Facemask wearing to prevent COVID-19 transmission and associated factors among taxi drivers in Dessie City and Kombolcha Town, Ethiopia

SVM-RLF-DNN: A DNN with reliefF and SVM for automatic identification of COVID from chest X-ray and CT images

Aim

To develop an advanced determination technology for detecting COVID-19 patterns from chest X-ray and CT-scan films with distinct applications of deep learning and machine learning methods.

Methods and Materials

The newly enhanced proposed hybrid classification network (SVM-RLF-DNN) comprises of three phases: feature extraction, selection and classification. The in-depth features are extracted from a series of 3×3 convolution, 2×2 max polling operations followed by a flattened and fully connected layer of the deep neural network (DNN). ReLU activation function and Adam optimizer are used in the model. The ReliefF is an improved feature selection algorithm of Relief that uses Manhattan distance instead of Euclidean distance. Based on the significance of the feature, the ReliefF assigns weight to each extracted feature received from a fully connected layer. The weight to each feature is the average of k closest hits and misses in each class for a neighbouring instance pair in multiclass problems. The ReliefF eliminates lower-weight features by setting the node value to zero. The higher weights of the features are kept to obtain the feature selection. At the last layer of the neural network, the multiclass Support Vector Machine (SVM) is used to classify the patterns of COVID-19, viral pneumonia and healthy cases. The three classes with three binary SVM classifiers use linear kernel function for each binary SVM following a one-versus-all approach. The hinge loss function and L2-norm regularization are selected for more stable results. The proposed method is assessed on publicly available chest X-ray and CT-scan image databases from Kaggle and GitHub. The performance of the proposed classification model has comparable training, validation, and test accuracy, as well as sensitivity, specificity, and confusion matrix for quantitative evaluation on five-fold cross-validation.

Results

Our proposed network has achieved test accuracy of 98.48% and 95.34% on 2-class X-rays and CT. More importantly, the proposed model's test accuracy, sensitivity, and specificity are 87.9%, 86.32%, and 90.25% for 3-class classification (COVID-19, Pneumonia, Normal) on chest X-rays. The proposed model provides the test accuracy, sensitivity, and specificity of 95.34%, 94.12%, and 96.15% for 2-class classification (COVID-19, Non-COVID) on chest CT.

Conclusion

Our proposed classification network experimental results indicate competitiveness with existing neural networks. The proposed neural network assists clinicians in determining and surveilling the disease.

Explainable COVID-19 Detection Based on Chest X-rays Using an End-to-End RegNet Architecture

COVID-19,which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is one of the worst pandemics in recent history. The identification of patients suspected to be infected with COVID-19 is becoming crucial to reduce its spread. We aimed to validate and test a deep learning model to detect COVID-19 based on chest X-rays. The recent deep convolutional neural network (CNN) RegNetX032 was adapted for detecting COVID-19 from chest X-ray (CXR) images using polymerase chain reaction (RT-PCR) as a reference. The model was customized and trained on five datasets containing more than 15,000 CXR images (including 4148COVID-19-positive cases) and then tested on 321 images (150 COVID-19-positive) from Montfort Hospital. Twenty percent of the data from the five datasets were used as validation data for hyperparameter optimization. Each CXR image was processed by the model to detect COVID-19. Multi-binary classifications were proposed, such as: COVID-19 vs. normal, COVID-19 + pneumonia vs. normal, and pneumonia vs. normal. The performance results were based on the area under the curve (AUC), sensitivity, and specificity. In addition, an explainability model was developed that demonstrated the high performance and high generalization degree of the proposed model in detecting and highlighting the signs of the disease. The fine-tuned RegNetX032 model achieved an overall accuracy score of 96.0%, with an AUC score of 99.1%. The model showed a superior sensitivity of 98.0% in detecting signs from CXR images of COVID-19 patients, and a specificity of 93.0% in detecting healthy CXR images. A second scenario compared COVID-19 + pneumonia vs. normal (healthy X-ray) patients. The model achieved an overall score of 99.1% (AUC) with a sensitivity of 96.0% and specificity of 93.0% on the Montfort dataset. For the validation set, the model achieved an average accuracy of 98.6%, an AUC score of 98.0%, a sensitivity of 98.0%, and a specificity of 96.0% for detection (COVID-19 patients vs. healthy patients). The second scenario compared COVID-19 + pneumonia vs. normal patients. The model achieved an overall score of 98.8% (AUC) with a sensitivity of 97.0% and a specificity of 96.0%. This robust deep learning model demonstrated excellent performance in detecting COVID-19 from chest X-rays. This model could be used to automate the detection of COVID-19 and improve decision making for patient triage and isolation in hospital settings. This could also be used as a complementary aid for radiologists or clinicians when differentiating to make smart decisions.

"Face mask utilization and associated factors among students: Mixed methods study"

BACKGROUND

Corona virus disease has gravely affected the world including students due to the high level of contracting an infection.

OBJECTIVE

Thus, this study assessed the magnitude of mask utilization and associated factors among students.

METHODS

a cross-sectional study using mixed methods was conducted among students in Gambella Teachers' Education and Health Science College, Gambella Region, Southwest Ethiopia from March 5 to March 30, 2021. Stratified random sampling technique was employed. Proportional allocation of samples was used to the randomly selected case teams, and a simple random sampling technique was employed to recruit the students. The data were collected by trained and experienced enumerators. Data were entered in to Epi Data version 3.1and exported to SPSS version 22 for analysis. Logistic regression was executed. Adjusted odds ratio with 95% CI was used to see the association and strength with the outcome variable. The qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. Then, the themes were used to triangulate the quantitative study.

RESULTS

The study included a total of 379 participants yielding a response rate of 95.5%. The majority of study participants were greater than 25 years of age with the mean age of 26.34 ±5.8 (SD). This study found that the magnitude of mask utilization among students was 87%. The odds of mask utilization among female students AOR=3.32 95 CI: (1.191, 9.248), younger age AOR=2.55,95 CI: (1.155,5.627), not all persons with COVID-19 develop severe cases AOR=3.38 95 CI: (1.36,8.41), who say yes has currently no effective cure AOR=6.28 95 CI:(1.36,28.99), proper washing with soap and water AOR=0.027,95 CI:(0.004,0.182), have started to stay home AOR=0.168, 95 CI: (0.054,0.52), COVID-19 is fatal AOR=0.236, 95 CI:(0.084,0.666), flu vaccine is sufficient for COVID-19 prevention AOR=3.874, 95 CI(1.540, 9.749), disinfect equipment and working area at least once a day AOR=0.222, 95, CI(0.086, 0.575) were associated with mask utilization.

CONCLUSIONS

In this study, the magnitude of mask utilization among students was relatively moderate in Ethiopia. Sex, age, not all persons with COVID-19 develop severe cases, currently, no effective cure, proper washing with soap and water, have started to stay home, COVID-19 is fatal, and the flu vaccine is sufficient to prevent COVID-19 were independently associated with mask utilization among students. Therefore, the college should aggressively encourage students to wear mask, monitor the implementation of COVID-19 prevention regulations along with the accessibility of masks.

Factors associated with COVID-19 preventive behaviors among taxi drivers in Bangkok

Objectives

This paper aimed to identify factors associated with COVID-19 preventive behaviors among taxi drivers in Bangkok.

Methods

This cross-sectional study included 401 taxi drivers. Data were analyzed using descriptive statistics. The association between predisposing factors, enabling factors, and reinforcing factors with COVID-19 preventive behaviors was analyzed by using analysis of variance and Pearson's Product Moment Correlation. Multiple linear regression analysis was used to determine the influencing factors in predicting COVID-19 preventive behaviors of taxi drivers.

Results

The present findings revealed that income adequacy, support from family, co-workers, and healthcare professionals, perceived susceptibility, severity, benefits, barriers, and health motivation, accessibility to personal protective equipment for COVID-19 and preventative measures against COVID-19 from other agencies were associated with good COVID-19 preventive behaviors among taxi-driver in Bangkok during COVID-19 pandemic (R ² = 0.349, p = 0.008). The model could predict 34.9% of variance in COVID-19 preventative behavior among taxi drivers.

Conclusion

Taxi drivers should be encouraged to engage in appropriate preventive behaviors against COVID-19, emphasizing the individual and organizational levels. There should be a policy by organizations to promote the implementation of COVID-19 safety control standards to ensure safe working conditions. In addition, appropriate welfare benefits should be provided for taxi drivers, such as loans, personal protective equipment, and access to health services to improve COVID-19 preventive behaviors.

Impact of Post-Covid-19 on driver behaviour: A perspective towards pandemic-sustained transportation

INTRODUCTION

With the announcement of novel Coronavirus disease 2019 (Covid-19) as a pandemic by World Health Organization (WHO) in March 2020, the whole world went into a lockdown that heavily affected human economic and social life. Since December 2020, with the discovery of effective vaccines, the world is now returning to some normality, particularly for those who are vaccinated. The multimodal transportation has resumed with majority of vaccinated drivers being back on road, driving to their work, and providing transport services. However, there are still several long-term Post-Covid-19 factors, affecting driver health and psychology.

METHODS

The study deployed a systematic search strategy and selected 62 research publications after rigorous evaluation of the literature. The review was based on (1) forming the inclusion and exclusion criteria, (2) selecting the appropriate keywords, and (3) searching of relevant publications and assessing the eligible articles.

RESULTS

A broad perspective study is carried out to gauge the impact of Post-Covid-19 scenarios on the driver physical health and mindset in the context of road safety and pandemic-sustained transportation. It was found that the Post-Covid-19 factors such as wearing face-mask during driving, taking oral anti-viral drugs, and fear of contracting disease, significantly impact the driver's performance and situation awareness skills. The analysis suggested that driver's health vitals and psychological driving awareness can be precisely detected through hybrid driver state monitoring methods.

CONCLUSIONS

The paper conducts a comprehensive review of the published work and provides unique research opportunities to counteract the challenges involved in precise monitoring of driver behaviour under the effects of different Post-Covid-19 factors. The perspective suggested the possible solutions to live with the pandemic in the context of pandemic-sustained transportation.

Cloud-based COVID-19 disease prediction system from X-Ray images using convolutional neural network on smartphone

COVID-19 has engulfed over 200 nations through human-to-human transmission, either directly or indirectly. Reverse Transcription-polymerase Chain Reaction (RT-PCR) has been endorsed as a standard COVID-19 diagnostic procedure but has caveats such as low sensitivity, the need for a skilled workforce, and is time-consuming. Coronaviruses show significant manifestation in Chest X-Ray (CX-Ray) images and, thus, can be a viable option for an alternate COVID-19 diagnostic strategy. An automatic COVID-19 detection system can be developed to detect the disease, thus reducing strain on the healthcare system. This paper discusses a real-time Convolutional Neural Network (CNN) based system for COVID-19 illness prediction from CX-Ray images on the cloud. The implemented CNN model displays exemplary results, with training accuracy being 99.94% and validation accuracy reaching 98.81%. The confusion matrix was utilized to assess the models' outcome and achieved 99% precision, 98% recall, 99% F1 score, 100% training area under the curve (AUC) and 98.3% validation AUC. The same CX-Ray dataset was also employed to predict the COVID-19 disease with deep Convolution Neural Networks (DCNN), such as ResNet50, VGG19, InceptonV3, and Xception. The prediction outcome demonstrated that the present CNN was more capable than the DCNN models. The efficient CNN model was deployed to the Platform as a Service (PaaS) cloud.

Factors affecting face mask-wearing behaviors to prevent COVID-19 among Thai people: A binary logistic regression model

OBJECTIVES

Face mask wearing is a standard preventive measure, in addition to handwashing and physical distancing. Individuals may find that wearing a face mask protects their physical health and prevents viral transmission. However, none of the studies in Thailand identified factors associated with face mask-wearing behaviors among Thai people. Therefore, this study aims to determine factors affecting face mask-wearing behaviors to prevent COVID-19.

METHODS

This research is analytical survey research. The data used in this study were under the project title "The assessment of psychosocial and behavioral response and compliance to restriction measures to prevent and control COVID-19: A series of the rapid survey." A total of 6,521 people participated in an online survey by multi-stage sampling. Bivariate logistic regression analysis was used to examine the factors associated with face mask-wearing behaviors.

RESULTS

After adjusting for independent variables (i.e., gender, age, education, career, smoking, and comorbidity disease), the bivariate logistic regression analysis revealed that gender, age, and career were statistically significant to the face mask-wearing behaviors (p < 0.05). Level of education, smoking, and comorbidity disease were not statistically significant with face mask-wearing behaviors among Thai people.

CONCLUSION

Further study should explore broader on individual face mask perceptions and wearing in the continuing of COVID-19 across gender, age, and careers to better understand their health behaviors and to inform further policy. In addition, the development of an intervention to promote face mask wearing should target men who age below 30 yrs. and did not work in government services careers as this group of the population was likely not to wear a face mask outside the home.

Transmission and control of SARS-CoV-2 on ground public transport: A rapid review of the literature up to May 2021

BACKGROUND

During a pandemic, public transport is strategically important for keeping the country going and getting people where they need to be. The essential nature of public transport puts into focus the risk of transmission of SARS-CoV-2 in this sector; rapid and diverse work has been done to attempt to understand how transmission happens in this context and what factors influence risk.

OBJECTIVES

This review aimed to provide a narrative overview of the literature assessing transmission, or potential for transmission, of SARS-CoV-2 on ground-based public transport, as well as studies assessing the effectiveness of control measures on public transport during the early part of the pandemic (up to May 2021).

METHODS

An electronic search was conducted using Web of Science, Ovid, the Cochrane Library, ProQuest, Pubmed, and the WHO global COVID database. Searches were run between December 2020 and May 2021.

RESULTS

The search strategy identified 734 papers, of which 28 papers met the inclusion criteria for the review; 10 papers assessed transmission of SARS-CoV-2, 11 assessed control measures, and seven assessed levels of contamination. Eleven papers were based on modelling approaches; 17 studies were original studies reporting empirical COVID-19 data.

CONCLUSIONS

The literature is heterogeneous, and there are challenges for measurement of transmission in this setting. There is evidence for transmission in certain cases, and mixed evidence for the presence of viral RNA in transport settings; there is also evidence for some reduction of risk through mitigation. However, the routes of transmission and key factors contributing to transmission of SARS-CoV-2 on public transport were not clear during the early stage of the pandemic. Gaps in understanding are discussed and six key questions for future research have been posed. Further exploration of transmission factors and effectiveness of mitigation strategies is required in order to support decision making.

COVID-19 Vaccine Acceptance and Associated Factors Among College Students in Dessie City, Northeastern Ethiopia

Background

The COVID-19 vaccine is regarded as an effective measure for reducing the pandemic’s impact. But, COVID-19 disease burden reduction efforts are being affected by the rising vaccine resistance.

Objective

To assess the COVID-19 vaccine acceptance and associated factors among college students in Dessie city, Northeastern Ethiopia.

Methods

An institutional-based cross-sectional study was carried out among college students in Dessie town from July 1–20, 2021. The association between independent and dependent variables was assessed by binary logistic regression analysis using crude odds ratio and adjusted odds ratio. Variables having p values of less than 0.05 at the 95% confidence interval were regarded as potential determinants of COVID-19 vaccine acceptance.

Results

A total of 422 college students participated in the study with a response rate of 95.6%. More than half 226 (56.2%) of the participants had willingness to accept COVID-19 vaccine. Respondents who had history of chronic medical illness (AOR: 4.340, 95% CI: 1.166, 16.149), training on COVID-19 vaccine (AOR: 4.755, 95% CI: 2.606, 6.674), history of regular vaccine uptake (AOR: 2.534, 95% CI: 1.412, 4.549), perception of COVID-19 severity (AOR: 4.109, 95% CI: 2.190, 7.710), perception that COVID-19 can be prevented by vaccine (AOR: 2.420, 95% CI: 1.160, 5.049), and development of herd immunity against COVID-19 vaccines (AOR: 2.566, 95% CI: 1.431, 4.599) were factors significantly associated with COVID-19 vaccine acceptance.

Conclusion

The acceptance of COVID-19 vaccine among college students was low. The history of chronic medical illness, training on COVID-19 vaccine, history of vaccine uptake, perception that COVID-19 can be prevented by vaccine, perception of herd immunity development against COVID-19, and severity of COVID 19 infection were factors significantly associated with the acceptance of COVID-19 vaccine. Hence, it is necessary to promote COVID-19 vaccination among college students through health education and vaccine outreach.

A systematic review of observational methods used to quantify personal protective behaviours among members of the public during the COVID-19 pandemic, and the concordance between observational and self-report measures in infectious disease health protection

OBJECTIVES

To assess the quantity and quality of studies using an observational measure of behaviour during the COVID-19 pandemic, and to narratively describe the association between self-report and observational data for behaviours relevant to controlling an infectious disease outbreak.

DESIGN

Systematic review and narrative synthesis of observational studies.

DATA SOURCES

We searched Medline, Embase, PsychInfo, Publons, Scopus and the UK Health Security Agency behavioural science LitRep database from inception to 17th September 2021 for relevant studies.

STUDY SELECTION

We included studies which collected observational data of at least one of three health protective behaviours (hand hygiene, face covering use and maintaining physical distance from others ('social distancing') during the COVID-19 pandemic. Studies where observational data were compared to self-report data in relation to any infectious disease were also included.

DATA EXTRACTION AND SYNTHESIS

We evaluated the quality of studies using the NIH quality assessment scale for observational studies, extracted data on sample size, setting and adherence to health protective behaviours, and synthesized results narratively.

RESULTS

Of 27,279 published papers on COVID-19 relevant health protective behaviours that included one or more terms relating to hand hygiene, face covering and social distancing, we identified 48 studies that included an objective observational measure. Of these, 35 assessed face covering use, 17 assessed hand hygiene behaviour and seven assessed physical distancing. The general quality of these studies was good. When expanding the search to all infectious diseases, we included 21 studies that compared observational versus self-report data. These almost exclusively studied hand hygiene. The difference in outcomes was striking, with self-report over-estimating observed adherence by up to a factor of five in some settings. In only four papers did self-report match observational data in any domains.

CONCLUSIONS

Despite their importance in controlling the pandemic, we found remarkably few studies assessing protective behaviours by observation, rather than self-report, though these studies tended to be of reasonably good quality. Observed adherence tends to be substantially lower than estimates obtained via self-report. Accurate assessment of levels of personal protective behaviour, and evaluation of interventions to increase this, would benefit from the use of observational methods.

Assessing the dynamic impacts of non-pharmaceutical and pharmaceutical intervention measures on the containment results against COVID-19 in Ethiopia

The rapid spread of COVID-19 in Ethiopia was attributed to joint effects of multiple factors such as low adherence to face mask-wearing, failure to comply with social distancing measures, many people attending religious worship activities and holiday events, extensive protests, country election rallies during the pandemic, and the war between the federal government and Tigray Region. This study built a system dynamics model to capture COVID-19 characteristics, major social events, stringencies of containment measures, and vaccination dynamics. This system dynamics model served as a framework for understanding the issues and gaps in the containment measures against COVID-19 in the past period (16 scenarios) and the spread dynamics of the infectious disease over the next year under a combination of different interventions (264 scenarios). In the counterfactual analysis, we found that keeping high mask-wearing adherence since the outbreak of COVID-19 in Ethiopia could have significantly reduced the infection under the condition of low vaccination level or unavailability of the vaccine supply. Reducing or canceling major social events could achieve a better outcome than imposing constraints on people's routine life activities. The trend analysis found that increasing mask-wearing adherence and enforcing more stringent social distancing were two major measures that can significantly reduce possible infections. Higher mask-wearing adherence had more significant impacts than enforcing social distancing measures in our settings. As the vaccination rate increases, reduced efficacy could cause more infections than shortened immunological periods. Offsetting effects of multiple interventions (strengthening one or more interventions while loosening others) could be applied when the levels or stringencies of one or more interventions need to be adjusted for catering to particular needs (e.g., less stringent social distancing measures to reboot the economy or cushion insufficient resources in some areas).

Hand hygiene practices during the COVID-19 pandemic and associated factors among barbers and beauty salon workers in Ethiopia

Coronavirus disease-2019 (COVID-19) is still causing morbidity and mortality all over the world. Preventive measures such as wearing a facemask, social distancing and hand hygiene continue to be the only options available in countries such as Ethiopia where vaccines are not yet widely available. Hand hygiene is one of the easiest and cheapest preventive measures, and one that is especially important for barbers and beauty salon workers who are widely exposed to the virus due to their contact with many customers. Therefore, measuring the proportion of good hand hygiene practices and associated factors among barbers and beauty salon workers may provide essential guidance in the development of effective interventions to improve COVID-19 prevention measures. A facility-based cross-sectional study was conducted among 410 barbers and beauty salon workers in Dessie City and Kombolcha Town from January 5 to February 10, 2021. The study participants were selected using a simple random sampling technique. A structured questionnaire and an observational checklist were used to collect the data. The collected data were entered into EpiData version 4.6 and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Logistic regression analysis using bivariate and multivariable logistic regression models was employed. From the bivariate analysis, variables with p <0.25 were retained into multivariable logistic regression analysis. Finally, from the multivariable analysis, variables that had a p-value < 0.05 were declared as factors significantly associated with good hand hygiene practices. Of the total 410 barbers and beauty salon workers, 52.9% [95% CI: 48.3–57.6] had good hand hygiene practices whereas 47.1% [95% CI: 42.4–51.7] had poor hand hygiene practices. From the total respondents, more than half 250 (61%) were male and 160 (39%) were female, with a mean age of 27.42 ±7.37 years. Out of 410 barbers and beauty salon workers, 73.7% had good knowledge about COVID-19 and 59.5% had a positive attitude towards taking precautions against COVID-19. Female sex (AOR = 2.17, 95% CI:1.29–3.65), educational level of college or above (AOR = 5.53, 95% CI:2.85–10.71), positive attitude towards taking precautions against COVID-19 (AOR = 2.4, 95% CI:1.46–4.17), belief in the effectiveness of hand hygiene practices (AOR = 3.78, 95% CI:2.18–6.55) and presence of a hand-washing facility with soap and water (AOR = 5.55, 95% CI:3.28–9.40) were factors significantly associated with good hand hygiene practices among barbers and beauty salon workers. The proportion of good hand hygiene practice was not sufficient to combat the virus. Good hand hygiene practice was higher among those with higher educational level, positive attitude towards taking precautions against COVID-19, belief in the effectiveness of hand hygiene practices, presence of a hand-washing facility with soap and water and those of female sex. Thus, improving hand hygiene practices through continued training, especially for those with a lower educational level and for male workers, is recommended. Moreover, government and non-government organizations should work together to provide alcohol-based hand sanitizer at a low cost to those barbershops and beauty salons if there is no access to water and soap.

COVID-19 Preventive Behaviors and Influencing Factors in the Thai Population: A Web-Based Survey

Objectives

To identify factors influencing COVID-19 preventive behaviors among the Thai population.

Methods

A cross-sectional web-based survey was used. A total of 6,521 Thai people completed the survey. The multiple linear regression analysis was performed to identify factors that influenced coronavirus disease 2019 (COVID-19) preventive behaviors. The Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model was applied to propose factors influencing COVID-19 preventive behaviors.

Results

The factors that mostly influenced COVID-19 prevention behaviors when controlling for the other variables are social support (β = 0.173, p < 0.001) follow by age (β = 0.162, p < 0.001), flu-like symptoms (β = 0.130, p < 0.001), gender (β = -0.084, p < 0.001), perceived risk of exposure (β = 0.035, p < 0.05), lock down policy (β = 0.029, p < 0.05), and residential area (β = -0.027, p < 0.05), respectively. These factors explained 52% of the COVID-19 preventive behaviors in Thai population.

Conclusion

The result of this study was a foundation for further studies on different groups of people to develop different strategies to adopt preventive behaviors to reduce the spread of the COVID-19.

Knowledge, Attitudes, and Misconceptions About COVID-19 Prevention Practices Among High and Preparatory School Students in Dessie City, Ethiopia

Background

Knowledge, attitudes, and misconceptions of students about COVID-19 (coronavirus disease) prevention have been examined in relatively few studies. This study aimed to assess the knowledge, attitudes and misconceptions about COVID-19 prevention practices among high and preparatory school (grades 9 to 12) students in Dessie City, Ethiopia.

Methods

This school-based cross-sectional study used a pre-tested structured questionnaire and direct observations from March 1 to 30, 2021 in 5 high and preparatory school students in Dessie City, Ethiopia. The sample size was proportionally allocated in each school based on the number of students registered in the first semester, stratified by grade level, and section. Data analysis employed 3 binary logistic regression models (Models I, II and III) with 95% CI (confidence interval). Bivariate analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were used. Variables with P-values <0.3 in the bivariate analysis were retained in the multivariable logistic regression analysis for each model. Variables with significance levels P<0.05 in the multivariable analysis of each model was identified as significant factors.

Results

The levels of good knowledge, positive attitudes, and low misconceptions were 74.8%, 60.2%, and 56.1%, respectively. After adjusting for the covariates, grade 12, positive attitude and living in households with more than 5 members were identified as factors significantly associated with good knowledge about COVID-19 prevention practices. Good knowledge of COVID-19 prevention practices, household size >5, infection prevention and control (IPC) training, and low level of misconceptions were factors significantly associated with positive attitudes, whereas students age ≥18 years, positive attitude, and IPC training were factors significantly associated with less misconceptions about COVID-19 prevention measures.

Conclusion

The prevalence of good knowledge, positive attitude, and low level of misconceptions of prevention practices for COVID-19 among students was relatively low. Therefore, Dessie City Health and Education Department and each high and preparatory school should implement continuous monitoring programs to ensure high prevention awareness and promote preventive behavior towards COVID-19.

Assessing face mask littering in urban environments and policy implications: The case of Bangkok

Face mask usage is one of the preventive measures encouraged worldwide to limit the transmission of the SARS-Cov-2 pandemic. Hence, production and mass use of face masks is on the rise due to the pandemic as well as government rules that mandate citizens to wear face masks. However, the improper disposal of face masks has been polluting the environment with enormous hazardous waste. In this study, a face mask littering assessment in an urbanized environment, Bangkok, was carried out. Three streets in the city were selected and observed for face mask littering for 5 h per day for 42 days. Moreover, a questionnaire from 605 participants was recorded to determine mask handling and disposal practices. The study found a total of 170 single-use face masks within a 13.30 km path. Furthermore, the highest (40) and lowest (17) cumulative litter were recorded on Sunday and Monday, respectively. Buffer analysis at 300 m showed 47% of mask litter was found within five mass transit stations, while 15% are within a single street market. Of 605 respondents, 82.15% used a single-use face mask. Surprisingly, most of them (70.58%) disposed of used face masks in regular bins along with their household waste. The results highlight three policy implications to tackle the growing problem: raising awareness, regulation, and provision of bins designed for used face masks in strategic places and supporting innovations and research for eco-friendly face masks.

Knowledge, Attitude, and Practice Towards Face-Mask Use Amid the Coronavirus 2019 Pandemic Among Public Transport Drivers in Gondar Town, A Cross-Sectional Study

Background. Coronavirus disease (COVID-19) is a highly communicable virus that continues to interrupt livelihoods, predominantly those of low-income segments of society. For the prevention of respiratory infections like the current COVID-19 outbreak, face masks are considered an effective approach.

Objective. This study intended to assess the knowledge, attitude, and practice of public transport drivers towards face mask use amid the COVID-19 pandemic in Gondar, Ethiopia.

Methods. A cross-sectional study was conducted among 412 public transport drivers in Gondar town from July to September 2021. The study subjects were recruited using a simple random sampling technique after proportionally allocating the sample size from the total number of public transport drivers, and finally, study subjects were selected using the convenience sampling method to select the participant drivers working in Gondar Town. The data were collected by face-to-face interview administered questioners and an on-the-spot observational checklist.

Results. A total of 412 public transport drivers have participated in the study. The mean age of the respondents was 32.75 years (±8.75 years). The majority of the participants were Bajaj drivers 193 (46.84%). Among the responders, 114 (27.67%) of them use radio to gather information about the pandemic and 50 (12.14%) of them had reported being caught by COVID-19. Meanwhile, only 32 (7.77%) were vaccinated against COVID-19. Drivers that had a diploma level of education were found to be 87.7% less knowledgeable than degree holders (AOR .123, 95% CI = .026, .573). Respondents that had good knowledge about COVID-19 and face masks were found to have 1.7 times more positive attitudes than those that had poor knowledge (AOR = 1.728, 95% CI = 1.150, 2.596). drivers whose family members have ever been caught by COVID-19 were found 2 times more likely to use face masks whenever they are working/driving (AOR = 2.173, 95% CI = 1.015, 4.652) than their counterparts.

Conclusion. This study revealed a very low Knowledge, attitude, and practice of face mask use among public transport drivers in Gondar town. Periodic reinforcement and training programs are needed for all public transport drivers in each level for proper understanding and adherence to COVID-19 prevention protocols and the use of face masks.

"In our culture, if you quarantine someone, you stigmatize them": Qualitative insights on barriers to observing COVID-19 prevention behaviors in Côte d'Ivoire

While vaccines are now authorized for use against the SARS-CoV2 virus, they remain inaccessible for much of the world and widespread hesitancy persists. Ending the COVID-19 pandemic depends on continued prevention behaviors such as mask wearing, distancing, hand hygiene, and limiting large gatherings. Research in low- and middle-income countries has focused on the prevalence of adherence and demographic determinants, but there is a need for a nuanced understanding of why people do or do not practice a given prevention behavior. The Breakthrough ACTION project led by Johns Hopkins Center for Communication Programs conducted a qualitative study in November 2020 in Côte d'Ivoire to explore people's experience with and perceptions of the COVID-19 pandemic. We conducted 24 focus group discussions and 29 in-depth interviews with members of the general population and health providers. This analysis explores barriers and facilitators to seven recommended prevention behaviors with a particular focus on response efficacy, self-efficacy, and social norms. We found these constructs to be salient for participants who generally felt that the behaviors were useful for preventing COVID-19 but were difficult to practice for a variety of reasons. The perception that COVID-19 prevention behaviors were anti-social emerged as a key theme. Behavior change interventions must reframe the recommended behaviors as pro-social, while making them very easy to practice by removing social and structural barriers such as the expense or inaccessibility of masks and hand sanitizer.

Facemask-wearing behavior to prevent COVID-19 and associated factors among public and private bank workers in Ethiopia

Background

Given widespread vulnerability to COVID-19 infection in areas with low vaccination rates, facemask wearing is repeatedly emphasized for the general population including bank workers, who have contact with many customers each day. Over the first year of the COVID-19 pandemic, studies focused on facemask wearing among healthcare workers but not among bank workers, who are also at risk of COVID-19. To address this gap and to consider intervention measures that encourage the wearing of facemasks, this study was conducted to identify behaviors of facemask wearing and associated factors among bank workers in Dessie City, Ethiopia.

Materials and methods

An institution-based cross-sectional study was conducted among 413 bank workers who were selected using a simple random sampling technique from January 1^st to 30^th, 2021 in Dessie City, Ethiopia. Data were collected using a structured questionnaire and on-the-spot observational checklist. The collected data were checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. Data were analyzed using bivariable (crude odds ratio [COR]) and multivariable (adjusted odds ratio [AOR]) logistic regression model at 95% confidence interval (CI). Variables from the bivariable analysis with a p-value <0.25 were considered for multivariable analysis. Then, variables that had a p-value <0.05 were declared as factors significantly associated with behavior of facemask wearing.

Main findings

In this study, the behavior of facemask wearing among bank workers was 50.4% [95%CI: 45.3–55.2%] with 21.1% always wearing a facemask, 72.4% sometimes, and 6.5% never. A majority of the bank workers 350 (84.7%) had good knowledge of COVID-19 and half of them 208 (50.4%) had a positive attitude towards taking precautions against COVID-19. Just over two-thirds of the respondents 284 (68.8%) preferred to wear a non-medical mask. Two hundred fifty-five (61.7%) said wearing a facemask interfered with communication and 259 (62.7%) felt that wearing a facemask was not comfortable. Facemask-wearing behavior was significantly associated with a high level of positive attitude towards taking precautions against COVID-19 (AOR = 3.27, 95% CI: 1.75–6.11), the perception that the consequences of getting COVID-19 could be serious (AOR = 4.87, 95% CI: 2.38–9.94), the presence of chronic illness (AOR = 2.19, 95% CI: 1.07–4.48), sex being female (AOR = 1.87, 95% CI: 1.06–3.32) and age being greater or equal to 35 years (AOR = 9.25, 95% CI: 4.79–17.88).

Conclusion

The main finding of the study showed that the behavior of facemask wearing among bank workers was relatively low (50.4%) compared to other types of workers as found in other studies. To increase the behavior of facemask wearing among bank workers, health decision makers need to develop updated guidance for promotion of facemask wearing to increase the practical and appropriate use of facemasks among bank workers. Bank managers and concerned government bodies should enforce mask use to change behavior of these workers.

COVID-19 knowledge, attitude and frequent hand hygiene practices among taxi drivers and associated factors in urban areas of Ethiopia

BACKGROUND

Although several studies have been conducted on COVID-19 knowledge, attitude and prevention practices among healthcare workers and the general population, there has not been any study among taxi drivers in Ethiopia, including Dessie City and Kombolcha Town, the lack of which hinders providing evidence-based interventions to this target group. Thus, this study was designed to contribute to proper planning of COVID-19 intervention measures among taxi drivers in Dessie City and Kombolcha Town, Ethiopia.

METHODS

A cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town during July to August, 2020. The data was collected using a structured questionnaire and an observational checklist. The collected data was checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The outcome variables of this study were good or poor knowledge, positive or negative attitude and good or poor frequent hand hygiene practices towards COVID-19. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analysis were employed to identify factors significantly associated with good knowledge, positive attitude and good frequent hand hygiene practices among taxi drivers. Significance level of variables was declared at a p < 0.05 from the adjusted analysis.

MAIN FINDINGS

Out of the total 417 taxi drivers, 69.8% [95% CI: 65.2-73.9], 67.6% [95%CI: 63.1-72.2] and 66.4% [95% CI: 62.1-71.0] of the drivers had good knowledge, positive attitude and good frequent hand hygiene practices, respectively. Educational level (AOR = 7.55, 95% CI = 4.55-12.54), place of residence (AOR = 5.41, 95% CI = 1.4-20.08) and attitude towards COVID-19 prevention (AOR = 1.67, 95% CI = 1.02-2.74) were factors associated with good knowledge about COVID-19. Further, age of taxi drivers greater than 30 years (AOR = 3.01, 95% CI = 1.76-5.13), educational level of secondary or above (AOR = 3.16, 95% CI = 1.88-5.31), income (AOR = 3.36, 95% CI = 1.48-7.61), and knowledge about COVID-19 (AOR = 2.1, 95% CI = 1.21-3.54) were factors associated with positive attitude towards COVID-19 prevention. In addition, attitude towards COVID-19 (AOR = 5.5, 95% CI = 3.40-8.88) and educational level (AOR = 1.84, 95% CI = 1.15-2.95) were the factors associated with good frequent hand hygiene practices.

CONCLUSION

We concluded that the rates of good knowledge, positive attitude and good frequent hand hygiene practices were relatively low among taxi drivers in Dessie City and Kombolcha Town. We strongly recommended providing training about COVID-19 prevention measures for taxi drivers that considers age, education status and attitude areas essential to improve their knowledge, attitude and frequent hand hygiene practices to prevent the spread of COVID-19.

"Public Health Behaviors during the COVID-19 Pandemic in Greece and Associated Factors: A Nationwide Cross-sectional Survey"

The objective of this cross-sectional survey was to estimate the association between multiple socioeconomic, and health-related characteristics, COVID-19 related attitudes and adoption of public health preventive behaviors. A national cross-sectional survey among 1205 adults was conducted in April 2020 in Greece. Multivariable ordered logistic regression models were used to estimate the association between COVID-19 related attitudes and knowledge and adoption of preventive behaviors, controlling for socioeconomic and health-related characteristics. A total of 923 individuals fully completed the survey. Individuals who believed that the virus is out of control, is transmitted through the air, and is not similar to the common flu were more likely to adopt public health preventive behaviors more frequently, particularly wearing masks in public spaces, washing their hands, and spending fewer hours out of their homes. Uncertainty about the virus symptomatology was associated with less frequent mask-wearing and handwashing. Increased social support, frequent media use for COVID-19 updates, trust to authorities, older age, worse health status, female gender and being a healthcare professional were also associated with uptake of some preventive health behaviors. Attitudinal and socioeconomic determinants critically affect public engagement in preventive behaviors. Health policy initiatives should focus on community outreach approaches to raise awareness and to strengthen social support mechanisms by integrating multiple stakeholders.