Knowledge, Attitudes, and Practices Toward the Prevention of COVID-19 in Bangladesh: A Systematic Review and Meta-Analysis

Meta-analysis of KAP toward COVID-19 in Chinese residents

Background

During the coronavirus disease-2019 (COVID-19) pandemic, there have been many studies on knowledge, attitudes, and practices (KAP) toward prevention of COVID-19 infection in China. Except for symptomatic treatment and vaccination, KAP toward COVID-19 plays an important role in the prevention of COVID-19. There is no systematic evaluation and meta-analysis of KAP toward COVID-19 in China. This study is the earliest meta-analysis of KAP toward COVID-19 in China's general population. Hence, this systematic review aimed to summarize the knowledge, attitudes, and practices (KAP) of Chinese residents toward COVID-19 during the pandemic.

Methodology

Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Chinese population were found in databases such as Scopus, ProQuest, PubMed, EMbase, Web of Science, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, CQVIP, Wanfang and Google Scholar. A random-effect meta-analysis is used to summarize studies on knowledge, attitudes, and practice levels toward COVID-19 infection in China's general population.

Results

Fifty-seven articles published between August 2020 and November 2022 were included in this review. Overall, 75% (95% CI: 72-79%) of Chinese residents had good knowledge about COVID-19, 80% (95% CI: 73-87%) of Chinese residents had a positive attitude toward COVID-19 pandemic control and prevention (they believe that Chinese people will win the battle against the epidemic), and the aggregated proportion of residents with a correct practice toward COVID-19 was 84% (95% CI: 82-87%, I2 = 99.7%).In the gender subgroup analysis, there is no significant difference between Chinese men and Chinese women in terms of their understanding of COVID-19. However, Chinese women tend to have slightly higher levels of knowledge and a more positive attitude toward the virus compared to Chinese men. When considering the urban and rural subgroup analysis, it was found that Chinese urban residents have a better understanding of COVID-19 compared to Chinese rural residents. Interestingly, the rural population displayed higher rates of correct behavior and positive attitudes toward COVID-19 compared to the urban population. Furthermore, in the subgroup analysis based on different regions in China, the eastern, central, and southwestern regions exhibited higher levels of knowledge awareness compared to other regions. It is worth noting that all regions in China demonstrated good rates of correct behavior and positive attitudes toward COVID-19.

Conclusion

This study reviews the level of KAP toward COVID-19 during the pandemic period in China. The results show that the KAP toward COVID-19 in Chinese residents was above a favorable level, but the lack of translation of knowledge into practice should be further reflected on and improved. A subgroup analysis suggests that certain groups need more attention, such as males and people living in rural areas. Policy makers should pay attention to the results of this study and use them as a reference for the development of prevention and control strategies for major public health events that may occur in the future.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=348246, CRD42022348246.

Knowledge, attitude and practices towards SARS-CoV-2 genetic mutations and emerging variants among the population in Bangladesh: a cross-sectional study

OBJECTIVES

The coronavirus is continuously mutating and creating new SARS-CoV-2 variants. Public awareness about SARS-CoV-2 mutation is essential for effective preventive measures. The present study aimed to assess the knowledge, attitude and practices (KAP) towards SARS-CoV-2 variants among the general population in Bangladesh.

DESIGN

We conducted this online survey between 9 April 2021 and 10 May 2021 using structured questionnaires to collect the information.

SETTING

We distributed the survey link among the participants from all 64 districts of Bangladesh using social media platforms.

PARTICIPANTS

A total of 1,090 respondents completed this survey. After careful evaluation, we excluded 18 responses due to partial or incomplete information, and 1,072 responses entered into the final analysis.

PRIMARY OUTCOME

The KAP of participants towards SARS-CoV-2 variants depends on their demographic backgrounds. Associations between demographic characteristics and the likelihood of having adequate KAP were estimated using adjusted logistic regressions.

RESULTS

Among the participants, 42% had a poor knowledge level, 4% had a low attitude level and 14% had a poor practice score. The average knowledge, attitude and practice score were 2.65, 4.194 and 4.464 on a scale of 5, respectively. Only 51.8% of the participants knew about mutant strains, and only 47.6% knew about the effectiveness of vaccines against new variants. The key factors associated with poor knowledge levels were educational levels, area of residence, geographic location, and concern regarding COVID-19. Sociodemographic factors for poor attitude levels were geographic location, vaccination and concern regarding COVID-19. The pivotal factors in determining poor practice scores were the residence area of people and concern regarding COVID-19.

CONCLUSIONS

The knowledge level and positive attitude are associated with better preventive measures against SARS-CoV-2 variants. Based on these findings, we recommended several awareness programmes on SARS-CoV-2 mutations and variants for the rural population in Bangladesh to increase overall awareness levels.

Assessment of attitudes and practices towards COVID-19 pandemic: a survey on a cohort of educated Syrian population

BACKGROUND

Coronavirus disease (COVID-19) caused the death of millions of people and affected the lives of hundreds of millions worldwide. The WHO recommendations aimed mainly to reduce transmission, minimize infection, and get people vaccinated. Nevertheless, opinions and attitudes about the disease varied. In this study, we evaluated personal attitudes and practices of a cohort of an educated Syrian population, after several waves of infection with COVID-19 and the release of different types of vaccines.

METHODS

A cross-sectional internet-based survey was launched in January 2022.The survey queried the participants' personal experience, attitudes, practices towards COVID-19, and vaccination.

RESULTS

The study included 408 individuals. The respondents were mainly females (72.6%), 20-29 years old (39.2%), and college graduates (59.3%). A large proportion (89.7%) reported having been infected at least once during the pandemic; a significant association was found with age (p = 0.001). Nearly half of the respondents got vaccinated; the majority were > 40 years old. Opinions differed regarding the effectiveness and safety of the vaccines; only a small percentage of the participants (17.4%) thought all vaccines were effective and safe. Remarkably, the level of education did not significantly dominate the participants' attitudes or practices towards the COVID-19 pandemic. Approximately half of the respondents (44.9%) stated their lives were affected by the pandemic and over the third were worried (38%). A significant association was detected with gender in favour of females. Most of the participants have taken at least one precautionary measure to limit the infection.

CONCLUSION

The level of education did not significantly dominate the participants' attitudes or practices towards the COVID-19 pandemic. Female respondents were more cautious, concerned and committed to taking precautionary measures regardless of their education level. However, their unwillingness to receive the vaccine raises significant concerns. Efforts should be made to emphasize the importance of immunization, the safety and effectiveness of vaccines, and encourage vaccination among individuals.

Internet addiction during the COVID-19 pandemic among adolescents in southeast Nigeria and implications for adolescent care in the post-pandemic era: A cross-sectional study

Objectives

This study aimed to determine the prevalence and associated factors of internet addiction amongst adolescents in Southeast Nigeria during the coronavirus disease 2019 (COVID-19) era.

Methods

A cross-sectional study was carried out in 10 randomly selected secondary schools, 2 (one urban and one rural) each from Abia, Anambra, Ebonyi Enugu and Imo states of southeastern Nigeria between July and August 2021. Data on demographic variables were collected using a structured self-administered questionnaire. Young's Internet Addiction Test was used to assess the extent of internet use. Analysis was done using the IBM SPSS Statistics version 23. The level of significance was set at a p-value of <0.05.

Results

The mean age of the respondents was 16.2 ± 1.8 years and the male: female ratio was 1:1.6. Most of the adolescents (61.1%) used the internet for academic purposes, while 32.8% used it for social interactions and the majority (51.5%) used their phones. The prevalence of internet addiction was 88.1% (24.9% had mild, 59.6% had moderate, while 3.6% had severe addiction) and a good proportion of the respondents (81.1%) perceived addiction as bad. Internet addiction was significantly associated with the respondent's age (p = 0.043), mother's level of education (p = 0.023), family size (p = 0.021), place of residence (p = 0.035), alcohol intake (p = 0.017), smoking (p = 0.015), substance use (p = 0.001) as well as the duration of internet use (p < 0.001). Internet addiction was predicted by the male gender (adjusted odds ratio (AOR): 2.054; confidence interval (CI): 1.200-3.518), early adolescent age group (10-13 years) (AOR: 0.115; C1: 0.015-0.895) as well as the duration of internet use (AOR: 0.301; CI: 0.189-0.479).

Conclusions

The prevalence of internet addiction among adolescents during the COVID-19 pandemic era was high. The predictors of addiction were the male gender, early adolescent age group and duration of internet use.

Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait

OBJECTIVES

To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients.

METHODS

A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics.

RESULTS

A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%).

CONCLUSIONS

Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.

Knowledge, Attitude, and Perception of Cancer Patients towards COVID-19 in Pakistan: A Cross-Sectional Study

Background: Cancer patients, being immunocompromised, are at higher risk of coronavirus disease (COVID-19). The current study determines cancer patients’ knowledge, attitude, perception, and impact of the COVID-19 pandemic. Method: A cross-sectional online survey was conducted in Pakistan from 1 April 2020 to 1 May 2020. The study respondents were cancer patients with ages equal to or greater than 18 years. Following a request for participation, the URL for the survey was distributed on numerous channels. Other social media platforms, including WeChat, WhatsApp, Facebook, Twitter, Instagram, Messenger, and LinkedIn, were used to increase cancer patient interaction. The questionnaire comprised five different sections such as: (1) sociodemographic information, (2) knowledge, (3) attitude, (4) perception, and (5) impact of COVID-19 on cancer patients. Descriptive medical statistics such as frequency, percentage, mean, and standard deviation were used to illustrate the demographic characteristics of the study participants. To compare mean knowledge scores with selected demographic variables, independent sample t-tests and one-way analysis of variance (ANOVA) were used, which are also practical methods in epidemiological, public health and medical research. The cut-off point for statistical significance was set at a p-value of 0.05. Results: More than 300 cancer patients were invited, of which 208 agreed to take part. The response rate was 69.33% (208/300). Gender, marital status, and employment status had a significant association with knowledge scores. Of the total recruited participants, 96% (n = 200) (p < 0.01) knew about COVID-19, and 90% were aware of general symptoms of COVID-19 disease, such as route of transmission and preventive measurements. In total, 94.5% (n = 197) (p < 0.01) were willing to accept isolation if they were infected with COVID-19, and 98% (n = 204) (p < 0.01) had reduced their use of public transportation. More than 90% (n = 188) (p < 0.01) of cancer patients were found to be practicing preventative measures such as using a face mask, keeping social distance, and avoiding handshaking and hugging. Around 94.4% (n = 196) (p < 0.01) of cancer patients had been impacted by, stopped or had changed cancer treatment during this pandemic, resulting in COVID-related anxiety and depression. Conclusion: The included cancer patients exhibited a good level of COVID-19 knowledge, awareness, positive attitude, and perception. Large-scale studies and efforts are needed to raise COVID-19 awareness among less educated and high-risk populations. The present survey indicates that mass-level effective health education initiatives are required for developing countries to improve and reduce the gap between KAP and COVID-19.

Facebook use and its predictive factors among students: Evidence from a lower- and middle-income country, Bangladesh

BACKGROUND

Facebook is a popular social networking site in the modern world. It has an adverse effect such as impairing daily health and psychological health and also interpersonal relationships when the use becomes problematic.

AIMS

To examine problematic Facebook use (PFU) and its predictors among Bangladeshi students during the COVID-19 pandemic.

METHOD

A cross-sectional online survey was conducted among 601 Bangladeshi students and collected data related to socio-demographic information, behavioral health, internet use behavior, depression, anxiety and problematic Facebook use [assessed using the Bergen Facebook Addiction Scale (BFAS)]. The data were analyzed using descriptive (frequencies and percentages) and inferential statistics (independent sample t-tests, one-way ANOVAs, correlations, and multivariable linear regression).

RESULTS

The results indicated that 29.1% of participants were problematic Facebook users (using cutoff ≥18 out of 30). Medical college students had higher mean score on PFU than other students (p < 0.001). In addition, the mean score of PFU was significantly higher among the students who were in a relationship (p = 0.001), did not engage in physical activity (p < 0.001), used the internet more than 5 h per day (p < 0.001), used social media (p < 0.001), and had depression or anxiety symptoms (p < 0.001). PFU was significantly associated with depression and anxiety among the whole sample. Predictive factors for PFU included relationship status, daily internet use time, gaming, social media use, depression, and anxiety. The model predicted almost 33.2% variance for PFU.

CONCLUSIONS

Findings suggest interventions should be implemented for students with a special focus on medical students who had higher score of PFU than other types of students.