Socio-economic Inequality in Comprehensive Knowledge about HIV in Malawi

Assessing HIV transmission knowledge and rapid test history among the general population in Iran

Considering the general population's lack of knowledge and, more importantly, the hidden proportion of people living with HIV (PLWHIV), we aimed to study people's knowledge of HIV transmission modes and investigate the history of rapid test usage in the south of Tehran, Iran. We conducted a telephone survey study on 1311 individuals aged 18 years and older. We asked the participants if they had undergone HIV testing at private or public health centers in the past year. Using five items, we assessed HIV transmission knowledge. We used multivariable logistic regression to analyze the relationship between various factors associated with HIV transmission knowledge. Overall, 40.9% of the general population demonstrated a high level of understanding about HIV transmission, with a 95% CI [37.85,44.12]. The result of multivariable logistic analysis revealed that the following factors were associated with better knowledge: higher education (OR = 7.83; [4.72,13.01] for academic and OR = 4.52; [2.78,7.35] for diploma), housekeeping (OR = 1.95; [1.47,2.59]), higher socioeconomic status (OR = 4.41; [3.01,6.15] for middle and OR = 5.46; [2.91,10.15] for middle upward), recent visits to the health center (OR = 1.29; CI [0.98,1.65]), and tobacco use (OR = 1.48; [1.07,2.06]). The knowledge of HIV transmission was negatively associated with age (OR = 0.97; [0.95,0.98]). In addition, 9.8% [7.31,12.87] of participants-4.7% in private clinics and 5.1% in public centers-had received an HIV test within the 12 months prior to the study. Our study emphasizes the importance of improving public knowledge about HIV transmission and expanding testing initiatives. Findings advocate for enhanced educational programs, increased accessibility to testing facilities, and broader public health campaigns. These measures are essential for fostering a well-informed and proactive community in efforts to address HIV/AIDS.

Explaining inequity in knowledge, attitude, and services related to HIV/AIDS: a systematic review

BACKGROUND

Equitable service provision and coverage are important responses to end the threat of the HIV/AIDS pandemic. Understanding inequity supports policies and programmes to deliver tailored interventions. There is continuous evidence generation on inequity in HIV/AIDS services. However, there was a lack of evidence on the global picture of inequity in behavioural and biomedical services related to HIV/AIDS. This systematic review assessed inequities in knowledge, attitude, HIV testing, and ART coverage across individual-level social groups and multiple (dis)advantage categories.

METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, with a PROSPERO registration number CRD42024521247. The risk of bias was assessed by using Hoy et al's and Joanna Brigg's quality appraisal checklists for cross-sectional quantitative and qualitative studies, respectively. The search date was from inception to the final database search date (May 29, 2023). The included articles were either quantitative or qualitative studies. We used mixed-methods approach to analyse the data from the review articles. Quantitative descriptive analysis was conducted to estimate frequency of articles published from different countries around the world. Qualitative content analysis of the findings from the original studies was conducted using the PROGRESS plus framework which stands for: place of residence, occupation or employment status, gender, religion, education status, socioeconomic status, and social capital.

RESULTS

Out of 6,029 articles that were accessed and screened, only 72 articles met the inclusion criteria. More articles on HIV-related equity in knowledge, attitude, testing, and ART were published in developed countries than in developing countries. Individuals from higher-income households had better knowledge about HIV/AIDS. Unfavourable attitudes towards people living with HIV and HIV/AIDS-associated stigma were common among women. HIV/AIDS service coverage (HIV testing or ART coverage) was higher among richer and urban residents. HIV/AIDS-associated stigma and lower levels of knowledge about HIV/AIDS were observed among multiple disadvantageous groups due to the intersection of two or more identities.

CONCLUSIONS

The current review revealed that there have been disparities in HIV/AIDS services between social classes. Ending service disparity towards the global threat of HIV/AIDS demands tailored interventions based on socially disadvantaged groups (e.g., poor, rural dwellers, and women) and intersectional determinants. There is a need to understand the deep-rooted causes of inequity and the challenges that an equity-oriented system faces over time. More studies on inequity are needed, including intersectional inequity, which has been rarely studied in developing countries.

Equity in HIV/AIDS services requires optimization of mainstreaming sectors in Ethiopia

BACKGROUND

Mainstreaming HIV and AIDS across sectors is crucial to close the disparities in service provision and coverage. However, evidence has shown that certain social groups are left behind in receiving HIV/AIDS services. The objective of this study was twofold: to understand the reasons behind the existing inequities and to explore challenges of equity in HIV/AIDS services in the Amhara region of Ethiopia.

METHODS

Twenty-two adults (aged 26-57 years) from eighteen sectors that are mainstreaming HIV and AIDS were purposefully selected until the point of saturation and participated in a semi-structured in-depth interview conducted between January 20 and February 17, 2023. Interviewees were asked to describe their mainstreaming experiences in equitable HIV/AIDS services, reflect on the challenges and barriers that impede equitable service provision, or explain the reasons behind the existence of inequity in HIV/AIDS services. The interviews were audio recorded, transcribed, translated, and iteratively analysed, with early analysis informing subsequent interviews. An inductive-reflexive thematic analysis was conducted, whereby themes and subthemes were identified, and the relationships between subthemes and patterns were critically reviewed.

RESULTS

The challenges to equitable HIV/AIDS service provision were grouped into eight thematic areas: (1) changing contexts that shifts public and government attention to emerging diseases, war and political instability, and poverty; (2) leadership-related, such as the lack of supervision and monitoring, not politicising HIV/AIDS (not providing political attention to HIV/AIDS) and weak intersectoral collaboration; (3) financial constraints due to a random budgeting and contract interruption with non-governmental organisations (NGOs); (4) lack of resources due to scarcity and unfair distribution; (5) inadequate skilled personnel due to inadequate numbers and lack of continuous professional and career development; (6) lack of equity-related evidence-based tools and guidelines; (7) inadequate understanding of equity due to lack of training and misunderstanding, and lack of access to equity-oriented tools and guidelines; and (8) cultural norms, values, and perceptions.

CONCLUSIONS

This study identified critical challenges faced in the equitable HIV/AIDS services provision. To achieve equity in HIV/AIDS services, mainstreaming sectors need to invest in mechanisms to sustain services in emergency situations; identify effective leaders to maintain collaboration, monitoring, and evaluation; institutionalise responsive budgeting and establish alternative funds to maintain non-governmental organisations initiatives; provide continuous up-to-date training and create a common evidence-sharing platform; implement proper recruitment, education, and professional development of HIV/AIDS focal persons; and promote and practice culturally safe care. It is, therefore, essential to optimise sectors that are mainstreaming HIV/AIDS and incorporate equity considerations in their strategic plans and working guidelines.

Knowledge, attitude and perception towards COVID-19 among representative educated sub-Saharan Africans: A cross-sectional study during the exponential phase of the pandemic

Coronavirus disease 2019 (COVID-19) pandemic, caused by the Severe Acute Coronavirus 2 (SARS-CoV-2), is a global health threat with extensive misinformation and conspiracy theories. Therefore, this study investigated the knowledge, attitude and perception of sub-Saharan Africans (SSA) on COVID-19 during the exponential phase of the pandemic. In this cross-sectional survey, self-administered web-based questionnaires were distributed through several online platforms. A total of 1046 respondents from 35 SSA countries completed the survey. The median age was 33 years (18-76 years) and about half (50.5%) of them were males. More than 40% across all socio-demographic categories except the Central African region (21.2%), vocational/secondary education (28.6%), student/unemployed (35.5%), had high COVID-19 knowledge score. Socio-demographic factors and access to information were associated with COVID-19 knowledge. Bivariate analysis revealed that independent variables, including the region of origin, age, gender, education and occupation, were significantly (p < 0.05) associated with COVID-19 knowledge. Multivariate analysis showed that residing in East (odds ratio [OR]: 7.9, 95% confidence interval (CI): 4.7-14, p<0.001), Southern (OR: 3.7, 95% CI: 2.1-6.5, p<0.001) and West (OR: 3.9, 95% CI: 2.9-5.2, p<0.001) Africa was associated with high COVID-19 knowledge level. Apart from East Africa (54.7%), willingness for vaccine acceptance across the other SSA regions was <40%. About 52%, across all socio-demographic categories, were undecided. Knowledge level, region of origin, age, gender, marital status and religion were significantly (p < 0.05) associated with COVID-19 vaccine acceptance. About 67.4% were worried about contracting SARS-CoV-2, while 65.9% indicated they would consult a health professional if exposed. More than one-third of the respondents reported that their governments had taken prompt measures to tackle the pandemic. Despite high COVID-19 knowledge in our study population, most participants were still undecided regarding vaccination, which is critical in eliminating the pandemic. Therefore, extensive, accurate, dynamic and timely education in this aspect is of ultimate priority.

Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa

BACKGROUND

Measuring socioeconomic inequalities in healthcare usage represents a critical step towards promoting health equity, in alignment with the principles of universal health coverage and the United Nations' Sustainable Development Goals. In this study, we assessed the socioeconomic inequalities in HIV testing during antenatal care (ANC) in sub-Saharan Africa.

METHODS

Sub-Saharan Africa was the focus of this study. Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Mauritania, Mozambique, Rwanda, Sierra Leone, Uganda, Zambia, and Zimbabwe were the countries included in the study. This study used current Demographic and Health Surveys data spanning from 2015 to 2022. A total of 70,028 women who tested for HIV as part of antenatal contacts formed the sample for analysis. We utilized the standard concentration index and curve to understand the socioeconomic inequalities in HIV testing during antenatal care among women. Additionally, a decomposition analysis of the concentration index was ran to ascertain the contributions of each factor to the inequality.

RESULTS

Overall, 73.9% of women in sub-Saharan Africa tested for HIV during ANC. The countries with the highest proportions were Malawi, Rwanda, Zambia, and Zimbabwe. Mali Benin, Guinea, Mali, and Mauritania were the countries with the lowest proportions of HIV testing. Being among the richer [AOR 1.10, 95% CI: 1.02,1.18] and richest [AOR 1.41, 95% CI:1.30, 1.54] wealth quintiles increased the odds of HIV testing during ANC. The concentration value of 0.03 and the curve show that HIV testing is more concentrated among women in the highest wealth quintile. Hence, wealthy women are advantaged in terms of HIV testing. As the model's residual value is negative (-0.057), the model overestimates the level of inequality in the outcome variable (HIV during ANC), which means that the model's explanatory factors can account for higher concentration than is the case.

CONCLUSION

We found that there is substantial wealth index-related inequalities in HIV testing, with women of the poorest wealth index disadvantaged in relation to the HIV testing. This emphasizes the necessity for sub-Saharan Africa public health programs to think about concentrating their limited resources on focused initiatives to grasp women from these socioeconomic circumstances. To increase women's access to HIV testing, maternal and child health programs in sub-Saharan Africa should attempt to minimize female illiteracy and poverty. Consequently, health education may be required to provide women with comprehensive HIV knowledge and decrease the number of lost opportunities for women to get tested for HIV. Given the link between knowledge of HIV and HIV testing, it is important to focus on community education and sensitization about HIV and the need to know one's status.

Socioeconomic inequality in knowledge about HIV/AIDS over time in Ethiopia: A population-based study

Socioeconomic inequality in comprehensive knowledge about HIV/AIDS can hinder progress towards ending the epidemic threat of this disease. To address the knowledge gap, it is essential to investigate inequality in HIV/AIDS services. This study aimed to investigate socioeconomic inequality, identify contributors, and analyze the trends in inequality in comprehensive knowledge about HIV/AIDS among adults in Ethiopia. A cross-sectional study was conducted using 2005, 2011, and 2016 population-based health survey data. The sample size was 18,818 in 2005, 29,264 in 2011, and 27,261 in 2016. Socioeconomic inequality in comprehensive knowledge about HIV/AIDS was quantified by using a concentration curve and index. Subsequently, the decomposition of the concentration index was conducted using generalised linear regression with a logit link function to quantify covariates' contribution to wealth-based inequality. The Erreygers' concentration index was 0.251, 0.239, and 0.201 in 2005, 2011, and 2016, respectively. Watching television (24.2%), household wealth rank (21.4%), ever having been tested for HIV (15.3%), and education status (14.3%) took the significant share of socioeconomic inequality. The percentage contribution of watching television increased from 4.3% in 2005 to 24.2% in 2016. The household wealth rank contribution increased from 14.6% in 2005 to 21.38% in 2016. Education status contribution decreased from 16.2% to 14.3%. The percentage contribution of listening to the radio decreased from 16.9% in 2005 to -2.4% in 2016. The percentage contribution of residence decreased from 7.8% in 2005 to -0.5% in 2016. This study shows comprehensive knowledge about HIV/AIDS was concentrated among individuals with a higher socioeconomic status. Socioeconomic-related inequality in comprehensive knowledge about HIV/AIDS is woven deeply in Ethiopia, though this disparity has been decreased minimally. A combination of individual and public health approaches entangled in a societal system are crucial remedies for the general population and disadvantaged groups. This requires comprehensive interventions according to the primary health care approach.

Knowledge, attitudes and practices (KAP) on COVID-19 among the general population in most affected districts of Nepal

The COVID-19 pandemic has become one of the global health challenges in the current context. In Nepal, the first confirmed case was reported on 23 January 2020, and since then, it has resulted in several negative impacts, including economic disruption and deterioration of physical and mental health. In such a pandemic, it is indispensable to understand the knowledge and behavioral patterns of the general population regarding COVID-19. Therefore, our study aimed to assess the knowledge, attitudes and practices on COVID-19 among the general population in most affected districts and its relationship with socio-demographic conditions. The cross-sectional study was conducted among the general population above the age of 18 years from eight districts of Nepal including Kathmandu, Bhaktapur, Lalitpur, Morang, Sunsari, Rupandehi, Chitwan, and Kaski. A convenient non-probability sampling method was considered with total sample size of 702. The questionnaire survey was conducted to collect data. Descriptive statistics, non-parametric statistical tests, and a logistic regression model were used for analysis. The study showed that 93.3% of respondents had knowledge of overall preventive practices, whereas only 32% had knowledge of overall symptoms of COVID-19. Regarding attitudes, only 14.3% strongly believed that the COVID-19 pandemic would end soon. The preventive practice was reduced after the lockdown compared to that of during the lockdown. The respondents with white-collar occupations, high-income, and unmarried were good at KAP. Similarly, highly educated and those residing in urban areas had good knowledge and practice. The study findings will help in the development of targeted programs to improve the general population's knowledge, attitudes and practices on COVID-19, which is paramount to dealing with the existing pandemic and also such possible future waves of the pandemic.

Public Anxiety, Attitudes, and Practices towards COVID-19 Infection in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

Coronavirus disease 2019, or COVID-19, still has a terrifying potential due to its continuous genetic variation. Although vaccines have been created, adherence to preventive measures remains a privileged choice to tackle the pandemic. This study aims to investigate the anxiety, attitudes, and practices (KAPs) towards COVID-19 infection in the Eastern Province of Saudi Arabia. In this cross-sectional study, data were collected from 400 participants via an online self-structured questionnaire. Anxiety, attitude, and practice scores were calculated by summing the points of the statements under the corresponding domain multiplied by 100 over 12, 21, or 15, respectively. Chi-square and one-way analysis of variance were used to investigate the relationships between vaccination, anxiety, attitude, practice scores, and demographic characteristics. More than half of the participants were female (58.5%; mean age of 29.5 years; the majority in the age groups of <20 years and 21-30 years). Only 21.5% of the participants were suffering from or previously had chronic diseases. Notably, 22.3% of the male participants were vaccinated (p = 0.000). The old age groups (41-50 years and >50 years) were more vaccinated (16.3% and 24.1%, respectively, p = 0.000), as well as the unemployed (36.4%; p = 0.000). The mean scores of anxiety, attitude, and practice were 66.8, 72.3, and 85.2, respectively. Females had an anxiety score of 68.5% (p = 0.008) and a higher attitude score of 68.5% (p = 0.008). Infected male participants had a lower practice score of 80% (p = 0.038), while females recorded higher practice scores (85.7 ± 11.6). The results highlight the importance of reliable communication from health representatives and legislators in educating the public and promoting their knowledge about non-therapeutic interventions. Efficient intervention approaches are required to fill the gap during the implementation of non-therapeutic measures. Also, it is recommended that awareness programs, during COVID-19 or any other similar pandemics, should be tailored to target Eastern Province inhabitants, especially males.

A multiplicative effect of Education and Wealth associated with HIV-related knowledge and attitudes among Ghanaian women

BACKGROUND

Knowledge and attitudes regarding HIV play a crucial role in prevention and control efforts. Understanding the factors influencing HIV-related knowledge and attitudes is essential for formulating effective interventions and policies. This study aims to investigate the possibility of an interaction between education and wealth in influencing HIV-related knowledge and attitudes among women in Ghana.

METHODS

Cross-sectional data from the Ghana Multiple Indicator Cluster Survey (MICS), a nationally representative sample, were analyzed. Statistical summaries were computed using place of residence, marital status, education level, wealth index quintile, use of insurance, functional difficulties, and exposure to modern media. Furthermore, a three-model Logistic regression analysis was conducted; Model 1 with main effects only, Model 2 with the interaction between education and wealth, and Model 3 with additional covariates. To account for the complexity of the survey data, the svyset command was executed in STATA.

RESULTS

Although most interaction terms between wealth index quintiles and education levels did not show statistical significance, a few exceptions were observed. Notably, women with primary education in the second, middle, and fourth wealth quintiles, along with those with secondary education in the second wealth quintile, exhibited a negative significant association with HIV-related attitude level. However, no significant associations were found between other factors, including age, place of residence, marital status, and health insurance, and HIV-related attitude. The study also found significant associations between socioeconomic variables and HIV-related knowledge. There was a significant positive association between higher levels of education and HIV-related knowledge level. Women in wealthier quintiles had a significant positive association with HIV-related knowledge level. Factors such as place of residence and media exposure, including radio and television were also observed to be associated with HIV-related knowledge level.

CONCLUSIONS

This study highlights the importance of socioeconomic status and media exposure in shaping HIV-related knowledge and attitudes among women in Ghana. Policy interventions should focus on reducing socioeconomic disparities, ensuring equitable access to education and healthcare services, and utilizing media platforms for effective HIV information dissemination.

Trends and correlates of low HIV knowledge among ever-married women of reproductive age: Evidence from cross-sectional Bangladesh Demographic and Health Survey 1996-2014

BACKGROUND

The human immunodeficiency virus (HIV) burden has frequently been changing over time due to epidemiological and demographic transitions. To safeguard people, particularly women of reproductive age, who can be exposed to transmitting this burden to the next generation, knowledge regarding this life-threatening virus needs to be increased. This research intends to identify the trends and associated correlates of "low" HIV knowledge among ever-married women of reproductive age in Bangladesh from 1996 to 2014.

METHODS

We analyzed data derived from six surveys of Bangladesh Demographic and Health Surveys conducted in 1996, 1999, 2004, 2007, 2011, and 2014. Analyses were primarily restricted to ever-married women aged 15-49 years who had ever heard of HIV. The correlates of "low" HIV knowledge were investigated using multiple binary logistic regression models.

RESULTS

The study found that the proportion of women with "low" HIV knowledge decreased from 72% in 1996 to 58% in 2014. In adjusted models, age at first marriage, level of education, wealth quintile, and place of residence (except in the survey year 2011) were found to be potential correlates of "low" HIV knowledge in all survey years. In the pooled analysis, we found lower odds of "low" HIV knowledge in the survey years 1999 (Adjusted Odds Ratio: 0.67; 95% CI: 0.57, 0.78), 2004 (AOR: 0.60; 95% CI: 0.52, 0.70), 2007 (AOR: 0.51; 95% CI: 0.44, 0.60), 2011 (AOR: 0.36; 95% CI: 0.32, 0.42) and 2014 (AOR: 0.47; 95% CI: 0.41, 0.54) compared to the survey year 1996.

CONCLUSION

The proportion of "low" HIV knowledge has declined over time, although the proportion of women with "low" HIV knowledge still remains high. The prevention of early marriage, the inclusion of HIV-related topics in the curricula, reduction of disparities between urban-rural and the poorest-richest groups may help to improve the level of HIV knowledge among ever-married Bangladeshi women.

Gender Differences in Knowledge, Attitudes, and Practices toward COVID-19 in Saudi Arabia: A Cross-Sectional Study

Days after the World Health Organization (WHO) declared that COVID-19 was a pandemic, Saudi Arabia took preventative and precautionary measures to avoid its spread and to safeguard its citizens. In this study, we investigated the knowledge, attitudes, and practices (KAP) of both men and women toward COVID-19 as well as associated factors. A cross-sectional study was conducted using an online, self-report questionnaire distributed via Google Forms. The overall percentage of correct answers for the knowledge statements was 80.2%, with a higher rate among the female respondents (82.4% vs. 78.5%, p = 0.005). Slightly more than half (i.e., 165: 51.6%) of the participants showed that they did not go to crowded places during the pandemic; however, more female respondents recorded that they avoided crowded places than male respondents (57.7% vs. 46.2%, p = 0.04). Most participants (i.e., 272: 85.0%) reported that they had worn a mask in recent days, and more than two-thirds (84.4%) said that they still follow the strategies recommended by government authorities to prevent the spread of the virus. Again, more female respondents reported this than males (89.9% vs. 79.5%; p = 0.01). Significant correlations (p < 001) were noted between knowledge and practices (r = 0.31), knowledge and attitudes (r = 0.37), and attitudes and practices (r = 0.29). In the multivariate logistic regression analysis, occupation and education were independently associated with knowledge among both the male and female respondents (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.2-7.2; aOR: 5.9; 95% CI: 2.2-15.9). Residence was independently associated with attitudes, but only among the male respondents (aOR: 2.3; 95% CI: 1.1-4.9), and COVID-19 was independently associated with practices among both the male and female respondents (aOR: 4.5; 95% CI: 1.4-14.2; aOR: 9.8; 95% CI: 1.2-81.2). There were significant gender differences in both knowledge and practices toward COVID-19, with the female respondents achieving better scores than the male respondents. Thus, we recommend that health education campaigns are tailored to specifically target males.

A peer group intervention implemented by community volunteers increased HIV prevention knowledge

BACKGROUND

HIV prevention knowledge levels are low in sub-Saharan Africa. In our efficacy study, the Mzake ndi Mzake (Friend-to-Friend; hereafter Mzake) 6-session peer group intervention, delivered by health workers, improved HIV prevention knowledge and other outcomes in Malawi. To expand HIV prevention approaches, this implementation study tested whether the intervention remained effective when implemented by trained community volunteers. HIV prevention knowledge findings are presented.

METHODS

Using a stepped wedge design, three communities implemented the Mzake program sequentially in randomly assigned order. Repeated surveys assessed outcomes, and participants served as controls until they completed the program. At Time 2, Community 1 became the intervention group, and at Time 3, Communities 1 and 2 were the intervention group. HIV prevention knowledge, the primary outcome, was assessed through two indicators: UNAIDS comprehensive knowledge (UNAIDS Knowledge), defined as correctly answering five HIV prevention questions (Yes/No), and a 9-item HIV/PMTCT Knowledge Index (number correct). Multivariate generalized estimating equation logistic regression (UNAIDS Knowledge) and mixed-effects regression models (HIV/PMTCT Knowledge Index) were used to assess knowledge controlling for five sociodemographic factors.

RESULTS

In bivariate analyses of UNAIDS Knowledge, more persons answered correctly in the intervention group than the control group at Time 2 (56.8% vs. 47.9%, p  < 0.01), but the difference was not significant at Time 3. In logistic regression, there was a significant linear increase in the proportion who correctly answered all questions in the control group, but the increase was significantly higher in the intervention group (log-odds estimate = 0.17, SE = 0.06, p-value < 0.01). The HIV/PMTCT Knowledge Index scores increased over time for both groups, but in the intervention group the increase was significantly higher than the control group (0.11 at Time 2; 0.21 at Time 3). In youth and adult subsamples analyses, the intervention was highly effective in increasing knowledge for youth, but not for adults.

CONCLUSION

This implementation study showed that Mzake was effective in increasing HIV prevention knowledge when delivered by community members. Community approaches offer an important strategy to increase HIV prevention in rural communities without burdening healthcare systems.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02765659. Registered 06/05/2016.

Knowledge, Attitudes and Practices of the General Population in Yemen Regarding COVID-19: A Cross-Sectional Study

BACKGROUND

Following the World Health Organization declaration of COVID-19 as a pandemic, Yemen has taken preventive and precautionary measures against COVID-19 to control its spread. This study evaluated the knowledge, attitudes, and practices (KAP) of the Yemeni public regarding COVID-19.

METHODS

A cross-sectional study using an online survey was conducted during the period from September 2021 to October 2021.

RESULTS

The mean total knowledge score was 9.50 ± 2.12. The majority of the participants (93.4%) were aware that to prevent infection by the COVID-19 virus, going to crowded places and gatherings should be avoided. Approximately two thirds of the participants (69.4%) believed COVID-19 is a health threat to their community. However, in terms of actual behavior, only 23.1% of the participants reported that they did not go to any crowded places during the pandemic, and only 23.8% had worn a mask in recent days. Moreover, only about half (49.9%) reported that they were following the strategies recommended by the authorities to prevent the spread of the virus.

CONCLUSION

The findings suggest that the general public has good knowledge and positive attitudes regarding COVID-19, but that their practices are poor.

Socioeconomic Inequality in Knowledge About HIV and Its Contributing Factors Among Women of Reproductive Age in Sub-Saharan Africa: A Multicountry and Decomposition Analysis

Aim

To examine the socioeconomic inequality in knowledge about HIV and its contributing factors among women of reproductive age in sub-Saharan Africa.

Methods

We have used the most recent demographic and health survey data of the 15 sub-Saharan African countries. 204,495 women of reproductive age made up the entire weighted sample. Erreygers normalized concentration index (ECI) was utilized to evaluate socioeconomic inequality in knowledge about HIV. The variables that contributed to the observed socioeconomic inequality were determined using decomposition analysis.

Results

We found the pro-rich inequality in knowledge about HIV (the weighted ECI was 0.16 with a Standard error = 0.007 and P value< 0.001). The decomposition analysis indicated that educational status (46.10%), wealth status (30.85%), listening to the radio (21.73%), and reading newspapers (7.05%) were among the contributors to the pro-rich socioeconomic inequalities in knowledge about HIV.

Conclusion

Having knowledge about HIV is concentrated among rich reproductive-age women. Educational status, wealth status, and media exposure were the major contributors and should be a priority for interventions to reduce the inequality in knowledge about HIV.

Factors associated with COVID-19 knowledge among Ghanaians: A national survey

BACKGROUND

Adequate knowledge about COVID-19 in a population may be relevant in the fight to control its spread among the populace. Thus, the aim of this study was to assess the factors associated with real knowledge of COVID-19 among Ghanaians to promote effective dissemination of appropriate information aimed at containing the spread.

METHODS

A cross-sectional online survey and computer assisted telephone interviews (CATI) was conducted among Ghanaians aged 18 years and above across the 260 districts of Ghana. The survey assessed the level of knowledge of COVID-19 and its associated factors and compared differences between perceived and real knowledge. One district health promotion officer per district was trained for the data collection. Participants were recruited via use of phone directories of both organized and non-organized local district groups. Phone calls were made to randomly selected phone contacts to schedule options for participation in the study. We used multivariable logistic regression to investigate the associated factors of COVID-19 knowledge among respondents.

RESULTS

Of the 2,721 participants who completed the survey, the majority (99.3%) were aware of the existence of the COVID-19 outbreak, had good knowledge on infection prevention (87.0%) and rated their knowledge about COVID-19 as good (81.7%). Factors associated with COVID-19 knowledge were: age ≥56 years (aOR = 0.5; CI: 0.3-0.8; p = 0.002), tertiary education (aOR = 1.8; CI: 1.2-2.6; p = 0.003), residing in Greater Accra region (aOR = 2.0; CI: 1.1-3.6; p = 0.019), not infected with the novel coronavirus (aOR = 1.5; Cl: 1.0-2.1; p = 0.045), knowing an infected person (aOR = 3.5; CI = 1.5-7.9; p = 0.003), good practice of effective preventive measures (aOR = 1.2: Cl: 1.1-1.5: 0.008), not misinformed (aOR = 0.7; Cl: 0.5-0.9; 0.015), and perceiving spreading speed of the virus as slow (aOR = 0.7; Cl: 0.5-0.9; 0.007).

CONCLUSION

The study found good knowledge regarding COVID-19, control measures, and preventive strategies. The Ghana Health Service should continuously provide accurate information to educate the media and citizens to prevent misinformation, which is vital in stopping the spread of the COVID-19 virus.

Knowledge, Attitude, and Practice towards COVID-19 among Mothers in Dessie Town, Northeast Ethiopia, 2020

Background

Coronavirus disease 2019 (COVID-19) is a highly infectious disease causing a catastrophic effect, and many of us are worried to find a new normal. Many burdens are occurring in households, predominantly to women and mothers. Women worldwide are naive on COVID-19 symptoms, transmission, and prevention measures and worried on being exposed to coronavirus. The study aimed to assess the mother's knowledge, attitude, and practice towards COVID-19.

Methods

A community-based cross-sectional study was conducted from July 22 to August 7, 2020, in Dessie town, Ethiopia. A total of 634 mothers were included in the study. Multistage cluster sampling was used to take the proper sample. An interviewer-administered pretested structured questionnaire was used. Data were entered into EpiData, version 3.1, and analyzed by using SPSS, version 23. Both binary and multivariate logistic regression analyses were performed to find factors associated with dependent variables. The mean score was used to grade the knowledge, attitude, and practice towards COVID-19.

Result

A total of 610 mothers participated in this study, making that a 96.2% response rate. More than half of the respondents 319 (50.3%) were in the age of 28–38 years. About 438 (71.8%) attended grades 1–12. About 531 (87.5%) were married, and most respondents 399 (65.4%) were housewives. The mean scores of knowledge, attitude, and practice were 15.36 (SD = 3.059), 6.4 (1.779), and 7.38 (3.068), respectively. Moreover, about 442 (72.5%), 354 (58%), and 338 (55.4%) of the respondents had good knowledge, a favorable attitude, and good practice on COVID-19, respectively.

Conclusion

Almost three-fourths of the mothers had good knowledge of COVID-19. However, more than two-fifths of the participants had an unfavorable attitude and poor practice on COVID-19 preventive measures, which may put a high risk of infection that could worsen maternal morbidity and mortality during this pandemic. Therefore, health education programs for mobilizing and improving COVID-19-related knowledge, attitude, and practice are urgently needed, especially for those mothers who have low access to information due to home duty.

Explaining socioeconomic inequality in cervical cancer screening uptake in Malawi

BACKGROUND

Cervical cancer is a prevalent public health concern and is among the leading causes of death among women globally. Malawi has the second highest cervical cancer prevalence and burden in the world. Due to the cervical cancer burden, the Malawi government scaled up national cancer screening services in 2011, which are free for all women. This paper is the first study to examine the socioeconomic inequality in cervical cancer screening uptake using concentration indices, in Malawi. Furthermore, it decomposes the concentration index to examine how each factor contributes to the level of inequality in the uptake of cervical cancer screening.

METHODS

The data used in this paper were obtained from the nationally representative Malawi Population HIV Impact Assessment (MPHIA) household survey, which was conducted in 2015. Concentration curves were constructed to explore whether there was any socioeconomic inequality in cervical cancer screening and, if so, its extent. This was complemented by concentration indices that were computed to quantify the magnitude of socioeconomic inequality. A decomposition analysis was then conducted to examine the factors that explained/were associated with greater socioeconomic inequality in cervical cancer screening. The methodology in this paper followed that of previous studies found in the literature and used the wealth index to measure socioeconomic status.

RESULTS

The results showed that the concentration curves lay above the line of equality, implying a pro-rich inequality in cervical cancer screening services. Confirming the results from the concentration curves, the overall concentration index was positive and significant (0.142; %95 CI = 0.127, 0.156; p < 0.01). The magnitude was lower in rural areas (0.075; %95CI = 0.059, 0.090; p < 0.01) than in urban areas (0.195; %95CI = 0.162, 0.228 p < 0.001). After undertaking a decomposition of the concentration index, we found that age, education, rural or urban location, and wealth status account for more than 95% of the socioeconomic inequality in cervical cancer uptake.

CONCLUSION

Despite the national scale-up of free cancer care at the point of use, cervical cancer screening uptake in Malawi remains pro rich. There is a need to implement parallel demand-side approaches to encourage uptake among poorer groups. These may include self-testing and mobile screening centres, among others.

Practice of people towards COVID-19 infection prevention strategies in Benishangul Gumuz Region, North–West Ethiopia: Multilevel analysis

Introduction

Coronavirus 2019 (COVID– 19) is an acute respiratory viral infectious disease in human being caused by RNA virus that belonged to the family of corona virus. The incidence of this disease was growing exponentially and affects millions of the world population that leads to expose thousands of peoples for death. Thus, this study was targeted to assess the practice of people on COVID-19 infections prevention strategies in the region.

Methods

A community based cross sectional study design was conducted in Benishangul Gumuz Region from May 25 –June 15, 2020. Multistage sampling technique was carried out to select 21 kebeles/ketena and 422 study participants. Data were collected by face to face interview using semi-structured questionnaires. The collected data were entered, cleaned and analyzed using STATA software version 14.0. Descriptive, bi-variable and multivariable multilevel models were applied. Variables with p value < 0.25 in bi-variable analysis were selected as candidates for multivariable analysis. Finally, the variables with p-value < 0.5 were considered as statistically significant, then variables with odds ratio, 95% CI were used to interpret the effect of association.

Results

The magnitude of good practice on prevention strategies of COVID– 19 infections was 62.1%. The most frequently practiced prevention strategies for COVID-19 infections were hand washing with water and soap (80.7%), alcohol-based hand rub (68.8%), maintaining social/physical distance (74.2%) and avoiding touching eyes. Individual and community level factors that affecting practice of COVID– 19 infection prevention strategies were discovered. Hence, community level factor was place of origin (AOR = 0.1; 95%CI: 0.03, 0.35) whereas individual level factors were able to read and write (AOR = 0.18; 95%CI: 0.04, 0.81) and being merchant (AOR = 2.07; 95%CI: 1.01, 4.28).

Conclusion

The level of practice of community towards COVID-19 infections prevention strategies were low as compared with the expected outcome. Individual and community level factors were identified. This implies that social mobilization and community engagement was not effective. Thus, designing appropriate strategies to improve of practice prevention strategies are strongly recommend.

Association between knowledge of Human Immunodeficiency Virus transmission and consistent condom use among sexually active men in Nigeria: An analysis of 2018 Nigeria Demographic Health Survey

An estimated 1.7 million people were living with HIV in Nigeria in 2020, with over 86,000 people newly infected. Although the global rates of HIV have remained consistent over time, Nigeria has the second-highest number of people living with HIV and contributes to 9% of the global burden of HIV/AIDS. This is due to several structural and individual-level factors that limit knowledge of HIV and condom utilization. In this context, this study examines the association between knowledge about HIV transmission and consistent condom use among sexually active men in Nigeria. The data utilised in this study was sourced from the latest Nigeria Demographic and Health Survey conducted in 2018. The sample included a total of 9,346 men between the ages of 15-59 years who were sexually active at the time of data collection. Frequency distribution, univariate and multivariable analyses were performed at 95% confidence interval and p-value less than 0.05 to determine the association between the key independent variables and covariates. The results showed that 85.03% of sexually active men who had no knowledge of HIV engaged in inconsistent condom use. The key independent variable showed that sexually active men who had knowledge of HIV had higher odds [AOR = 1.37; 95%(CI = 1.10-1.72)] of consistent condom use compared to those without knowledge of HIV. However, sexually active men who were previously married [AOR = 0.38; 95%(CI = 0.24-0.61)], and those residing in the South Eastern region of Nigeria [AOR = 0.62; 95%(CI = 0.44-0.96)] had lower odds of consistent condom use. This study established the association between HIV knowledge and consistent condom use among sexually active males in Nigeria even after controlling for confounders. Educational level, wealth index, and ethnicity are also associated with condom use. This calls for the consideration of social determinants of health, localised and cultural health promotion and targeted public health strategies at all governmental levels to combat the HIV/AIDS epidemic in Nigeria.

Knowledge of people in the East London District of South Africa about Coronavirus SARS-CoV-2: an online survey

Introduction: World Health Organization declared Coronavirus SARS-CoV-2 a pandemic after two months of its propagation in China. The lack of coordination among people about the new Coronavirus threat is evident mainly due to the dearth of knowledge. Objective: To assess the knowledge of people in the East London district of South Africa about Coronavirus SARS-CoV-2. Methods: The study was anchored on a quantitative method approach and adopted a descriptive research design. The sample consisted of 160 adults. Using the virtual snowball sampling technique, people who were 18 years and above of age and can read English were selected for the online survey. The data were collected using a 3-point Likert scale questionnaire which was uploaded in Google Form. Data were analyzed using descriptive and inferential statistics. Results: The majority of the participants knew the myths and facts about the news. They were aware that wearing a face mask prevents Coronavirus transmission, drinking liquor and using hand dryers would not kill the virus. Some people were not sure whether eating garlic or rinsing the nose regularly with saline water would help to prevent from being affected by Coronavirus. The findings also showed that there was a significant difference (p<0.05) among different age groups of people on their knowledge about the Coronavirus. Conclusion: By comparing the overall findings with the facts issued by World Health Organization, people in the East London district of South Africa had sound knowledge about Coronavirus SARS-CoV-2 on its transmission and what preventive measures should be taken.

Risks assessment of Adherence to non-pharmaceutical measures towards COVID-19 among residents of Mashhad in the North-East of Iran during the awful wave of the epidemic

Background:

Since the Coronavirus disease 19 (Covid-19) rampaged in Iran, three waves of the epidemic occurred.

Objective:

In the present study, two issues are considered. First: What proportion of the people adhere to the mitigation approaches towards the disease? Second: Which are the reasons to disobey these rules?

Methods:

A cross-sectional, population-based phone survey was applied among the population aged over 16 years in Mashhad between November 5 and December 1, 2020. A valid and reliable knowledge, attitude, and performance (KAP (designed questionnaire was used and logistic regression was performed with STATA 14.

Results:

The final sample size was 776; 90.59, 89.8 and 48.1% of the participants had sufficient reliable knowledge, attitude, and practice, respectively; 20.1% of the participants did not wear masks; nearly half of them visited traditional healers for the prevention and cure; 97.8% of them believed the efficiency of the vaccine and stated that they will consume it if it is distributed. Among the sociodemographic factors, only the unemployed had low adherence to the preventive approach; 51.7% of the main worry was the weak economic situation and 69% of jobs and expenditures were poorly affected. The odds ratio (OR) for optimising attitude reduced from 4.64 to 3.22, and for good performance from 5.64 to 5.43 after adjusting for the economic, knowledge and perception factors.

Conclusion:

Despite all the health rules and probably COVID-19 vaccines global access (COVAX), it seems that the most effective way to reverse this horrific wave and its economic consequences is the improvement of the economy and livelihood of the society.

Inequalities in Knowledge About COVID-19 in the Kingdom of Saudi Arabia

Background: As the world is still being ravaged by the coronavirus disease 2019 (COVID-19) pandemic, the first line of prevention lies in understanding the causative and preventive factors of the disease. However, given varied socioeconomic circumstances, there may be some inequality in the level of proper knowledge of COVID-19. Despite a proliferation of studies on COVID-19, the extent and prevalence of inequalities in knowledge about COVID-19 in Saudi Arabia are not known. Most related studies have only focused on understanding the determinants of COVID-19 knowledge. Therefore, the aim of this study was to assess the socioeconomic inequalities in knowledge regarding COVID-19 in Saudi Arabia.

Methods: Data were extracted from an online cross-sectional self-reported questionnaire conducted on the knowledge about COVID-19 from 3,388 participants. Frequencies and graphs were used to identify the level and distribution of inequality in knowledge about COVID-19. Concentration curves and concentration indices were further used to assess and quantify the income- and education-related inequality in knowledge about COVID-19.

Results: The level of COVID-19 knowledge was high among the surveyed sample, although the extent of knowledge varied. The findings further suggest the existence of socioeconomic inequality in obtaining proper knowledge about COVID-19, indicating that inequality in comprehensive knowledge is disproportionately concentrated among the wealthy (concentration index = 0.016; P < 0.001) and highly educated individuals (concentration index = 0.003; P = 0.029) in Saudi Arabia.

Conclusions: There is inequality in the level of knowledge about COVID-19 among the more socioeconomically privileged population of Saudi Arabia. Given that COVID-19 cases ebb and flow in different waves, it is important that proper policies be put in place that will help in improving knowledge among the lower income and less educated individuals, leading to behavior that can help reduce transmission.

Public Knowledge, Attitude, and Perception towards COVID-19 Vaccination in Saudi Arabia

Coronavirus disease-19 (COVID-19) is a highly contagious infection that mainly affects the respiratory system of patients. To date, more than 10 million people have been affected by this virus, and Saudi Arabia has also reported over 210 million cases. At present, there is no established treatment for COVID-19. Vaccination is one of the ways to defeat the pandemic. Recent reports have indicated rare but serious adverse events after vaccination, causing an anxious response from the general public worldwide. Therefore, this study was aimed at evaluating the knowledge, attitude, and perception of the COVID-19 vaccine among the Saudi population. This study is a cross-sectional, web-based online survey conducted using a snowball sampling technique. A self-administered questionnaire prepared in Arabic and English was used to collect feedback from the general population on their knowledge, attitudes, and perceptions about the COVID-19 vaccine. Participants (n = 2022) from different regions of the country replied to the questions. The responses to the questions were recorded on a spreadsheet and analyzed using the SPSS software. Statistical analysis was performed using one-way ANOVA and non-parametric tests to draw conclusions about the results. Multivariate stepwise regression analysis was performed to determine the association between the knowledge, attitude, and perception scores and the demographic variables. p < 0.05 was used to indicate the significance of the data. The data from the study indicated that most of the participants were males (81%), between 18 and 59 years of age (85.9%), Saudi nationals (98.3%), and possessed graduation or above as a qualification (62.9%). The results suggest that a major portion of respondents have satisfactory knowledge (76%), a positive attitude (72.4%), and perception (71.3%) towards the use of COVID-19 vaccines. Their responses can be categorized as between 'good' and 'fair'. However, 30-40% of respondents lacked information about COVID-19 vaccination availability for under 18-year-olds as well as for pregnant women, in addition to the lack of knowledge about the serious unreported adverse reactions and long-term protection offered by the vaccine against coronavirus. The correlation analysis between the variables (p > 0.05) indicated that the response to the KAP domains has no direct relationship. The survey results suggest that most of the Saudi population has sound knowledge and a positive attitude and perception. Since the COVID-19 vaccines have been approved for use in pregnancy and above 12-year-old children by health authorities, the lack of information shown by a significant percentage of participants requires strategies to update this information. Awareness programs targeting all sections of the population must be continued to provide all the updates, including vaccinations for pregnant women and children.

Knowledge of Students regarding HIV/AIDS at a Rural University in South Africa

Introduction:

Knowledge about HIV/AIDS is essential for facilitating safer sexual behaviour hence, it is important in controlling HIV. Therefore, in the absence of a cure for the pandemic, adequate knowledge about the virus remains the backbone of prevention efforts.

Objective:

To assess the knowledge regarding HIV/AIDS among undergraduate students at a rural university in Limpopo Province, South Africa.

Methods:

A cross-sectional descriptive quantitative survey-based study was conducted at a rural-based university in South Africa. Stratified random sampling was used to select 345 students. A self-administered questionnaire composed of 26 questions was utilised to gather data and the data were analysed using SPSS version 26. Multiple logistic regression and chi-square tests [χ2] were employed to determine the association between HIV/AIDS knowledge and demographic variables.

Results:

The overall HIV/AIDS knowledge score of students shows that (74)21% had a poor level of knowledge, (126)37% had average knowledge, and (145)42% had adequate knowledge. There was no significant difference between male and female students regarding their knowledge about HIV/AIDS. Factors, such as age, level of study, the field of study, and religion, were not significantly associated with HIV/AIDS knowledge. However, the race was significantly associated with knowledge with coloureds and mixed races, almost six times less knowledgeable than blacks.

Conclusion:

In conclusion, students had inadequate knowledge about HIV/AIDS. Misconceptions about HIV/AIDS facts, transmission routes, and prevention aspects were also prevalent among students. The present study accentuates the need for providing students with more HIV/AIDS education to fill HIV knowledge gaps and misconceptions.

Handwashing knowledge, attitudes, and practices during the COVID-19 pandemic in Saudi Arabia: A non-representative cross-sectional study

Handwashing (HW) with water and soap is one of the cheapest and most effective ways of protecting oneself and others against the coronavirus. Here, the HW knowledge, attitudes, and practices of Saudi adults were assessed during the COVID-19 pandemic using a cross-sectional study conducted between May 8 and June 8, 2020, during a partial lockdown period. A web-based validated questionnaire was distributed through different social media platforms, and the sociodemographic characteristics of the participants, seven items related to knowledge, four items related to attitudes, and thirteen items related to the practice of HW were assessed. A total of 1323 (51% male and 49% female) adults from all regions of Saudi Arabia responded to the questionnaire. The overall mean (± SD) was 5.13 (± 1.18) for knowledge of HW and COVID-19, 2.79 (± 0.77) for attitude toward HW, and 7.8 (± 2.56) for HW practice. A multiple linear regression analysis revealed factors associated with knowledge to be age and family income. Sex, educational level, family income, and HW knowledge were associated with negative and neutral attitude, whereas age, sex, family income, and HW knowledge were associated with practice. These results suggest that HW knowledge was strongly associated with positive attitudes toward HW and correct HW practice in Saudi adults during the COVID-19 lockdown.

Exemption for the poor or the rich? An assessment of socioeconomic inequalities in Ghana's national health insurance exemption policies

Out-of-pocket payments for health are considered a major limitation to universal health coverage (UHC). Policymakers across the globe are committed to achieving UHC through the removal of financial barriers to health care. In Ghana, a national health insurance scheme was established for this purpose. A unique feature of the scheme is its premium exemption policies for vulnerable groups. In this article, we access the nature of socioeconomic inequality in these exemption policies. We used data from the Ghana Living Standards Survey rounds six and seven. Socioeconomic inequality was assessed using concentration curves and indices. Real household annual total consumption expenditure adjusted by adult equivalence scale was used as a wealth indicator. Four categories of exemption were used as outcome variables. These were exemptions for indigents, individuals <18 years, the aged and free maternal service. The analysis was also disaggregated by rural and urban locations of individuals. We found that while overall national health insurance scheme (NHIS) coverage was concentrated among the wealthy, all categories of premium exemption were concentrated among the poor. There was also evidence of a general decline in the magnitude of inequality over the survey years. With the specific exemptions, inequalities in exemption for indigents and maternal services were most relevant in rural locations, while inequalities in exemption for individuals <18 years and the aged were significant in urban areas. The findings suggest that the exemption policies under the NHIS are generally progressive and achieve the objective of inclusion for the underprivileged. However, it also provides lessons for better targeting and effective implementation. There may be a need for separate efforts to better target individuals in rural and urban locations to improve enrolment.

Knowledge of community members on COVID-19 in Ibadan, Oyo State, Nigeria

INTRODUCTION

more cases of COVID-19 continue to be reported in Nigeria. The level of knowledge could prompt individuals to take precautionary measures and reduce the spread. This study aimed to assess the knowledge of community members in Ibadan on COVID-19.

METHODS

using a descriptive cross-sectional study design, an interviewer-administered semi-structured questionnaire was used to obtain information from adult community members. Multistage sampling methods were used to select respondents from four local government areas (LGAs). Knowledge scores of causes, mode of spread, signs and symptoms and preventive measures were computed. Scores above the mean were categorized as satisfactory. Bivariate chi-square tests and binary logistic regression were performed on respondents' characteristics and knowledge of COVID-19.

RESULTS

respondents interviewed were 480 with a median age of 32 years (range: 18-80 years), and 191 (39.8%) aged between 25 and 34 years. Females were 275 (57.3%), 18 (3.8%) had never heard of COVID-19. The main source of information was radio 88.1% and television 54.3%. In all the knowledge domains 200 (43.3%) had satisfactory knowledge of COVID-19. Respondents in Ibadan North-West LGA had five times odds [OR=5.23 (95%CI=2.87-9.54)] of having satisfactory knowledge of COVID-19 while respondents in Ibadan North-East LGA had three times odds [OR=3.35 (95%CI=1.85-6.09)] compared to those in Ibadan South East LGA.

CONCLUSION

an even dissemination strategy of COVID-19 information across the communities is required. More sensitization and health education sessions should be broadcast on the radio and television. Regular COVID-19 broadcast is required to improve the knowledge level of community members.

KAP-COVIDGLOBAL: a multinational survey of the levels and determinants of public knowledge, attitudes and practices towards COVID-19

OBJECTIVE

The adherence to public health recommendations to control COVID-19 spread is influenced by public knowledge, attitudes and practices (KAP). We performed this cross-sectional study to assess the levels and determinants of public KAP towards COVID-19 in a large, multinational sample.

DESIGN

Cross-sectional study (survey).

SETTING

The questionnaire was distributed to potential respondents via online platforms.

PARTICIPANTS

71 890 individuals from 22 countries.

METHODS

We formulated a four-section questionnaire in English, followed by validation and translation into seven languages. The questionnaire was distributed (May to June 2020) and each participant received a score for each KAP section.

RESULTS

Overall, the participants had fair knowledge (mean score: 19.24±3.59) and attitudes (3.72±2.31) and good practices (12.12±1.83) regarding COVID-19. About 92% reported moderate to high compliance with national lockdown. However, significant gaps were observed: only 68.2% knew that infected individuals may be asymptomatic; 45.4% believed that antibiotics are an effective treatment; and 55.4% stated that a vaccine has been developed (at the time of data collection). 71.9% believed or were uncertain that COVID-19 is a global conspiracy; 36.8% and 51% were afraid of contacting doctors and Chinese people, respectively. Further, 66.4% reported the pandemic had moderate to high negative effects on their mental health. Female gender, higher education and urban residents had significantly (p≤0.001) higher knowledge and practice scores. Further, we observed significant correlations between all KAP scores.

CONCLUSIONS

Although the public have fair/good knowledge and practices regarding COVID-19, significant gaps should be addressed. Future awareness efforts should target less advantaged groups and future studies should develop new strategies to tackle COVID-19 negative mental health effects.

COVID-19: Knowledge of Mode of Spread and Preventive Practices among College Adolescents in Nigeria

BACKGROUND

Corona virus pandemic (COVID 19) has emerged as the single most important topical issue and poses a challenge to medicine. Adolescent school children are exposed to a varying degree.

OBJECTIVES

The study is aimed to determine the knowledge of the mode of spread and preventive practices among college adolescents attending six secondary schools in Enugu metropolis.

METHODOLOGY

This was a cross-sectional study carried out in 6 secondary schools among 500 college adolescents. A pretested, interviewer-administered questionnaire was used for data collection.

RESULTS

Majority of the respondents, 98.4% were aware of COVID-19. Although, a higher proportion of the respondents, 52.0% were aware COVID-19 could be transmitted through contact with infected persons, only a minor proportion of them, 42.4% had a good knowledge of the mode of spread of COVID-19. However, a high proportion of the respondents, 69.2% practiced good preventive measures against COVID-19. Also, respondents whose parents were self-employed were 1.4 times more likely to have good knowledge of the mode of spread of COVID-19 when compared with those whose parents were on paid employment [adjusted odd ratio (AOR) = 1.4, 95% confidence interval (CI): 0.9-2.0]. The respondents whose fathers have attained tertiary education were 1.6 times more likely to have good preventive practices against COVID-19 when compared with those who had secondary school and below (AOR = 1.6, 95% CI: 1.04-2.5).

CONCLUSION

Though college adolescents were aware of COVID-19, not a significant proportion practiced good preventive measures against COVID-19. Knowledge of mode of spread and preventive practices were significantly enhanced by fathers' educational status and being a female adolescent child.

The Knowledge and Attitude of the Community from the Aseer Region, Saudi Arabia, Toward COVID-19 and Their Precautionary Measures Against the Disease

BACKGROUND

Community adherence to current control measures is one of the vital factors that determines the success of controlling the spread of COVID-19. This adherence depends on the knowledge and attitude of a community toward COVID-19 and their precautionary measures against the disease.

OBJECTIVE

This study aims to evaluate the knowledge and attitude of the community from the Aseer Region, Saudi Arabia, toward COVID-19 and their precautionary measures against the disease.

METHODS

The descriptive cross-sectional study involved an online sample of participants from the Aseer Region, Saudi Arabia, who were recruited based on a nonprobability convenience sampling method from April to May 2020. The self-administered online questionnaire comprised four parts: the first included the demographic details of the participants; the second consisted of 11 closed-ended questions that assessed the participants' knowledge of COVID-19; the third contained six closed-ended questions that assessed the participants' overall attitude toward COVID-19; and the fourth comprised six closed-ended questions on the participants' precautionary measures against COVID-19. The data were analyzed using Statistisoftware SPSS 21.0.

RESULTS

Altogether, 740 participants completed the online questionnaire. The mean knowledge score concerning COVID-19 was 8.08 ± 1.765. Graduate participants scored significantly higher for all knowledge items than those from other educational levels. Furthermore, the main source of COVID-19 information was the Ministry of Health website 661 (89.3%). The mean attitude score regarding COVID-19 was 9.74 ± 1.935, whereas the mean precautionary measures score was 10.09 ± 1.91. University-educated participants scored significantly higher for all knowledge items than those from other educational levels. Female participants had significantly higher precautionary measures scores than male participants.

CONCLUSION

This study confirms that residents of the Aseer Region have high knowledge of, demonstrate a positive attitude toward, and use appropriate precautionary measures against COVID-19, which is associated with obtaining information about the virus from the Ministry of Health website.

Trends and Factors Associated with Comprehensive Knowledge about HIV among Women in Vietnam

This study aimed to assess the trends and associated factors of comprehensive knowledge about HIV among women in Vietnam using the dataset of the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000, 2006, 2011, and 2014. The outcome variable was comprehensive knowledge about HIV, defined as the ability to correctly answer three knowledge questions and to reject the three most common misconceptions about HIV prevention. We found that comprehensive knowledge about HIV increased from 26.1% in 2000 to 44.1% in 2011, but it decreased slightly between 2011 and 2014, from 44.1% to 42.4%. Increased comprehensive knowledge about HIV was associated with women who had higher education and those in the fourth and fifth quintiles of household wealth in all four rounds of the MICS. Comprehensive knowledge about HIV among women was also associated with those who had ever been tested for HIV and those with knowledge of where to be tested for HIV. Women in the urban areas were more likely to have higher levels of comprehensive knowledge about HIV as compared to the women in the rural areas in 2000, 2006, and 2011 but not in 2014. Comprehensive knowledge about HIV among women in Vietnam increased from 2000 to 2014, but it was still relatively low.

REALITIES OF COVID-19 PANDEMIC IN NIGERIA: COPING WITH THE CHALLENGES AND CHARTING A WAY FORWARD

The impacts of COVID-19 have cut across both developed and developing countries alike. This has prompted different coping mechanisms for survival through these trying times. The reality of stigmatization in this period has negatively affected health-seeking behavior and public response to the outbreak. Challenges exist at both the community and the healthcare providing facilities. We present a review of best practices in coping with COVID-19. Our focus is on how to cope with the challenges and strategies to improve the response to the pandemic in Nigeria. It is required that safety measures be fully adopted and practiced by individuals and groups. Collaborative efforts are required by all stakeholders, government, healthcare workers, and private organizations to mitigate the negative effects of the pandemic, avoid stigmatization, and ease the return journey to normalcy.

Knowledge, Attitude and Practice Toward COVID-19 Among the Public in the Kingdom of Saudi Arabia: A Cross-Sectional Study

Background: Saudi Arabia has taken unprecedented and stringent preventive and precautionary measures against COVID-19 to control its spread, safeguard citizens and ensure their well-being. Public adherence to preventive measures is influenced by their knowledge and attitude toward COVID-19. This study investigated the knowledge, attitudes, and practices of the Saudi public, toward COVID-19, during the pandemic. Methods: This is a cross-sectional study, using data collected via an online self-reported questionnaire, from 3,388 participants. To assess the differences in mean scores, and identify factors associated with knowledge, attitudes, and practices toward COVID-19, the data were run through univariate and multivariable regression analyses, respectively. Results: The majority of the study participants were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 17.96 (SD = 2.24, range: 3-22), indicating a high level of knowledge. The mean score for attitude was 28.23 (SD = 2.76, range: 6-30), indicating optimistic attitudes. The mean score for practices was 4.34 (SD = 0.87, range: 0-5), indicating good practices. However, the results showed that men have less knowledge, less optimistic attitudes, and less good practice toward COVID-19, than women. We also found that older adults are likely to have better knowledge and practices, than younger people. Conclusions: Our finding suggests that targeted health education interventions should be directed to this particular vulnerable population, who may be at increased risk of contracting COVID-19. For example, COVID-19 knowledge may increase significantly if health education programs are specifically targeted at men.