Pregnant women's knowledge, attitude, and practice towards COVID-19 infection prevention in Ethiopia: A systematic review and meta-analysis

Knowledge, attitude, and practice towards COVID-19 and associated factors among students in Ethiopia: Systematic review and meta-analysis

INTRODUCTION

The World Health Organization (WHO) has not confirmed the eradication of the COVID-19 pandemic or the development of a cure. Ongoing research is necessary to update public understanding, attitudes, and behaviors. Therefore, this study aims to evaluate the knowledge, attitudes, and practices related to COVID-19 among students in Ethiopia.

OBJECTIVE

To estimate the pooled proportions and associated factors of knowledge, positive attitude, and prevention practice toward COVID-19 among students in Ethiopia.

METHODS

The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered on the PROSPERO database. Data extraction was done using an Excel spreadsheet, and analysis was conducted using STATA. The quality of the articles was assessed using the Joanna Briggs Institute (JBI) grading approach. A narrative summary and random-effects model with a 95% confidence interval were used. Heterogeneity and publication bias were also assessed. The results were presented using a forest plot and tables.

RESULT

Out of 2089 studies reviewed, only 16 met the inclusion criteria. The pooled proportions of COVID-19 good knowledge, positive attitude, and good prevention practice among students in Ethiopia were found to be 62.68% [95% CI 50.96-74.40, I2 = 98.93%], 60.22% [95% CI 51.64-68.80, I2 = 97.68%], 48.47% [95% CI, 44.16-52.78, I2 = 91.45%] respectively. Factors that affected knowledge included marital status, family size, sex, study year, and residency. Knowledge and residency were identified as predictors of attitude. Determinants of practice included knowledge, attitude, sex, study program, and residency.

CONCLUSION

The pooled proportion of students in Ethiopia with good knowledge, positive attitudes, and good practices regarding COVID-19 was low. Policymakers, the Ministry of Health, Public Health Institutions, and other stakeholders should intensify their efforts on COVID-19 and develop interventions aimed at females, rural residents, and extension students. The protocol was registered on the PROSPERO database with ID = CRD42023478234.

Knowledge, attitude and practice towards COVID-19 among pregnant women in Africa: A systematic review and meta-analysis

Background

Pregnant women and recent mothers face a higher risk of severe illness from Coronavirus disease 2019 due to physiological and immunological shifts during pregnancy, rendering them more vulnerable to inflammatory lung conditions. This susceptibility poses serious threats to both maternal and newborn health. Therefore, it is imperative for pregnant women to be fully informed about Coronavirus disease 2019 and to implement preventive measures. This study aimed to evaluate the collective knowledge, attitudes, and practices related to Coronavirus disease 2019 among pregnant women across Africa.

Methods

The researchers collected studies from multiple databases, including Pub Med/MEDLINE, EMBASE, CINAHL, Science Direct, Scopus, Web of Science, Cochran library, and Google Scholar. A combination of search terms and Boolean operators were utilized to gather relevant literature. Each study underwent quality assessment by five authors independently, using the modified Newcastle Ottawa Scale tailored for cross-sectional research. Statistical analysis was conducted using STATA™ Version 11 software, and meta-analysis was performed using the random-effects (Der Simonian and Laird) method. Heterogeneity was evaluated using I-squared (I2) statistics, and a one-out sensitivity analysis was carried out.

Results

This systematic review and meta-analysis included 19 articles, involving a total of 7852 participants. It revealed that the combined estimated prevalence of good knowledge about Coronavirus disease 2019, positive attitudes, and good practices among pregnant women was found to be 61.8 % (95 % CI: 53.0%-70.65 %; I2 = 98.7 %), 51.7 % (95 % CI: 30.34%-73.6 %; I2 = 99.3 %), and 52.31 % (95 % CI: 41.48%-63.15 %; I2 = 98.8 %) respectively.

Conclusion

This study emphasizes a significant concern: pregnant women exhibit a notable lack of knowledge, positive attitudes, and preventive practices regarding Coronavirus disease 2019. Considering their heightened vulnerability, urgent action is required to improve their understanding, attitudes, and behaviours related to the virus. Healthcare professionals should take proactive measures to educate pregnant women, addressing this crucial gap through various strategies.

Examining students' level of understanding toward COVID-19 and its associated factors in Ethiopia: a systematic review and meta-analysis

Background

This systematic review and meta-analysis aim to investigate students' understanding of COVID-19 in Ethiopia and identify associated factors. The primary goal is to pinpoint key contributors shaping students' perception and comprehension of the virus. The study aims to offer valuable insights for developing targeted educational interventions, ultimately enhancing students' overall knowledge and awareness of the pandemic in the specific context of Ethiopia.

Methods

The study adhered rigorously to PRISMA criteria, ensuring a standardized methodology. Data from reputable databases like Google Scholar and PubMed were systematically collected. Ten relevant articles were meticulously analyzed using STATA version 11, with heterogeneity assessed by the I2 test. A funnel plot and Egger's test were used to check for publication bias. The determination of the pooled effect size utilized a random-effect model meta-analysis, offering a robust 95% confidence interval.

Results

This meta-analysis, based on 10 articles, reveals an overall prevalence of 61.58% (95% CI: 47.26-75.89). Significant contributors to students' comprehension include Social media users (AOR) = 2.38, urban residence AOR = 3.31, news media followers AOR = 2.51, fathers' educational status AOR = 2.35, watching television AOR = 4.71, and health science students AOR = 4.21. These findings underscore crucial elements shaping students' understanding of COVID-19 in Ethiopia.

Conclusion

Our analysis indicates that 61.58% of Ethiopian students possess a good understanding of COVID-19. Factors such as active social media engagement, geographic location, frequency of news consumption, father's level of education, television viewing habits, and enrollment in health science programs significantly influence their comprehension. These findings underscore the importance of implementing targeted interventions to enhance health literacy and education among students, thereby facilitating a more effective response to pandemics.

Effect of COVID-19 Pandemic on Knowledge, Attitude and Practices Towards Antenatal Care Among Antenatal Women: A Study From a Tertiary Care Hospital in Delhi, India

OBJECTIVE

 Effect of the COVID-19 pandemic on knowledge, attitude, and practices toward antenatal care among antenatal women.

DESIGN

 Prospective observational study.

METHOD

After taking written and informed consent, 3000 term/near-term SARS CoV2-negative antenatal women admitted to the hospital for emergency were enrolled; excluding those in advance labour or critically ill. An interview was conducted and a knowledge, attitude, and practices (KAP) questionnaire was filled out based on verbatim answers. All women were then given individualized antenatal and postnatal care as per hospital protocols and discharged accordingly. The data obtained during the study was recorded on predesigned case proforma and analysed at the end of the study using the SPSS v. 23 software, after the application of appropriate statistical tests.

MAIN RESULT

All women knew about the pandemic and its signs and symptoms along with precautions to be taken. Most of the women 2652 (88.4%) thought that they were at increased risk of contracting an infection during pregnancy and 2208 (73.6%) thought that coronavirus can harm the baby and will increase the risk of pregnancy. Awareness of nearby health facilities providing antenatal care was in 71.2% and 94% were aware of functional outpatient department services but only 1.4% were aware of teleconsultation services. About 2094 women have had any ANC visits. All of them knew that taking iron, Ca and vitamin supplements and getting an ultrasound and investigations were necessary but only 1524 (50.8%) took these supplements regularly, 1752 (58.4%) got their ultrasound done and 41.6% got investigations done. Two thousand four hundred thirty-six (81.2%) women had this fear that they would contract COVID-19 infection during their visit to the hospital. All the respondents of our study wanted to have hospital delivery and knew that it was necessary to have ANC registration and none of them wanted to have home delivery.

CONCLUSION

Mastering correct knowledge will foster a positive attitude among antenatal women and will not only prevent disease transmission but also improve pregnancy outcomes.

COVID Perceptions among Pregnant Women Living in a Malaria Hyperendemic Rural Region in Uganda: A Cross-Sectional Study

Both SARS-CoV2 and Plasmodium falciparum infection during pregnancy increases the risk for adverse maternal and fetal outcomes, including abortion, severe disease, and death. Indeed, although malaria and COVID-19 show an overlapping clinical presentation, they require a profoundly different approach. The aim of this study was to explore COVID-19 awareness among pregnant women living in a P. falciparum hyperendemic region in rural Uganda. This cross-sectional, prospective study was conducted in one Hospital and two Health Centers (HC) in Lango region, Uganda, from July 14, 2022, to March 14, 2023. Data about demographics, COVID-19 history, and COVID-19 and malaria perceptions were collected using RedCap mobile app platform. Study endpoint was a context-specific COVID-19 awareness score, accounting for the most common disease misconceptions. Association between study variables and good COVID-19 awareness was assessed by χ2 and t test, as appropriate, and variables found to be statistically significant were further explored in multivariate logistic regression analysis. A total of 888 pregnant women were recruited. Median age was 24 (interquartile range: 20-29) years, whereas 79% (n = 704) attained only primary education and 66.6% (n = 591) were used in agriculture. SARS-CoV2 vaccination rate was 92%. In multivariate analysis (Table 3), variables associated with high COVID knowledge were presenting at antenatal care visit in Atipe HC (adjusted odds ratio [aOR]: 8.1, 95% CI: 4.1-16.48) having a previous good knowledge about malaria (aOR: 1.76, 95% CI: 1.21-2.56). Among pregnant women living in rural Uganda, COVID-19 awareness relies on the overall educational level, malaria knowledge and reference HC. Among pregnant women living in P. falciparum endemic areas, community-level malaria awareness might guide educational interventions during future pandemics.

Knowledge, attitudes and practices towards COVID-19: Community survey in southern Ethiopia

BACKGROUND

Being well informed about the pandemic and how the virus spreads help to prevent and control the pandemic. Health authorities should monitor community practice to prevent the pandemic to identify gaps and minimize risks. This study was, therefore, designed to assess community knowledge, attitude and practices (KAP) related to COVID-19 prevention and its associated factors in urban settings.

METHODS

Community based cross-sectional study was conducted in southern Ethiopia. Twelve towns with high population density and mobility and 1162 participants were included in the study using multi-stage sampling. Semi-structured questionnaire was used to collect data. Mask use was assessed by observation while social distancing and handwashing were assessed by interview. Good practice was defined as wearing face mask, keeping social distance and handwashing. Data was collected by health professionals who have BSc and above (in nursing and public health) and analyzed using SPSS version 25. Descriptive statistics and binary logistic regression at 95% confidence level were performed.

RESULTS

From 1162 respondents, about three fifths, 714 (61.4%), were females and 829 (64.2%) were married. The mean knowledge score was 69.7 (SD±17.87) while mean score for attitude was 80.6 (SD±6.29). Only about one third, 380 (32.7%), had good practice. Occupation, age and overall knowledge about COVID-19 and its prevention were associated with good COVID-19 prevention measures.

CONCLUSION

Knowledge and attitude related to COVID-19 prevention and control were moderate while practice was low. The risk communication strategy should be strengthened using precautionary advocacy.

Global knowledge, attitude, and practice towards COVID-19 among pregnant women: a systematic review and meta-analysis

BACKGROUND

Pregnant women form a specially vulnerable group due to unique changes in pregnancy, leading to a higher risk of getting a severe infection. As severe COVID-19 increases the risk of preeclampsia, preterm delivery, gestational diabetes, and low birth weight in pregnancy, there is a need to enhance pregnant women's knowledge, attitudes, and practices to prevent these complications. This systematic review and meta-analysis aimed to determine their levels of knowledge, attitudes, and practice (KAP) regarding COVID-19 at the global level.

METHODS

The systematic literature search was conducted in the English language, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest, from the occurrence of the pandemic until September 2022. We used The Newcastle Ottawa scale for cross-sectional studies checklist to evaluate the risk of bias in the studies. Data were extracted by a Microsoft Excel spreadsheet and analyzed by STATA software version 14. We also employed Cochran Q statistics to assess the heterogeneity of studies and utilized Inverse variance random-effects models to estimate the pooled level of pregnant women's KAP towards COVID-19 infection prevention.

RESULTS

Based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 53 qualified studies were acquired from several countries. In total, 51 articles (17,319 participants) for knowledge, 15 articles (6,509 participants) for attitudes, and 24 articles (11,032 participants) for practice were included in this meta-analysis. The pooled good knowledge, positive attitude, and appropriate practice in pregnant women were estimated at 59%(95%CI: 52-66%), 57%(95%CI: 42-72%), and 53%(95%CI: 41-65%), respectively. According to subgroup analysis, the level of knowledge, attitude, and practice were 61%(95%CI: 49-72), 52%(95%CI: 30-74), and 50%(95%CI: 39-60), respectively, in Africa, and 58.8%(95%CI: 49.2-68.4), 60%(95%CI: 41-80) and 60% (95%CI: 41-78), respectively, in Asia.

CONCLUSION

The Knowledge, attitude, and practice towards COVID-19 infection prevention in pregnant women were low. It is suggested that health education programs and empowerment of communities, especially pregnant women, about COVID-19 continue with better planning. For future studies, we propose to investigate the KAP of COVID-19 in pregnant women in countries of other continents and geographical regions.

SARS-CoV-2 Infection Anxiety, Knowledge and Attitudes in University Degree Pregnant Women from Romania-A Cross-Sectional Observational Survey in the First Two Pandemic Years

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a high economic cost, morbidity, and death toll. Due to high rates of mortality and morbidity from coronavirus disease 2019 (COVID-19), pregnant women were at particular risk during this pandemic. We designed and conducted a cross-sectional observational survey in Romanian pregnant women to evaluate the outcome of the SARS-CoV-2 pandemic along with the preventive measures taken by authorities. We applied a 43-item questionnaire. We included 147 women over 18 years old from Romania who were pregnant or gave birth between March 2020 and March 2022. All pregnancies were monitored, most of them by a gynecologist, and only 23% faced rescheduled pregnancy visits. The majority (84%) were screened through the TORCH panel, 95.91% felt anxious because of the pandemic, 87% followed SARS-CoV2 preventive recommendations, and 82% were not infected with the coronavirus. Additionally, 80% were vaccinated against COVID-19. They felt the consequences of the pandemic through anxiety, and their level of anxiety influenced their vaccination decisions, the TORCH testing and the method of giving birth despite the level of education. Fortunately, their pregnancies were monitored properly, and there were no consequences noticed for fetuses at birth.