Knowledge, attitude and practice survey of COVID-19 pandemic in Northern Nigeria

Abstract

Background A pandemic of coronavirus disease 2019 (COVID-19) emerged and affected most of the world in early 2020. To inform effective public health measures we conducted a knowledge, attitude and practice (KAP) survey among a Hausa Muslim society in Nigeria in March 2020. Methods The study is an analytic cross-sectional survey with questionnaires administered to the general population including Health Care Workers (HCW) in Kano, Nigeria. Participants were recruited by convenience sampling following informed consent. The percentage of KAP scores were categorized as good and poor. Independent predictors of good knowledge of COVID 19 were ascertained using a binary logistic regression model. Results The questionnaire was administered among urban 32.8%, peri-urban dwellers 32.4%, and to online participants 34.8%. The peri-urban and urban participants were given paper questionnaires. There were 886 study participants with mean age 28.58yrs [SD:10.25] (Interquartile range [IQR]:22yrs–32yrs), males 55.4% with 57.3% having had or were in tertiary education. Most participants were students 40% and civil servants 20%. The overall mean [standard deviation (SD)] for knowledge, attitude and practice scores expressed in percentage was 65.38%[SD15.90], 71.45% [SD14.10], and 65.04% [SD17.02] respectively. Out of the respondents, 270(30.47%) had good knowledge (GK), 158(17.8%) had good attitude (GA), and 230(25.96%) had good practice (GP) using cut-off scores of 75%, 86.5%, and 75% respectively. Over 48% did not agree COVID-19 originated from animals while 60% perceived the pandemic to be due to God’s punishment. Also, 36% thought it was a man-made virus. When rating fear, most respondents [63.5%] had marked fear i.e. ≥ 7 out of 10 and 56% admitted to modifying their habits recently in fear of contracting the virus. As regards attitude to religious norms, 77.77% agreed on cancellation of the lesser pilgrimage as a measure to curb the spread of the disease while 23.64% admitted that greater pilgrimage (Hajj) should proceed despite the persistence of the ongoing pandemic. About 50% of the respondents insisted on attending Friday congregational prayers despite social distancing. One in four people still harbored stigma towards a person who has recovered from the virus. 28% felt some races are more at risk of the disease though 66% mentioned always practicing social distancing from persons coughing or sneezing. Almost 70% of respondents said they were willing to accept a vaccine with 39% saying they would be willing to pay for it if not publicly funded. In univariate analysis increasing age and having been ever married were associated with GK while tertiary education was associated with GA [Odds Ratio; 95% Confidence Interval] 2.66(1.79–3.95). Independent positive predictors of GK were those who were or had ever been married, those who had marked fear of COVID-19, and had modified their habits in the last three months. Those who had non-tertiary education and had the questionnaire administered as paper rather than online version had GK but age was not a predictor. Conclusion Knowledge of transmission and preventive measures should be improved in the general population cognizant of cultural norms and Islamic practices. The study highlights the importance of considering belief systems and perception in developing control measures against COVID-19.

Knowledge, Attitudes and Practices of Pregnant Women Attending the Antenatal Clinic of Rivers State University Teaching Hospital, Nigeria towards the Coronavirus (COVID-19) Pandemic

“…The overall level of good attitude of respondents towards the covid-19 pandemic in the present study of 20.2% was similar to the 25% documented in South Africa [21] and 17.8% in Kano, [27] northern Nigeria. Similarly, low percentage of good attitude of 51.5% and 56.4% were reported in Uganda [26] and Onitsha, [32] south-east Nigeria respectively.…”

“…Most respondents had tertiary level of education as was also observed in other cities in Nigeria, [6,15,17,18,22,[27][28][29] India, [23] Uganda, [26] Chad [30] and China. [31] In contrast, secondary level of education predominated in Benin, [16] southern Nigeria.…”

“…Television being the commonest source of information was also reported by Adesegun et al, [6] Anikwe et al, [15] Nicholas et al [20] and Okello et al [26] In contrast, social media was the commonest source of information by Ejeh et al, [14] Reuben et al, [18] Sayedahmed et al [19] Habib et al [27] and Egbi et al [28] Close to 2/3 rd (65.6%) of the respondents knew that COVID-19 was a viral disease. Much higher knowledge level was observed in Northern Nigeria [27] (73.1%), Cameroon [20] (77.1%), Onitsha, [15] south-east Nigeria (88.0%), Oyo state, [24] south-west Nigeria (88.6%), north-central Nigeria [18] (91.9%) and Abakaliki, [25] southeast Nigeria (98.4%). A lower knowledge level (60%) was however documented in Onitsha, [32] south-east Nigeria.…”

“…This high knowledge level corroborates the 85.3%, 86.6% and 88.75% documented by Omozuwa et al, [16] Edet et al [17] and Ejeh et al [14] in Nigeria but lower than the over 90% and 90% reported by Anozie et al [25] and Zhong et al [31] in Abakaliki south-east Nigeria and China respectively. Lower knowledge levels of 78.7%, 60.7%, 30.47%, 75.3%, 43%, 68.3% and 21.9% were reported in Nigeria, [6,32,27] India, [23] South Africa, [21] Sudan [19] and Cameroon [20] respectively. This varying knowledge could be attributable to the varying study population and time of study in relation to when the pandemic began as well as difference in the questions asked in the various studies.…”

“…Majority of the respondents in the present study identified transmission of COVID-19 infection via droplets from air (60.7%) and contact with infected surfaces (51.6%). Air droplets was similarly documented as the commonest mode of transmission in Nigeria [18,25,27,29,32] and India. [23] Contrary to the present study however, human and animal modes of transmission accounted for 38% and 32% respectively followed by air droplets (30%) in Abakaliki, [15] south-east Nigeria whereas in Cameroon, [20] 74.6% identified direct contact, 51.9% air droplets and 45.2% contact with infected surfaces.…”