Knowledge About COVID-19 in Brazil: Cross-Sectional Web-Based Study

Emerging global patterns of COVID-19 vaccine information fatigue in 23 countries in 2023

Vaccine information fatigue, exacerbated by the infodemic, misinformation, and cultural influences, hampers public responsiveness to the uptake of vaccines for COVID-19 and other vaccine-preventable diseases. This cross-sectional study of 23,000 respondents surveyed in 23 countries in October 2023 analyzed trust in information sources, perceptions of the pandemic's conclusion, and confidence in one's ability to discern false information from true and the association of these factors with willingness to pay attention to COVID-19 vaccine information, adjusting for sociodemographic characteristics. Results revealed that satisfaction with health authority communication was positively associated with individuals' willingness to pay attention to COVID-19 vaccine information in all 23 countries. Confidence in one's own capacity to distinguish true information from false was associated with willingness in 20 countries. Belief that the pandemic is over was associated with unwillingness to pay attention to COVID-19 vaccine information in 14 countries. These findings underscore the need for tailored communication strategies that build trust in information sources, combat complacency, and enhance discernment skills to address vaccine and pandemic fatigue, aiming to sustain public engagement with vaccine information and, ultimately, support vaccination efforts.

The Level of Knowledge, Attitudes, and Practices in a Caribbean Colombian Population That Recovered from COVID-19 during the Pandemic

This study aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Colombians. A cross-sectional descriptive study was carried out during the pandemic between November 2020 and May 2021 using a survey that focused on knowledge, attitudes, and practices regarding COVID-19. The online survey was completed by 1424 participants who had a history of COVID-19 illness, and the study spanned 3 months. Many respondents were male students who demonstrated adequate knowledge of COVID-19 symptoms and prevention measures, although their understanding of its transmission routes was limited. Nevertheless, 65.9% expressed optimism that COVID-19 would ultimately be successfully controlled, and 71.8% had confidence in the Colombian government's handling of the crisis. Additionally, more than half of the participants admitted to visiting crowded places, and this practice was more common among those who were less informed about COVID-19. However, many respondents reported using face masks in public. This highlights a significant gap between theoretical knowledge and actual practices that need to be addressed. To bridge this gap, establishing an interdisciplinary support network is crucial, as is launching mass education campaigns targeting specific population groups, and compiling reports on successful practices implemented during the pandemic. These efforts are essential for enhancing the overall level of knowledge, and the attitudes and practices related to COVID-19, and also for preparing for future health emergencies.

Social Media and the Influence of Fake News on Global Health Interventions: Implications for a Study on Dengue in Brazil

Social media usage is growing globally, with an exponential increase in low- and middle-income countries. Social media changes the ways in which information-sharing occurs, intensifying the population's exposure to misinformation, including fake news. This has important repercussions for global health. The spread of fake news can undermine the implementation of evidence-based interventions and weaken the credibility of scientific expertise. This is particularly worrisome in countries, such as Brazil, in a sociopolitical context characterized by a lack of popular trust in public institutions. In this project report, we describe our experience with the spread of fake news through the social media platform WhatsApp during the implementation of a cluster randomized controlled trial aimed at reducing dengue incidence in children in Fortaleza (Brazil). During initial visits to selected clusters, the research team was met with resistance. Then, soon after data collection started, fake news began circulating about the study. As a result, the research team developed strategies to dispel suspicion and further promote the study. However, the climate of violence and mistrust, coupled with the COVID-19 pandemic, forced the interruption of the study in 2019. The lessons learned from our experience in Fortaleza can be useful to other researchers and practitioners implementing large-scale interventions in this era of health-related misinformation.

Knowledge, attitudes, and practices towards COVID-19 among the population of the state of São Paulo, Brazil

BACKGROUND

The population's adherence to COVID-19 preventive measures is influenced by their knowledge, attitudes, and practices (KAP) towards the disease, making research into people's awareness of the disease essential. The present survey was designed to assess KAP towards COVID-19 among the population of the state of São Paulo, Brazil.

METHODS

An online questionnaire was disseminated via social media between September 14 and October 5, 2020. The intended population was Brazilians over the age of 18, living in the state of São Paulo.

RESULTS

A total of 1,111 individuals completed the questionnaire. The majority were women (71.6%), 31.6% were aged 31-40 years old, and 82.8% had higher education. Among the participants, 17.5% reported that they had taken some medication without a medical prescription to prevent COVID-19. The participants showed good knowledge about the transmission and prevention of the disease. The knowledge mean score was lower among participants with complete high school or less, with poor self-perception of their health status, who almost never seek information about COVID-19, and those who are not sure to belong to a risk group for the disease. Only 51.3% of the participants believed that COVID-19 would finally be successfully controlled, and 56.6% were confident that Brazil could win the battle against the virus.

CONCLUSIONS

Participants demonstrated good knowledge of COVID-19 but were pessimistic about the pandemic's future. The findings of this study can help in the development of effective health communication strategies to promote better knowledge and a positive attitude about prevention measures.

Trustworthiness of information sources on vaccines for COVID-19 prevention among Brazilians

OBJECTIVE

This study aims to assess the trustworthiness of information sources, perception of clear information about the vaccine, and strategies to increase adherence to vaccination to provide managers with information that helps establish effective communication with the population about vaccination.

METHOD

This is an online survey conducted between January 22 and 29, 2021, preceded by an Informed Consent, that aims to assess vaccine hesitancy, which corresponded to the first week of vaccination initiation to prevent COVID-19 in Brazil. Data were obtained from a questionnaire made available through a free platform and stored in Google Forms and later exported to the SPSS statistical package for analysis. The sample consisted of all questionnaires from participants who self-declared as age 18 or older, Brazilian, and residing in Brazil at the time of the survey. Incomplete records with more than 50% of blank items and duplicates were excluded. All categorical variables were analyzed from their absolute and relative frequencies. Multivariate logistic regression was performed to verify the relationship between dependent variables and independent variables.

RESULTS

The results show that trust in information sources diverges between hesitant and non-hesitant. They also showed that some participants show an overall distrust that seems to have deeper foundations than issues related only to the source of information. The high rejection of television and the WHO as sources of information among hesitant suggests that integrated actions with research institutes, public figures vaccinating, and religious leaders can help to combat vaccine hesitation. Two actors become particularly important in this dynamic, both for good and bad, and their anti-vaxxer behavior must be observed: the doctor and the Ministry of Health.

CONCLUSION

This study contributes to gathering valuable information to help understand the behavior and thinking relevant to the adherence to vaccination recommendations.

Análise comparativa das características demográficas, sintomatologia e comorbidades de adultos e idosos notificados e confirmados com COVID-19 nas capitais brasileiras

Objetivo: comparar o perfil demográfico, a sintomatologia e as comorbidades de adultos e idosos notificados com COVID-19 nas capitais brasileiras e no Distrito Federal. Métodos: estudo ecológico, desenvolvido a partir dos dados da plataforma online e-SUS Notifica, preenchidos até dia 4 de janeiro de 2021, com amostra constituída por 1.416.252 indivíduos, utilizando como critérios de inclusão: ter idade > 20 anos; residir nas capitais brasileiras ou no Distrito Federal; e apresentar resultado do teste positivo para COVID-19. A análise descritiva contou com a exposição das frequências absoluta e relativa e medidas de tendência central. Para análise inferencial, aplicou-se o teste qui-quadrado de Pearson, considerando diferença significativa para valores de p<0,05. Resultados: predominou sexo masculino (52%), com média de idade de 43,29 ± 14,85 anos. Os indivíduos apresentaram tosse (45,4%), febre (38,8%) e outros sintomas (83,1%). As comorbidades mais prevalentes foram: doenças cardíacas (7,1%) e diabetes (4,5%). Houve diferença significativa (p<0,001) entre as regiões brasileiras, ao comparar sexo, idade, ser profissional da saúde, sintomas e comorbidades. Conclusão: os dados contribuíram para o conhecimento acerca do processo epidêmico de COVID-19 no Brasil, no primeiro ano de pandemia, e demonstrou a distribuição dos casos e as relações existentes entre perfil demográfico, sintomatologia e doenças pré-existentes com os agrupados das capitais brasileiras.

Dynamics of social corrections to peers sharing COVID-19 misinformation on WhatsApp in Brazil

OBJECTIVE

Online COVID-19 misinformation is a serious concern in Brazil, home to the second-largest WhatsApp user base and the second-highest number of COVID-19 deaths. We examined the extent to which WhatsApp users might be willing to correct their peers who might share COVID-19 misinformation.

MATERIALS AND METHODS

We conducted a cross-sectional online survey using Qualtrics among 726 Brazilian adults to identify the types of social correction behaviors (SCBs) and health and technological factors that shape the performance of these behaviors.

RESULTS

Brazil's WhatsApp users expressed medium to high levels of willingness to engage in SCBs. We discovered 3 modes of SCBs: correction to the group, correction to the sender only, and passive or no correction. WhatsApp users with lower levels of educational attainment and from younger age groups were less inclined to provide corrections. Lastly, the perceived severity of COVID-19 and the ability to critically evaluate a message were positively associated with providing corrections to either the group or the sender.

DISCUSSION

The demographic analyses point to the need to strengthen information literacy among population groups that are younger with lower levels of educational attainment. These efforts could facilitate individual-level contributions to the global fight against misinformation by the World Health Organization in collaboration with member states, social media companies, and civil society.

CONCLUSION

Our study suggests that Brazil's WhatsApp users might be willing to actively respond with feedback when exposed to COVID-19 misinformation by their peers on small-world networks like WhatsApp groups.

Knowledge, attitudes, and practices related to COVID-19 among patients at Hospital Universitario de Caracas triage tent: A cross-sectional study

INTRODUCTION

The studies on knowledge, attitudes, and practices (KAP) regarding COVID-19 help to identify erroneous concepts and inadequate practices related to the disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures.

OBJECTIVE

To identify the COVID-19-related KAP in Venezuelan patients screened at the Hospital Universitario de Caracas triage tent.

MATERIALS AND METHODS

We conducted a cross-sectional study among 215 patients between April 25th and May 25th, 2020, with in-person interviews using a KAP survey.

RESULTS

Most surveyed patients (53.5%) were asymptomatic. Most of them, both from the symptomatic and the asymptomatic groups, had adequate knowledge about the symptoms and transmission of the disease and the majority said they were practicing quarantine, frequent handwashing, and the use of face masks in public areas. However, the daily replacement of cloth face masks was more frequent in the asymptomatic group whereas replacement every three days was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, a common practice among the symptomatic compared to the asymptomatic patients.

CONCLUSIONS

This is the first KAP study in Venezuela about COVID-19. Knowledge and practices among Venezuelans could be improved by strengthening education and training programs. This information from the early phase of the pandemic in Venezuela may contribute to the design of COVID-19 promotion and prevention strategies.

The impact of fake news on social media and its influence on health during the COVID-19 pandemic: a systematic review

PURPOSE

As the new coronavirus disease propagated around the world, the rapid spread of news caused uncertainty in the population. False news has taken over social media, becoming part of life for many people. Thus, this study aimed to evaluate, through a systematic review, the impact of social media on the dissemination of infodemic knowing and its impacts on health.

METHODS

A systematic search was performed in the MedLine, Virtual Health Library (VHL), and Scielo databases from January 1, 2020, to May 11, 2021. Studies that addressed the impact of fake news on patients and healthcare professionals around the world were included. It was possible to methodologically assess the quality of the selected studies using the Loney and Newcastle-Ottawa Scales.

RESULTS

Fourteen studies were eligible for inclusion, consisting of six cross-sectional and eight descriptive observational studies. Through questionnaires, five studies included measures of anxiety or psychological distress caused by misinformation; another seven assessed feeling fear, uncertainty, and panic, in addition to attacks on health professionals and people of Asian origin.

CONCLUSION

By analyzing the phenomenon of fake news in health, it was possible to observe that infodemic knowledge can cause psychological disorders and panic, fear, depression, and fatigue.

COVID-19: A Cross-Sectional Study of Healthcare Students' Perceptions of Life during the Pandemic in the United States and Brazil

Societal influences, such as beliefs and behaviors, and their increasing complexity add to the challenges of interactivity promoted by globalization. This study was developed during a virtual global educational exchange experience and designed for research and educational purposes to assess personal social and cultural risk factors for students’ COVID-19 personal prevention behavior and perceptions about life during the pandemic, and to inform future educational efforts in intercultural learning for healthcare students. We designed and implemented a cross-sectional anonymous online survey intended to assess social and cultural risk factors for COVID-19 personal prevention behavior and students’ perceptions about life during the pandemic in public health and healthcare students in two public universities (United States n = 53; Brazil n = 55). Statistically significant differences existed between the United States and Brazil students in degree type, employment, risk behavior, personal prevention procedures, sanitization perceptions, and views of governmental policies. Cultural and social differences, risk messaging, and lifestyle factors may contribute to disparities in perceptions and behaviors of students around the novel infectious disease, with implications for future global infectious disease control.

Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that health authorities must promote health educations, implement related policies to disseminate COVID-19-awareness that can prevent and control the spread of COVID-19 infection.

SARS-CoV-2 testing disparities across geographical regions from a large metropolitan area in Brazil: Results from a web-based survey among individuals interested in clinical trials for COVID-19 vaccines

After more than a year since the novel coronavirus (SARS-CoV-2) disease 2019 or COVID-19 has reached the status of a global pandemic, the number of COVID-19 cases continues to rise in Brazil. As no effective treatment been approved yet, only mass vaccination can stop the spread of SARS-CoV-2 and end the COVID-19 pandemic. Multiple COVID-19 vaccine candidates are under development and some are currently in use. This study aims to describe the characteristics of individuals who have registered in an online platform to participate in clinical trials for COVID-19 vaccines. Additionally, participants' characteristics according to age and presence of comorbidities associated with severe COVID-19 and differences of SARS-CoV-2 testing across different geographical areas/neighborhoods are provided. This was a cross-sectional web-based study conducted between September and December/2020, aiming to reach individuals aged ≥18 years who live in Rio de Janeiro metropolitan area, Brazil. Among 21,210 individuals who completed the survey, 20,587 (97.1%) were willing to participate in clinical trials for COVID-19 vaccines. Among those willing to participate, 57.8% individuals were aged 18-59 years and had no comorbidity, 33.7% were aged 18-59 years and had at least one comorbidity, and 8.6% were aged ≥ 60 years regardless the presence of any comorbidity. Almost half (42.6%) reported ever testing for COVID-19, and this proportion was lower among those aged ≥ 60 years (p < 0.001). Prevalence of positive PCR results was 16.0%, higher among those aged 18-59 years (p < 0.009). Prevalence of positive antibody result was 10.0%, with no difference across age and comorbidity groups. Participants from areas/neighborhoods with higher Human Development Index (HDI) reported ever testing for SARS-CoV-2 more frequently than those from lower HDI areas. Interest to participate in clinical trials for COVID-19 vaccines candidates in Rio de Janeiro was significantly high. The online registry successfully reached out a large number of individuals with diverse sociodemographic, economic and clinical backgrounds.

Classification Models for COVID-19 Test Prioritization in Brazil: Machine Learning Approach

BACKGROUND

Controlling the COVID-19 outbreak in Brazil is a challenge due to the population's size and urban density, inefficient maintenance of social distancing and testing strategies, and limited availability of testing resources.

OBJECTIVE

The purpose of this study is to effectively prioritize patients who are symptomatic for testing to assist early COVID-19 detection in Brazil, addressing problems related to inefficient testing and control strategies.

METHODS

Raw data from 55,676 Brazilians were preprocessed, and the chi-square test was used to confirm the relevance of the following features: gender, health professional, fever, sore throat, dyspnea, olfactory disorders, cough, coryza, taste disorders, and headache. Classification models were implemented relying on preprocessed data sets; supervised learning; and the algorithms multilayer perceptron (MLP), gradient boosting machine (GBM), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), k-nearest neighbors (KNN), support vector machine (SVM), and logistic regression (LR). The models' performances were analyzed using 10-fold cross-validation, classification metrics, and the Friedman and Nemenyi statistical tests. The permutation feature importance method was applied for ranking the features used by the classification models with the highest performances.

RESULTS

Gender, fever, and dyspnea were among the highest-ranked features used by the classification models. The comparative analysis presents MLP, GBM, DT, RF, XGBoost, and SVM as the highest performance models with similar results. KNN and LR were outperformed by the other algorithms. Applying the easy interpretability as an additional comparison criterion, the DT was considered the most suitable model.

CONCLUSIONS

The DT classification model can effectively (with a mean accuracy≥89.12%) assist COVID-19 test prioritization in Brazil. The model can be applied to recommend the prioritizing of a patient who is symptomatic for COVID-19 testing.