Knowledge, Attitudes, and Practices Regarding COVID-19 among Healthcare Workers in Uganda: A Cross-Sectional Survey

A comparative study on perception and use of generic drugs between public and private health practitioners

Context

The perception of generic drugs may vary significantly between government and private doctors because physicians in the private sector have more prescribing choices and flexibility. Hence, this study was undertaken to analyse the knowledge, attitude and perception (KAP) of government and private physicians on generic drugs.

Materials and Methods

This was a questionnaire-based cross-sectional study conducted among physicians working in public and private health sectors. The questionnaire had 25 closed-ended questions related to the KAP of generic medicine. The overall scores were categorised using Bloom's cut-off point. The Chi-square or Mann-Whitney U-test was used to compare the differences between the two groups.

Results

About 80% of the participants in both groups agreed that generic medicines contain the same active ingredients as brand-name drugs, are less expensive and are available in the Indian market. Nearly 84% of government physicians and only 64% of private physicians believed that generic medicines are just as effective and secure as branded medicines (P - 0.003). The majority of physicians from both groups concurred that there is a lack of quality check in generic drug manufacturing, and they require more information about bioequivalence studies. In both categories, about 75% of participants preferred generic medications for their patients. However, in both groups, more than 50% of physicians were concerned about therapeutic failure and expressed reluctance to prescribe generic medications in life-threatening situations.

Conclusions

Knowledge and acceptance of generic drugs regarding efficacy, safety, bioequivalence and therapeutic failure are low among both government and private physicians.

Factors associated with compliance with Infection Prevention and Control measures during the COVID-19 pandemic among healthcare workers in Kampala City, Uganda

BACKGROUND

In the context of the COVID-19 pandemic that originated from China in December 2019 and spread around the world, Kampala City witnessed a high number of infections and deaths among healthcare workers (HCWs). This study assessed the level of compliance with Infection Prevention and Control (IPC) measures and its associated factors among HCWs during the COVID-19 pandemic, in Kampala City, Uganda.

METHODOLOGY

A cross-sectional study was conducted in Nakawa Division, Kampala City, among 240 HCWs and used multistage sampling in government and private not-for-profit (PNFP) healthcare facilities. The outcome variable was self-reported IPC compliance which was composed of the use of masks, gloves, and hand hygiene. These were assessed using a 4-scale tool: always as recommended, most of the time, occasionally, and rarely. Only HCWs who responded "always as recommended" were considered compliant while the rest were considered non-compliant. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI).

RESULTS

Forty-six (19.2%) respondents were compliant with all the three IPC measures, and this was associated with the presence of a COVID-19 patients' ward in the healthcare facility (Adjusted Prevalence Ratio, APR: 2.51, 95%CI: 1.24-5.07). Factors associated with the use of masks were being of the Muslim religion (APR: 1.31, CI: 1.05-1.65), and working in a healthcare facility that has COVID-19 patients' ward (APR: 1.29, CI: 1.06-1.59). Factors associated with the use of gloves were the age of the HCW, those above 40 years old being less complaint (APR: 0.47, CI: 0.24-0.93), working in the diagnosis department (APR: 2.08, CI: 1.17-3.70), and working in a healthcare facility that has COVID-19 patients' ward (APR: 1.73, CI: 1.13-2.64). Factors associated with hand hygiene were working in a health center (HC) IV (PR: 1.7, CI: 1.26-2.30) or a HC II (PR: 1.68, CI: 1.28-2.21).

CONCLUSION

Considering the elevated risk of disease transmission in health settings, IPC compliance was low; indicating an increased risk of COVID-19 infection among health care workers in Kampala City.

Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey

OBJECTIVES

Concepts related to SARS-CoV-2 laboratory testing and result interpretation can be challenging to understand. A cross-sectional survey of COVID-19 positive adults residing in Ontario, Canada was conducted to explore how well people understand SARS-CoV-2 laboratory tests and their associated results.

DESIGN AND METHODS

Participants were recruited through fliers or by prospective recruitment of outpatients and hospitalized inpatients with COVID-19. Enrolled participants included consenting adults with a positive SARS-CoV-2 polymerase chain reaction test result. An 11-item questionnaire was developed by researchers, nurses, and physicians in the study team and was administered online between April 2021 to May 2022 upon enrolment into the study.

RESULTS

Responses were obtained from 940 of 1106 eligible participants (85% participation rate). Most respondents understood 1) that antibody results should not influence adherence to social distancing measures (n=602/888, 68%), 2) asymptomatic SARS-CoV-2 infection following test positivity (n=698/888, 79%), 3) serological test sensitivity in relation to post-infection timeline (n=540/891, 61%), and 4) limitations of experts' knowledge related to SARS-CoV-2 serology (n=693/887, 78%). Conversely, respondents demonstrated challenges understanding 1) conflicting molecular and serological test results and their relationship with immune protection (n=162/893, 18%) and 2) the impact of SARS-CoV-2 variants on vaccine effectiveness (n=235/891, 26%). Analysis of responses stratified by sociodemographic variables identified that respondents who were either: 1) female, 2) more educated, 3) aged 18-44, 4) from a high-income household, or 5) healthcare workers responded expectedly more often.

CONCLUSIONS

We have highlighted concepts related to SARS-CoV-2 laboratory tests and associated results which may be challenging to understand. The findings of this study enable us to identify 1) misconceptions related to various SARS-CoV-2 test results, 2) groups of individuals at risk, and 3) strategies to improve people's understanding of their test results.

Psychological distress and related factors regarding COVID-19 among the ancillary hospital staff: A cross-sectional study

Background

Healthcare workers (HCWs) are at the front line of the Coronavirus disease (COVID-19) outbreak response. They have faced great risks to both physical and mental health. We aimed to assess the psychological effect of COVID-19 among ancillary hospital staff.

Methods

A cross-sectional study was conducted among 267 on-duty ancillary hospital staff using a semi-structured questionnaire to assess their psychological status and risk perception. In addition, their knowledge, attitude, and practices (KAP) and risk perception were also assessed. The General Health Questionnaire (GHQ-12) was used to screen for psychological distress.

Results

Among 267 participants, the mean (±SD) age was 33.5 (7.6) years. The majority knew about the symptoms of COVID-19 (88.4%), droplet spread (99.3%), and the importance of isolation (99.3%). About 35.2% were worried about infecting family members, while 26.2% were worried about colleagues at the frontline. Only 38.9% of them had a good knowledge score. Participants with high school and above education level had significantly good knowledge about COVID-19 (OR = 1.99; 95% CI = 1.17- 3.39) than those with primary school or below. Being female (OR 1.99; 95% CI 1.17-3.39) and working with COVID-19 patients (OR 3.88, 95% CI 1.77-8.47, P = 0.001) was associated with psychological distress.

Conclusion

The ancillary hospital staff had insufficient knowledge regarding the risk factors of COVID-19 but possessed positive attitudes and practices. Continued health education and appropriate psychological interventions may improve understanding and reduce psychological distress.

Knowledge, attitudes, and practices toward COVID-19 among the general population: a cross-sectional study in Kankan, Guinea

Background

Implementing decisive and effective infection prevention and control measures necessitates a thorough grasp of the general population's level of knowledge in order to identify existing gaps and react appropriately.

Objective

The goal of this cross-sectional research was to assess public knowledge, attitudes, and practices (KAP) about COVID-19 in Kankan Guinea, in order to better understand the socio-demographic factors that are associated with poor KAP.

Materials and Methods

The study population consists of 1230 people who reside in five health districts in the Kankan region. An anonymous paper-based questionnaire, given face-toface by trained field agents, was used to gather data.

Results

The research included 1230 Guineans in total. The bulk of respondents (60%) were familiar with COVID-19. Only 44% of respondents under the age of 29 had a clear understanding of COVID-19. Male participants knew more about COVID-19 than female ones (P=0.003). The majority of participants (82%) had negative attitudes toward COVID-19, while 61% reported positive practices linked to COVID-19 measures. In this research, being female was a risk factor for poor knowledge of COVID-19 (P0,001), and being single was a risk factor for negative attitudes toward COVID-19 (P=0,009).

Conclusion

Appropriate measures should be taken to increase public awareness and improve general practice of preventive measures aimed at reducing the spread of infectious diseases such as COVID-19.

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.

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

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

Healthcare workers' mental health and perception towards vaccination during COVID-19 pandemic in a Pediatric Cancer Hospital

The consistent increase of Coronavirus disease 2019 (COVID-19) cases parallel with the rate of deaths and the controversial response regarding the vaccines caused an increase in the burden of psychological diseases. This study aimed to evaluate the psychological condition of healthcare workers (HCWs) in a pediatric cancer hospital and to identify the knowledge, attitude, and perception (KAP) of HCWs toward COVID-19 vaccination. A cross-sectional observational study was conducted between April to May 2021. A validated, confidential survey was employed to measure the mental health of HCWs and the KAP toward COVID-19 vaccines. The total responses were 395, of which 11.4% physicians, 18.5% pharmacists, and 70.1% were nurses. Sixty-six percent of HCWs had different degrees of anxiety and depression. Nurses significantly accounted for the highest anxiety levels (P = 0.003), while the cumulative anxiety score was significantly higher in HCWs who had a positive history of COVID-19 infection (P = 0.026). Although 67.6% of HCWs believe that "vaccines are essential for us,", the vaccination rate was 21.3%. The Factors associated with not receiving the vaccine were younger ages (P = 0.014), nurses (P = 3.6987 × 10^-7), negative history of COVID-19 infection (P = 0.043) and believing that infections can happen after taking the vaccine (P = 1.5833 × 10^-7). Healthcare organizations must take serious intervention to decrease the mental load on HCWs and facilitate the vaccination process.

"Right now we are scared of each other, we fear everyone, the whole world has COVID": The impact of COVID-19 on young female sex workers in Kampala, Uganda, during national lockdowns in 2020-2021

In 2020-2021 the COVID-19 pandemic led to multiple and diverse global public health response strategies globally and in Uganda to slow the spread of the virus by promoting wearing face coverings in public, frequent hand washing, physical distancing, restricting travel, and imposing home lockdowns. We conducted 146 interviews over four rounds of phone-follow up calls over 15 months with 125 young female sex workers coinciding in time with four different government-imposed lockdown periods in Kampala, Uganda, to assess the impact of these measures on young sex workers, their families and their communities as well as to gauge their resilience. Our findings revealed how COVID-19 fears and public health restrictions over time pushed an already marginalized population to the brink and how that pressure drove some participants into a new way of life.

Undergraduate Students' Knowledge, Attitudes and Willingness to Receive COVID-19 Vaccines: A Survey of Convenience Sample in Namibia

Introduction

The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students' understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia.

Objectives

To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia.

Methods

The study employed a cross-sectional descriptive study from 200 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables.

Results

The data showed that 54.2% (1.54  ±  0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines (r  =  .546, P  =<.001), while a negative relation existed between knowledge and attitudes (r  =  -.017, P  =>.001).

Conclusions

This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated.

Knowledge, attitude, and practices of front line health workers after receiving a COVID-19 vaccine: a cross-sectional study in Pakistan

Background

Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine.

Methods

A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant.

Results

Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination.

Conclusion

The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).

Methods

Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles.

Results

A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection.

Conclusion

This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.

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.

Burnout prevalence and contributing factors among healthcare workers during the COVID-19 pandemic: A cross-sectional survey study in an urban community in Thailand

Background

Burnout is associated with an increased risk for severe COVID-19. Few studies have examined burnout prevalence related to healthcare workers during the pandemic. This study investigated the burnout prevalence and contributing factors among HCWs, including medical staff and support staff, during the COVID-19 pandemic in an urban community in Thailand.

Methods

A cross-sectional online survey was distributed among HCWs in Bangkok, Thailand, from July–August 2021. The independent t-test and one-way analysis of variance (ANOVA) were used to compare the contributing factors and burnout items. Variable factors associated with burnout among HCWs were used in multiple linear regression models.

Results

A total of 517 HCWs’ survey responses were received. Most participants were medical staff (55.3%), female (83.4%), and over the age of 35 (59.4%); most participants (65.6%) did not have any diseases but had family members that did (63.6%). The prevalence of overall burnout presented among medical staff (25.9%). The results of the multiple linear regression models found that female (vs. male, β 0.088; 95% CI 0.033, 6.614) was higher associated with overall burnout score. In addition, hours of sleep as > 6 hr./day (vs. ≤ 6 hr./day, β -0.120; 95% CI -6.012, -0.969) was lower associated with overall burnout score.

Conclusion

This study highlights the importance of addressing burnout among HCWs, in which female medical staff who slept less than six hours per day were associated with burnout. Our study further suggested that both intervention and identification are needed of frontline HCWs to prevent and reduce the risk of burnout, as the proportion of females compared to males is high. Thus, the government should provide support in these areas to prevent a humanitarian crisis.

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

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

More than a year into the pandemic: Do higher education students still practice protective behaviors against COVID-19?

BACKGROUND

The exponential increase of cases and the emergence of the new COVID-19 variants continue to be a challenge. It remains crucial to assess whether or not minimum health standards against COVID-19 are consistently followed. This study determined the higher education students' practice of protective measures against COVID-19 of more than a year into the pandemic.

MATERIALS AND METHODS

A questionnaire web survey, cross-sectional study was conducted among higher education students (n = 2309) of a public university in the Philippines. Data were analyzed using the SPSS software.

RESULTS

Results indicated that students generally had a high practice of COVID-19 preventive measures. However, only 45.9% always practice physical distancing measures, and only 35.9% always seek information related to COVID-19 after more than a year into the pandemic. Female, married, graduate level, with a monthly family income of PHP 10,000 and above, and personal knowledge of someone who tested for COVID-19 had a significantly higher practice of COVID-19 protective measures. Older age, higher general self-reported health status, and higher intention to comply with recommended protective health behaviors were significantly correlated with higher practice of preventive measures against COVID-19.

CONCLUSION

After more than a year of being into the pandemic, students still practice preventive health behaviors, however, this is not done consistently. As the pandemic is still not over in the country and many parts of the world, continuous monitoring and a reminder to practice minimum protective health protocols are needed to mitigate and prevent the spread of COVID-19.

Perceived risks of COVID-19, attitudes towards preventive guidelines and impact of the lockdown on students in Uganda: A cross-sectional study

Background

This study explored students’ perceptions of COVID-19 risks and preventive measures and assessed the impacts of the national lockdown on students in Uganda.

Methods

A web-based survey was conducted to explore students’ perceived risks of COVID-19 and preventive measures; sources of COVID-19 information and impacts of the lockdown. Both undergraduate and post-graduate students (n = 398) participated in the study. Data were analysed using IBM-SPSS-26.

Results

Students acknowledged COVID-19 as a health risk, and their preventive behaviours were influenced by age, gender, marital status and living situation. Most students followed face mask guidelines but did not comply with lockdown restrictions. Social distancing was not always possible due to overcrowding. Students’ main sources of COVID-19 information were local media (e.g., TV, radio) and social media. Most students (especially females) were unable to access online learning platforms due to poor internet connectivity, high costs and no access to computers. Meanwhile, a majority of those who studied online did not enjoy the experience. Students experienced depression, frustration, stress and anxiety during the lockdown; became less physically active and spent most of their time on social media, sleeping, eating or watching movies. Some students indulged in smoking, drinking alcohol, taking drugs and gambling for their first time, while others did them more often than before.

Conclusion

The increase in sedentary activity, poor mental health and substance use over the lockdown period puts students at risk of health complications and poses a potential threat to the healthcare system. These risks may also negatively impact their future learning and academic potential. Further research is needed to understand the transitional experiences of students between physical and virtual learning, and how they can be supported. There is also a need to ascertain the feasibility of guidelines such as social distancing in developing countries, to increase compliance.

Knowledge, Attitudes, and Practices About COVID-19 Among Healthcare Workers in Iran During the First Wave of the Pandemic

Background and Objective

Investigating the knowledge, attitudes, and practices about the coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) could be an early step toward identifying their potential educational needs and possible factors involved in misinformation. The objective of this study was to investigate the knowledge, attitudes, and practices about COVID-19 among healthcare workers in Iran during the first wave of the pandemic.

Materials and Methods

The current descriptive-correlational study was conducted during the 1st days of the COVID-19 epidemic in Iran from March 24th to April 3rd, 2020. Participants included all healthcare workers at hospitals, including physicians, dentists, pharmacists, nurses, midwives, laboratory and radiology assistants, and other hospital professionals during the study period. Data were collected through an online self-administrative questionnaire.

Results

The responses of 1,310 participants were analyzed, of which 900 (68.7%) were female. The mean (SD) knowledge score was 25.4 (3.3), 84.7% out of 30. More than 90% of participants correctly recognized the main symptoms, transmission route, and preventive measures for COVID-19. The mean (SD) attitude score was 16.9 (1.1), 93.9% out of 18. Most participants agreed with keeping safe physical distancing, self-isolation upon symptom onset, and city lockdowns. The mean (SD) score for general practices about COVID-19 was 20.8 (2.0), 86.7% of 24.

Conclusion

The knowledge and practice of HCWs were appropriate, and their attitudes were mainly positive. However, there is still room for improvement regarding concerning misinformation and quackeries about COVID-19.

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study

Introduction

In sub-Saharan Africa, there is a need to better understand and guide the practice of primary care physicians (PCPs), especially in a crisis context like the COVID-19 pandemic. This study analyses the experiences of PCPs facing COVID-19 in Benin and draws policy lessons.

Methods

The study followed a fully mixed sequential dominant status design. Data were collected between April and August 2020 from a sample of PCPs in Benin. We performed descriptive analyses on the quantitative data. We also performed bivariate analyses for testing associations between various outcomes and the public/private status of the PCPs, their localization within or outside the cordon sanitaire put in place at the beginning of COVID-19, and their practice' category. A thematic content analysis was done on qualitative data. Results from both analyses were triangulated.

Results

Ninety PCPs participated in the quantitative strand, and 14 in the qualitative. The median percentage of the COVID-19 control measures implemented in the health facilities, as reported by the PCPs, was 77.8% (interquartile range = 16.7%), with no difference between the various groups. While 29.4% of the PCPs reported being poorly/not capable of helping the communities to deal with COVID-19, 45.3% felt poorly/not confident in dealing with an actual case. These percentages were bigger in the private sector. The PCP's experiences were marked by anxiety and fear, with 80.2% reporting stress. Many PCPs (74.1%) reported not receiving support from local health authorities, and 75.3% felt their concerns were not adequately addressed. Both percentages were higher in the private sector. The PCPs especially complained of insufficient training, insufficient coordination, and less support to private providers than the public ones. For 72.4 and 79.3% of the PCPs, respectively, the pandemic impacted services utilization and daily work. There were negative impacts (like a decrease in the services utilization or the quality of care), but also positive ones (like improved compliance to hygiene measures and new opportunities).

Conclusion

Our study highlighted the need for more structured support to PCPs for optimizing their contribution to epidemics control and good primary healthcare in Benin. Efforts in this direction can build on several good practices and opportunities.

Relationship between Quality of Nursing Work Life and Uniformed Nurses' Attitudes and Practices Related to COVID-19 in the Philippines: A Cross-Sectional Study

(1) Background: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. Uniformed nurses have played a critical role during the COVID-19 pandemic in the Philippines; however, uptake of literature is limited. This study assessed the relationship between quality of nursing work life (QNWL) and nurses’ attitudes and practices during the COVID-19 pandemic. (2) Methods: A descriptive cross-sectional design was used. Participants were recruited from four government hospitals in the Manila metropolitan area of the Philippines. Participants completed three questionnaires in an online survey: a demographic questionnaire, a QNWL questionnaire, and the attitude and practices toward COVID-19 questionnaire. Descriptive statistics, an independent t-test, a one-way analysis of variance, the Pearson correlation coefficient, and hierarchical linear regression were applied for data analysis. (3) Results: The mean age of the participants was 29 years. Most of the participants were single women who were not certified in their specialties. A total of QNWL scores were high, indicating that the participants displayed favorable attitudes and practices in relation to COVID-19. A statistically significant relationship was observed between QNWL, specialty certification, and practices related to COVID-19. Practices related to COVID-19 were a significant predictor of QNWL and one of its subscales, work design. (4) Conclusion: Young adult uniformed nurses in the Philippines have assumed numerous responsibilities during the COVID-19 pandemic. Providing these frontline nurses with comprehensive specialized education and training is crucial.

Analysis of COVID-19 in Professionals Working in Geriatric Environment: Multicenter Prospective Study

Healthcare workers (HCWs) are exposed to a higher risk of coronavirus disease (COVID-19) contamination. This prospective multicenter study describes the characteristics of HCWs tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) while working in a geriatric environment. We also compared HCWs with a positive reverse transcription polymerase chain reaction (RTPCR) assay (RTPCR+ group) and those with a negative test result (RTPCR− group). Between 15/5/2020 and 15/9/2020, 258 HCWs, employed in the acute geriatric unit (AGU), geriatric rehabilitation unit (GRU) or nursing home of three hospitals in Burgundy (France) were invited to complete an online survey. Among the 171 respondents, 83 participants, with mean age 42 years and 87.9% female, were tested for SARS-CoV-2 infection. Among these 83 participants, COVID-19 was confirmed in 38 cases (RTPCR+ group) of which 36 were symptomatic, and the RTPCR assay was negative in 45 cases (RTPCR− group) of which 20 participants were symptomatic. A total of 22.9% (of 83) had comorbidities, 21.7% were active smokers, and 65.1% had received the flu vaccine. A total of 37.3% worked in AGU, 19.3% in GRU and 16.9% in nursing homes. The most common symptom described was headache (23.2%), followed by fatigue or cough (12.5% each), and fever or myalgia (10.7% each). There were more participants with normal body mass index (p = 0.03) in the RTPCR+ group. In contrast, there were more users of non-steroidal anti-inflammatory drugs (p = 0.01), active smokers (p = 0.03) and flu vaccinated (p = 0.01) in the RTPCR− group. No difference was found between the two groups for the type of work (p = 0.20 for physicians and p = 0.18 for nurses). However, acquiring COVID-19 was significantly associated with working in AGU (p < 0.001) and nursing homes (p = 0.001). There were significantly more users of surgical masks (p = 0.035) in the RTPCR+ group and more filtering facepiece-2 mask users (p = 0.016) in the RTPCR− group. Our results reflect the first six months of the COVID-19 pandemic in France. Further studies are needed to evaluate and track the risks and consequences of COVID-19 in HCWs.