Malaysian public demonstrated good knowledge towards COVID-19, adequate practice of preventive measures and high acceptance towards the new norm. Knowledge on antibiotics use and resistance was poor, which warrants attention from the health authorities.