Knowledge, attitude, and practice of healthcare workers toward COVID-19 and its prevention in Ethiopia: A multicenter study

COVID-19 prevention and preparedness among healthcare workers in Sierra Leone

Background

Sierra Leone's health system has faced significant challenges, including the long-term impacts of the 2014 Ebola outbreak, prolonged conflicts before that, and economic factors contributing to the fragility of healthcare systems in many low-income settings. This qualitative study explores COVID-19 prevention practices among healthcare workers in the context of their past experiences with disease outbreaks.

Aim

This study aims to understand COVID-19 prevention practices among healthcare workers in Sierra Leone and how their past experiences with disease outbreaks influence these practices.

Setting

The study was conducted in three districts of Sierra Leone - Freetown, Makeni and Kenema - focusing on healthcare workers in a low-income setting with ongoing public health challenges.

Methods

In-depth interviews were conducted with 24 healthcare workers, and the data were analysed for themes using the Health Belief Model and Theory of Planned Behaviour.

Results

Healthcare workers demonstrated positive attitudes and strict adherence to infection prevention measures, influenced by their Ebola outbreak experience. Barriers included limited personal protective equipment and social disapproval.

Conclusion

Interventions should focus on improving access to infection prevention tools and combating disapproval through community engagement. These findings are crucial for enhancing infectious disease prevention among healthcare workers in low-income settings.

Contribution

This study provides insights into how past outbreak experiences influence disease prevention practices among healthcare workers in Sierra Leone, highlighting the need to address adherence barriers. These findings contribute to a broader understanding of infectious disease prevention in low-income settings and enhance global efforts in preparing for future public health emergencies.

COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study

The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.

Healthcare workers' compliance with COVID-19 prevention and control measures at De Martino Hospital, Mogadishu, Somalia: a cross-sectional study

BACKGROUND

Healthcare workers are a high-risk group for COVID-19 and protecting them is crucial for healthcare delivery. Limited studies have explored compliance with infection prevention and control (IPC) practices among Somali healthcare workers. This study aimed to determine compliance with IPC practices among healthcare workers in De Martino Public Hospital, Somalia.

METHODS

A cross-sectional study was conducted at the De Martino Public Hospital, Mogadishu, Somalia from August to October 2022, with the participation of 204 healthcare workers (response rate = 97%). Compliance was assessed using responses to 25 questions on a five-point Likert-type scale, and a median score of 20 was used to dichotomize compliance scores. A chi-square test and logistic regression analysis were performed to check the associations between healthcare workers' socio-demographic information, IPC-related factors, work conditions and practices on COVID-19, and IPC compliance during healthcare interventions using SPSS 23 version.

RESULTS

In total, 58.3% of the participants had good compliance with IPC. There were significant associations between IPC compliance and the type of healthcare worker (doctors and doctor assistants: 72.3%, nurses and paramedical staff: 67.3%, non-clinical staff: 5.7%, p < 0.01). After adjusting for potential confounding factors, compared to non-clinical staff, doctors and doctor assistants (OR: 12.11, 95% CI: 2.23-65.84) and nurses and paramedical staff (OR: 21.38, 95% CI: 4.23-108.01) had higher compliance with IPC measures. There were no significant associations between compliance and sex, marital status, vaccination status, or smoking (p > 0.05 for all).

CONCLUSIONS

Low levels of compliance with COVID-19 IPC measures were observed among hospital workers. Prioritizing awareness campaigns and behavior change interventions, especially among non-clinical staff, is crucial for effective COVID-19 infection prevention and control within hospitals.

Practice of COVID-19 prevention measures and its factors in long-distance truck drivers of Tigray

Introduction

long-distance truck drivers are a population group that moves in and out of a country and can meet with different individuals and can easily expose to COVID-19. Therefore, this study aimed to assess the level of practice and associated factors towards COVID-19 prevention measures in long-distance truck drivers of Tigray.

Methods

this is a cross-sectional study conducted on 350 long-distance truck drivers recruited by systematic random sampling in the Mekelle entry point from July 5th to July 20th 2020. Variables with a p-value ≤0.30 in the bivariate regression analysis were entered into the final model of logistic regression to recognize factors. All associations with the practice of COVID-19 prevention were tested for statistical significance with alpha set at the 0.05 level.

Results

around 293 (83.7%) with a 95% CI of (79.7-87.6%) of the long-distance truck drivers who participated in this study had good practice towards COVID-19 prevention measures. Having a previous test for COVID-19 is positively significantly associated with good practice towards COVID-19 prevention methods. However, individuals who had a history of COVID-19-like symptoms in the last four months and who have non-communicable diseases are 78% and 84% of the time less likely to practice COVID-19 prevention measures respectively.

Conclusion

based on this study, the practice of COVID-19 prevention measures among the long-distance truck drivers of Tigray was very good. The results of this study suggest that more emphasis should be placed on drivers who have non-communicable diseases and providing COVID-19-like symptoms to the drivers.

Knowledge, attitudes and practices towards COVID-19 among healthcare workers: A cross-sectional survey from Kiambu County, Kenya

BACKGROUND

The knowledge possessed by healthcare workers (HCWs), along with their attitudes and practices play a vital role in effectively managing a pandemic. This is crucial considering that HCWs are exposed to great risk at the forefront of such crises. We aimed to describe the knowledge, attitude, and practices (KAP) of HCWs during the COVID-19 pandemic in Kiambu county, Kenya.

METHODS

A cross-sectional study using a structured questionnaire was conducted from 11th March 2021 to 12th August 2021. Bloom's cutoff points were used to determine KAP scores (>80%: good, 60-79%: medium and <60% poor). Multivariable ordinal logistic regression analyses were conducted, calculating adjusted odds ratios (AOR) at a 95% confidence interval. Spearman's rank correlations were used to examine the relationship between KAP scores.

RESULTS

438 HCWs participated in the study, majority of whom were female (64.5%), had obtained a diploma (59.6%) and were informed through government websites (78.6%). 43.0% had good knowledge, 17.5% good attitudes, and 68.4% good practice. 23.0% had medium knowledge, 35.6% medium attitude, 15.7% medium practice, while 34.0% had poor knowledge, 46.9% poor attitude and 15.9% poor practice. Only 68.9% of the caregivers correctly recognized the county's COVID-19 isolation centre and only 7.9% chose the two correct documents for the entry of data for a suspected COVID-19 case. Furthermore, the general attitude towards their own personal safety and their training regarding PPEs (17.8% and 23.8% strongly agreed with the contrary) were less compelling. There was a significant positive association between obtaining information from international government sites [AOR: 1.382 (1.058-1.807); p = 0.0178)] and good knowledge. Referring to local government sites for information regarding COVID-19 produced better attitudes [AOR: 1.710 (1.194-2.465); p = 0.0036] and produced almost twice the odds of having better practice [AOR: 1.800 (1.181-2.681); p = 0.0048]. There was a significant correlation between knowledge and practice (r = -0.330, p = 2.766×10-11), and knowledge and attitude (r = -0.154, p = 6.538×10-3).

CONCLUSION

This study emphasizes the substantial impact that governing bodies have on shaping favorable KAP. As a result, it's crucial for local government platforms to prioritize the dissemination of up-to-date information that aligns with international standards. This information should be tailored to the specific region, focusing on addressing deficiencies in healthcare practices and patient management. The identification of a significant number of HCWs lacking confidence in managing COVID-19 patients and feeling unprotected underscores a clear need for improvement in their understanding and implementation of preventive measures. This gap can be bridged by adequately equipping HCWs with locally manufactured PPEs. This aspect is crucial for pandemic preparedness, and we further advocate for the creation of a locally produced repository of medical equipment. These actions are pivotal in improving future crisis management capabilities.

Knowledge, attitudes and practices of French university students towards COVID-19 prevention-are health students better?

During the COVID-19 outbreak in 2020, public health measures (PHM) were implemented to prevent the spread of SARS-CoV-2. At university, we wondered whether health students would be more likely to comply with these safety measures against infectious disease transmission compared to other students. Thus, we collected 1 426 university students' responses to an online anonymous survey to describe their knowledge, attitudes and practices (KAP) of COVID-19 prevention measures and to compare the opinions and practices of health students and science students at the same university of Rouen Normandy (France). A higher proportion of science students (84.6%) compared to health students (73.9%) reported knowledge of the university's COVID-19 protocol, p<0.001. However, the health students compared to science students reported a higher compliance with PHM at home (91.4% vs 88.0%) and at university (94.1% vs 91.1%). In a multiple regression analysis, after adjustment for age, sex and university department, factors associated with higher compliance with PHM were knowledge of the university's COVID-19 protocol and a high perceived efficacy of PHM. A SARS-CoV-2 PCR result was not predictive of compliance with PHM. The results of this online survey in French students show a high level of knowledge and practices of COVID-19 prevention Although their performances could still be improved by training, the good results of health students regarding knowledge, attitudes and practices are encouraging as these students could be an added backup force to fight against viral pandemics.

Knowledge, attitude, and practices toward infection prevention and control among undergraduate pharmacy students in Zambia: findings and implications

Background

Infection prevention and control (IPC) measures are critical in preventing the risk of acquiring and transmitting nosocomial infections. In Zambia, there is little information concerning IPC practices among pharmacy students who are exposed to potentially infectious areas both in public and private healthcare settings. Therefore, this study assessed the knowledge, attitude, and practices of undergraduate pharmacy students toward infection prevention and control at the University of Zambia.

Materials and methods

This cross-sectional study was conducted among 290 undergraduate pharmacy students at the University of Zambia using a structured questionnaire from August 2022 to October 2022. Data analysis was performed using SPSS version 25.0, and statistical significance was set at a 95% confidence level.

Results

Of the 290 participants, 166(57.2%) were female and the majority were aged between 18 and 23 years. Overall, 252(86.9%) had good knowledge, 167(57.6%) had positive attitudes, and 248(85.5%) had good practices toward IPC measures. These results indicate lower attitude scores compared to knowledge and practices. Having good knowledge of IPC was associated with being a Christian by religion compared to other religions (OR = 5.314, 95% CI: 1.141-24.745). There was no association between sociodemographics and attitude and practice concerning IPC.

Conclusion

This study found that pharmacy students had good knowledge, positive attitudes, and good practices toward IPC measures. Consequently, more emphasis is needed to improve the student's knowledge, attitudes, and practices toward IPC, especially in areas where gaps were identified. Additionally, there is a need to improve curricula on IPC measures in the training of pharmacy programs.

Adherence to infection prevention and control measures and risk of exposure among health-care workers: A cross-sectional study from the early period of COVID-19 pandemic in Addis Ababa, Ethiopia

BACKGROUND AND AIM

Healthcare workers (HCWs) are considered a high-risk group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, ascribed to the amount of time they spend in health-care facilities (HCFs). This study aimed to assess HCWs' compliance with Infection Prevention and Control (IPC) procedures and the risk of exposure during the early period of the pandemic in Addis Ababa, Ethiopia.

METHODS

A descriptive cross-sectional survey was conducted from June to September 2020. With a response rate of 79.2%, a standardized questionnaire was administered among 247 HCWs, working in eight HCFs. Descriptive and multivariate regression analysis was carried out in STATA version 16.

RESULTS

About 22.5% (55) of the HCWs had proper adherence to IPC procedures. Of the total participants, 28.2% (69) had proper use of Personal Protective Equipment (PPE), 40% (98) had proper hand hygiene practices, and 33.1% (81) had frequently cleaned their working environment. HCWs who received training on IPC protocols were four times more likely to follow IPC standards than those with no training (adjusted odds ratio [AOR] = 3.93; 95% confidence interval [CI]: 1.46, 10.58). Besides, HCWs working in treatment centers were four times more likely to follow IPC standards than those working in conventional hospitals (AOR = 3.61; 95% CI:1.63, 8.02). Nurses were four times more likely to have adherence to IPC measures than cleaners and runners (AOR = 4.37; 95% CI: 1.38-13.88).

CONCLUSION

The nature and magnitude of the pandemic did not introduce the required degree of adherence to IPC procedures, per se does not match the level of diligence needed to halt SARS-CoV-2 transmission. Our finding suggested that providing periodic training of HCWs with particular emphasis on nonclinical staff is commendable. Furthermore, it is necessary to maintain resilent IPC in HCF through continous follow up and safety drills, to assess the readiness of HFCs' adherance to IPC measures under normal circumstances, which could improve prepardeness for an effective response during epidemics.

Knowledge, attitudes and practices of infection prevention and control among healthcare workers during the COVID 19 pandemic: a descriptive cross-sectional study in three Nigerian states

BACKGROUND

Emergence of the COVID-19 pandemic created unexpected challenges for health care workers. The global and national supply chain system was disrupted, and affected infection, prevention and control (IPC) practices. This study aimed at documenting health workers knowledge, attitudes and practices (KAP) on IPC in Nigeria during the COVID-19 pandemic.

METHODS

The descriptive, mixed-methods cross-sectional study was conducted in Ebonyi, Ondo and Niger states in October 2020. A structured questionnaire was administered to the health workers, complemented by semi-structured interviews that were audio recorded, transcribed and analyzed in Atlas.ti. Quantitative data were entered into REDCap and cleaned, transformed and analyzed using descriptive statistics in SPSS version 25.0 Findings from the qualitative interviews were used to explain the trends observed from quantitative study.

RESULTS

There were demographic differences between community and facility-based health workers in our population. A greater proportion of facility-based providers reported having IPC training compared to community-based health workers ever (p < 0.01) and during the pandemic (p < 0.05). Health care workers had moderate knowledge of general IPC, and attitudes toward and practice of IPC during COVID-19 pandemic. However, the knowledge of the relative effectiveness of prevention measures was low. The mean knowledge scores were greater among facility-based workers compared to community based healthcare workers (p = 0.001). Self-reported IPC practices increased during the pandemic compared to prior to the pandemic, with the exception of the use of N-95 masks and hand sanitizer.

CONCLUSION

This study found moderate IPC knowledge, attitudes and practices in our study population during the pandemic as compared to pre-pandemic for the study found gaps in correct hand hygienevaried application of different IPC practices to ensure adherence to COVID-19 preventive measures. The study recommends sustained training for IPC and encourages policy makers that budget line specific to COVID-19 response across all the levels of health care delivery will enhance compliance and emergency readiness.

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.

Knowledge of COVID-19 and Its Treatment Among Healthcare Worker in Al-Ahsa Region of Saudi Arabia

Objective

To find out how well healthcare workers (HCWs) in Saudi Arabia's eastern region knew about the novel coronavirus illness 2019 (COVID-19) in terms of its symptoms, transmission, and treatment.

Methods

This is a cross-sectional study conducted in the Saudi Arabian region of Al-Ahsa. Between December 2020 and March 2021, a questionnaire was distributed in the main hospitals in the eastern region: King Fahad Hospital, Prince Saud Bin Jalawi Hospital, Prince Sultan Cardiac Center, and Maternity and Children's Hospital. Participants' knowledge of COVID-19 symptoms, transmission, and treatment was assessed using our developed questionnaire tool. The Student's t-test/ANOVA test was used to compare the mean knowledge scores of different demographic groups.

Results

A total of 300 HCWs participated in this study. Our study sample's mean knowledge score was 6.9 (SD = 2.1) out of 13 (53.1%), indicating a marginal degree of understanding. The duration of practice had a significant effect on the participants' knowledge of COVID-19. Senior and non-Saudi HCWs had a higher knowledge score than the rest of the groups (p ≤ 0.05). The majority of the participants were able to identify that COVID-19 is transmitted from human to human through respiratory droplets, populations at higher risk of developing severe complications, populations needing screening for COVID-19, main clinical symptoms of COVID-19, and were following the WHO guidelines for the treatment of COVID-19.

Conclusion

According to our findings, HCWs only had marginal knowledge about the symptoms, transmission, and treatment of COVID-19. As our findings represent early investigation at the start of the pandemic, more research is needed to evaluate the degree of information gathered two years after the outbreak began. Furthermore, future research should identify knowledge gaps in the targeted population of HCWs and provide strategies to address them.

COVID-19 preventive practice and associated factors in Ethiopia: A systematic review and meta-analysis

Objectives

COVID-19 is a global health concern due to its rapid spread and impact on morbidity and mortality. Implementing preventive measures plays an essential role in curbing the spread of COVID-19 infection. This study aimed to assess COVID-19 preventive practice and associated factors in Ethiopia.

Study design

This study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.

Methods

Medline, PubMed, Scopus, Cochrane, EMBASE, African Journal Online (AJOL) and Science Direct search engines were used to identify relevant articles published up to early December 2021. The Joana Brigg's Institute (JBI) checklist was used for quality appraisal. A random-effect model was fitted to calculate the pooled estimates. Higgins I² statistics and Egger's test with funnel plots were analysed to check heterogeneity and publication bias, respectively. Due to significant heterogeneity, subgroup analysis by region, study population, study design and publication year, as well as sensitivity analysis, were done to assess the source of heterogeneity.

Results

The pooled level of poor preventive practice for COVID-19 in Ethiopia was 51.60% (95% confidence interval [CI]: 40.30-62.90). Poor COVID-19 preventive practice declined from 61% in studies published in 2020 to 45% in 2021. Lack of knowledge about COVID-19 (adjusted odds ratio [AOR] = 4.61 [95% CI: 2.49-10.73]), a negative attitude towards COVID-19 management (AOR = 2.64 [95% CI: 1.82-3.82]), rural residence (AOR = 2.95 [95% CI: 2.12-4.12]), a low educational level (AOR = 2.93 [95% CI: 2.16-3.98]) and being female (AOR = 1.75 [95% CI: 1.27-2.40]) were significantly associated with a poor level of COVID-19 preventive practice in Ethiopia.

Conclusions

The level of poor COVID-19 preventive practice in Ethiopia was relatively high. Poor COVID-19 prevention practices were significantly correlated with inadequate COVID-19 knowledge, a negative attitude towards COVID-19 management, low educational attainment, living in a rural area and being female. Creating awareness and health education programmes targeting COVID-19 prevention should be strengthened, especially in the target populations identified in this study.

Predictors of knowledge and adherence to COVID-19 safety protocols among nurses at health facilities in Tamale Metropolis of Northern Ghana

Background

Corona Virus Disease of 2019 (COVID-19) emerged in 2019 and caused widespread disruption to many facets of life, including healthcare. Healthcare workers, particularly nurses, became the front-line fighters against the pandemic, making it imperative to comply with recommended safety protocols. However, many nurses were infected by the virus in the Tamale Metropolis, raising concerns regarding their level of adherence to the safety protocols. This study assessed the predictors of knowledge and adherence to COVID-19 safety protocols among nurses at selected health facilities in the Tamale Metropolis of northern Ghana.

Methods

A facility based cross-sectional study design was adopted and 339 nurses from six (6) public health facilities in the Tamale Metropolis were recruited for the study using questionnaires. The questionnaires were transformed into Google Forms for respondents to answer online via WhatsApp or email. The data were exported from the Google spreadsheet into SPSS and analyzed using descriptive and inferential statistics.

Results

Of the 339 participants, 60.2% were classified as having adequate knowledge while only 9.1% demonstrated high adherence to COVID-19 safety protocols. Knowledge of COVID-19 was predicted by source of information, and marital status, whereas health facility types predicted level of adherence. The odds of having adequate knowledge were higher among unmarried nurses (AOR = 1.94; 95% CI: 1.16–3.25; p = 0.012) and nurses using social media (AOR = 1.80; 95%CI 1.02–3.18; p = 0.042) compared to their counterparts. Meanwhile, primary health care nurses (AOR = 0.24; 95% CI = 0.12–0.50; p<0.001) and secondary health care nurses (AOR = 0.52; 95% CI = 0.31–0.88; P = 0.016) had reduced odds of exhibiting higher adherence compared to nurses from tertiary-level facility.

Conclusion

In this study, we found that knowledge was high but adherence to COVID-19 safety protocols was low. We suggest that facility managers should enforce compliance of their staff to the safety protocols to prevent spread of the virus within healthcare settings.

COVID-19 vaccine knowledge, attitudes, perceptions and uptake among healthcare workers of Pune district, Maharashtra

Background

Healthcare workers play a vital role in vaccine promotion and acceptance through community dialogue, education, and myth-busting. Vaccinated healthcare workers will likely recommend the vaccine to their families and community.

Methods

A cross-sectional study was conducted with healthcare workers (n=357) to understand their knowledge, attitudes, perceptions, and acceptance of the coronavirus disease 2019 (COVID-19) vaccine. The study was conducted in two blocks (Haveli and Velhe) of Pune, Maharashtra.

Results

The findings showed that over 90% of healthcare workers knew about COVID-19 vaccination and had a positive attitude towards COVID-19 vaccination. Among them, vaccine uptake was high (93% with two doses and 4% with a single dose). 98% of healthcare workers believed that vaccine is safe to use. However, few gaps existed around vaccine safety, side effects and allergic reactions, as 27.7% believed that the COVID-19 vaccine could increase the risk of allergic reactions, 51.8% believed that acquiring natural immunity by contacting the virus is better than vaccination, 16.5% believed that it is possible to reduce the incidence of COVID-19 without vaccination, 28.9% believed that vaccine might have side effects and 14% believed vaccine is not the most likely way to control the pandemic.

Conclusions

Addressing the existing gaps and reinforcing the relevance of the COVID-19 vaccine through a structured program is critical to empower health workers to disseminate accurate information to the community, consecutively improve vaccination uptake, and boost vaccination efforts in India.

COVID-19 and Saudi Arabia: Awareness, Attitude, and Practice

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic has transformed our appreciation of healthcare awareness worldwide. The amount of related data accumulated during this time has surpassed any other outbreak of a viral pathogen. Healthcare awareness is related to one of the nine pillars of the "World health organization (WHO) operational planning guidelines to support country preparedness and response". This review is structured around the awareness/knowledge, attitudes, and practices (KAP)-related publications in Saudi Arabia up to date to understand the impact of COVID-19 on these domains. The excellent communication effort response from governments, international, and individuals to keep the public informed about the outbreak is highlighted. Unraveling such impacts on the Saudi communities, including healthcare workers (HCWs)/professionals (HCPs), students, patients with different diseases, and non-professional individuals, is essential in containing the outbreak and planning preventive measures in case of future outbreaks.

Health Professionals' Knowledge, Attitude and Practices Regarding COVID-19 in Dessie City, Northeast Ethiopia: A Facility-Based Cross-Sectional Study

Background

Knowledge and attitudes are among the key drivers of social behavioral change. We assessed employed health professionals' (HPs) knowledge, attitude, and practice regarding COVID-19 in Dessie city, northeast Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 419 HPs working at Dessie city from 17 to 21 May 2020. The data were collected using a self-administered structured questionnaire. Knowledge, attitude, and practice are measured using 19, 16, and 8 questions, respectively. Knowledge and attitude scores are dichotomized at the 3rd quartile, while practice is using the mean value. Data entry and analysis were conducted using EpiData Manager 4.2 and SPSS 25, respectively. Three independent logistic regression analyses were carried out to determine the associated factors. We defined significant association at a p-value of < 0.05.

Results

Out of 419 participants, 369 (88.1%) have sufficient knowledge regarding COVID-19 (95% CI: 85–91). The mean knowledge score is 16.8 with a ± 2.1 SD. Similarly, 355 (84.7%) of the HPs have a favorable attitude toward COVID-19 (95% CI: 81–87.9). The mean attitude score is 14 with ± 2.1 SD. However, practice regarding COVID-19 is adequate only in 69.7% (292) of the HPs (95% CI: 65.2–94). The mean practice score is 5.1 with a ± 1.3 SD. Sufficient knowledge is significantly associated with the type of health facility (AOR: 4.4, 95% CI: 1.4–13.3), degree and above education (AOR: 2.6, 95% Cl: 1.4–4.9), radio availability (AOR: 2.4, 95% CI: 1.3–4.7), and social media utilization (AOR: 2.3, 95% CI: 1.1–5.1). The predictors of favorable attitude are training (AOR: 3.1, 95% CI: 1.6–6.1), sufficient knowledge (AOR: 5.2, 95% Cl: 2.6–10.4), and type of health facility (AOR: 2.3, 95% CI: 1.1–5.2).

Conclusion

Most HPs have sufficient knowledge and a favorable attitude regarding COVID-19. However, practice is relatively low and there remains plenty to build assertive preventive behaviors. The gap between knowledge and practice should be narrowed through an appropriate social and behavioral change communication strategy.

Practices and associated factors of infection prevention of nurses working in public and private hospitals toward COVID-19 in Bahir Dar City, Northwest Ethiopia: Institution-based cross-sectional study

Objective

To assess the levels of practices and associated factors of infection prevention of nurses working in public and private hospitals toward coronavirus 2019 (COVID-19) in Bahir Dar City, Ethiopia.

Methods

Institution-based cross-sectional study design employed in public and private hospitals in Bahir Dar city from 26 March 2021 to 8 April 2021. A total of 442 study participants were recruited using stratified followed by simple random sampling techniques. A self-administered questionnaire was prepared and pretested on 5% of the total sample. The collected data were checked for completeness and consistency, and then the data were coded, entered, and cleaned with SPSS version 25 software. Descriptive statistics were carried out to display the means and proportions of sociodemographic characteristics. Logistic regression analysis was used to assess the association between the level of prevention practices and the independent variables. An adjusted odds ratio with 95% confidence interval was used to report the results. A significant association was set at p-value <0.05.

Results

Of the total 442 samples, 431 (with response rate of 97.5%) answered the questions completely. The mean (±standard deviation) age of the participants was 29.33 (±5.62) years and 217 (50.3%) were females. The proportion of good prevention practices of nurses toward COVID-19 was 39.4% (95% confidence interval: 35%-44%). Female (adjusted odds ratio = 1.77, 95% confidence interval: 1.18-2.68), have training on COVID-19 (adjusted odds ratio = 1.65, 95% confidence interval: 1.10-2.48), personal protective equipment access (adjusted odds ratio = 1.57, 95% confidence interval: 1.01-2.44), availability of infection prevention guideline (adjusted odds ratio = 1.63, 95% confidence interval: 1.06-2.49), and favorable attitude (adjusted odds ratio = 2.05, 95% confidence interval: 1.25-3.36) were factors significantly associated with good infection prevention practices.

Conclusion

Most nurses in Bahir Dar City public and private hospitals had poor prevention practices against COVID-19. Training provision, infection prevention guidelines distribution, sustainable personal protective equipment access, and promotion to change their attitudes are intervention areas that required emphasis.

Prevalence and Associated Factors of Intimate Partner Violence Among Married Women During COVID-19 Pandemic Restrictions: A Community-Based Study

Ethiopia has taken unprecedented preventive measures, such as confinement to home and closure of schools and offices to halt the spread of Corona virus pandemic in the country. Unfortunately, such orders may have been associated with intimate partner violence (IPV) against women but there is no study conducted to assess the magnitude of IPV during the lock-downs in the country. Thus, this study intended to investigate the prevalence and associated factors of IPV against women during the COVID-19 pandemic restrictions. A community-based cross-sectional study was conducted on sample of 617 married or cohabited women. A systematic random sampling technique was employed to identify and enroll women who are married. A logistic regression analysis was used to identify the predictors of IPV among women and all statistical analyses were carried out using STATA 14.2. In this study, amongst the 589 married women who were included in the analysis, 22.4% [95% CI: 19.1%, 25.9%] were experienced at least one form of IPV. Additionally, 11.0%, 20.0%, and 13.8% of women also experienced physical, psychological, and sexual IPVs respectively. After adjusting for covariate; being illiterate [AOR=2.37: 95% CI 1.29, 4.35], having illiterate husband [AOR=2.67: 95% CI 1.36, 5.21], having substance user husband (alcohol, chat or cigarettes) [AOR=2.75: 95% CI 1.42, 5.34], and community tolerant attitude to violence [AOR=2.97: 95% CI 1.17, 7.61] were the independent predictors of IPV amongst married women. In conclusion, the prevalence of IPV among married women was comparable to the national pre-COVID figure of IPV. Therefore, national and regional governments should work toward enhancing gender equality, coupled with addressing risk factors at multiple levels, using community- and institution-based approaches to prevent IPV and to specifically achieve SDG5 of eliminating violence against women by 2030.

Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation

BACKGROUND

Inadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic.

METHODS

An institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result.

RESULTS

From the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities.

CONCLUSION

Despite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs.

Knowledge, Perception and Preparedness Related to COVID-19 among Adult Rural Population in Konso, Southern Ethiopia

BACKGROUND

According to the world health organization, the COVID-19 outbreak has currently affected millions of people worldwide. Since the start of the pandemic in China, everything countries have thrown at the virus turned unsuccessful. As there is no established vaccine to halt the virus transmission, it might be very difficult for developing countries like Ethiopia even after vaccine development. Thus, focusing on improving knowledge, perception, and preparedness related to the virus might be very vital.

METHODS

A community-based cross-sectional survey was conducted using the questionnaire applied in most countries which is suitable to apply in the Konso zone in South Nations Nationalities Region (SNNPR) from April.2020 to July 2020. Data were collected, cleaned, coded, checked, and entered into Epi Info and then exported and analyzed in STATA 15. We fitted a binary logistic regression model. Categorical variables were presented using figure tables, and proportion and for continuous variables, mean and standard deviation were used. The results were also presented using Adjusted Odds Ratio (AOR) with 95% CI.

RESULTS

From 636 respondents expected, 615(97%) were participated and possessed the knowledge of 39%, and 64% perception and preparedness each. Measurements related to the policy and interventions like restrictions to movement, self-isolation, wearing a face mask, & the need for more tests was not supported by most participants.

CONCLUSION

The poor knowledge, perception, and preparedness were correlated with the unavailability of water and electricity, less education, and informal source of information which could be improved through area appropriate health education interventions.

Knowledge, Attitudes, and Practices Regarding COVID-19 Among Health Care Workers in Public Health Facilities in Eastern Ethiopia: Cross-sectional Survey Study

Background

On March 13, 2020, Ethiopia reported the first confirmed case of COVID-19 in Addis Ababa. COVID-19 is likely to overwhelm an already-fragile health care delivery system and reduce the availability of essential health services. This analysis of data from the Somali Region of Eastern Ethiopia on health care workers’ (HCWs) knowledge, attitudes, and practices regarding the prevention and control of COVID-19 may be used in planning health education programs about the emerging viral disease.

Objective

This study aimed to investigate the knowledge, attitudes, and practices of HCWs regarding COVID-19 infection.

Methods

This cross-sectional study was conducted among HCWs in three public health facilities in the Somali Region, Eastern Ethiopia. A self-administered questionnaire was shared with all HCWs working at the public health facilities. A total of 15 knowledge questions were scored as 1 or 0 for correct or incorrect responses, respectively. A total of 14 practice questions were scored on a 3-point scale from 1 (“always”) to 3 (“never”). A total of six attitude questions were rated on a 5-point Likert scale, in a negative dimension, as follows: 1 (“strongly agree”), 2 (“agree”), 3 (“neutral”), 4 (“disagree”), and 5 (“strongly disagree”). Mean scores were calculated and used as a cut point to dichotomize the outcome variables (>13.7 indicated good knowledge, <18.8 indicated good practices, and ≤10.5 indicated favorable attitudes). We used t tests and analyses of variance (ie, F tests) to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores.

Results

Of the 686 HCWs approached, a total of 434 HCWs responded (63.3% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 13.7 (SD 2.6), and 73.3% (318/434) of participants had sufficient knowledge. The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 18.8 (SD 5.8), and 61.5% (267/434) of the participants practiced precautionary measures to prevent COVID-19. There was a negative correlation between knowledge and attitude scores (r=–0.295, P<.001) and between knowledge and practice scores (r=–0.298, P<.001).

Conclusions

The overall levels of knowledge and practice were relatively better than the attitude level. This highlights the need to implement strategies that enhance the positive attitudes and safe practices of the HCWs for better containment of the pandemic and supporting of essential health care services.

Health care workers intention to accept COVID-19 vaccine and associated factors in southwestern Ethiopia, 2021

INTRODUCTION

Health care workers are the most affected part of the world population due to the COVID-19 pandemic. Countries prioritize vaccinating health workers against COVID-19 because of their susceptibility to the virus. However, the acceptability of the vaccine varies across populations. Thus, this study aimed to determine the health care worker's intentions to accept the COVID-19 vaccine and its associated factors in southwestern Ethiopia, 2021.

METHODS

A facility-based cross-sectional study was conducted among health care workers in public hospitals in southwestern Ethiopia from March 15 to 28, 2021. A simple random sampling method was used to select 405 participants from each hospital. Data were collected using self-administered questionnaires. Descriptive statistics, such as frequency and percentage, were calculated. Multivariable logistic regression was also performed to identify factors associated with health care worker's intention to accept the COVID-19 vaccine. Statistically significant variables were selected based on p-values (<0.05) and the adjusted odds ratio was used to describe the strength of association with 95% confidence intervals.

RESULT

Among the respondents, 48.4% [95% CI: 38.6, 58.2] of health care workers intended to accept COVID-19. Intention to accept COVID-19 vaccination was significantly associated with physicians (AOR = 9.27, 95% CI: 1.27-27.32), professionals with a history of chronic illness (AOR = 4.07, 95% CI: 2.02-8.21), perceived degree of risk of COVID-19 infection (AOR = 4.63, 95% CI: 1.26-16.98), positive attitude toward COVID-19 prevention (AOR = 6.08, 95% CI: 3.39-10.91) and good preventive practices (AOR = 2.83, 95% CI: 1.58-5.08).

CONCLUSION

In this study, the intention of health care workers to accept the COVID-19 vaccine was low. Professional types, history of chronic illness, perceived degree of risk to COVID-19 infection, attitude toward COVID-19 and preventive practices were found to be factors for intention to accept COVID-19 vaccine in professionals. It is important to consider professional types, history of chronic illness, perceived degree of risk to COVID-19, attitude of professionals and preventive behaviors to improve the intention of professionals' vaccine acceptance.

COVID-19 Knowledge, Perception, Preventive Measures, Stigma, and Mental Health Among Healthcare Workers in Three Sub-Saharan African Countries: A Phone Survey

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented public health crisis globally. Understanding healthcare providers' (HCPs') knowledge and perceptions of COVID-19 is crucial to identifying effective strategies to improve their ability to respond to the pandemic in sub-Saharan Africa. A phone-based survey of 900 HCPs in Burkina Faso, Ethiopia, and Nigeria (300 per country) was conducted to assess knowledge, perceptions, COVID-19 prevention measures, stigma, and mental health of HCPs. Modified Poisson regression models were used to evaluate predictors of knowledge, perceptions, and prevention measures; adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) were calculated. Three-fourths of the HCPs had adequate knowledge, and over half had correct perceptions of risk and high levels of self-reported prevention measures. The majority of the HCPs (73.7%) reported self-perceived social stigma. There was relatively low prevalence of depression (6.6%), anxiety (6.6%), or psychological distress (18%). Compared with doctors, being a nurse was associated with lower levels of knowledge (ARR: 0.83; 95% CI: 0.77-0.90) and was also negatively associated with having correct perceptions toward COVID-19 (AOR: 0.82; 95% CI: 0.73-0.92). HCPs treating COVID-19 patients had higher likelihood of having high levels of prevention measures (AOR: 1.37; 95% CI: 1.23-1.53). Despite high levels of knowledge among HCPs in sub-Saharan Africa, there is a need to improve COVID-19 perceptions and compliance with prevention measures as well as address social stigma toward HCPs to better ensure their safety and prepare them to deliver health services.