Knowledge, practice and associated factors towards the prevention of COVID-19 among high-risk groups: A cross-sectional study in Addis Ababa, Ethiopia

Atkure Defar

Gebeyaw Molla

Saro Abdella

Masresha Tessema

Muhammed Ahmed

Ashenif Tadele

Fikresilassie Getachew

Bezawit Hailegiorgis

Eyasu Tigabu

Sabit Ababor

Ketema Bizuwork

Asefa Deressa

Geremew Tasaw

Adisu Kebede

Daniel Melese

Andargachew Gashu

Kirubel Eshetu

Adamu Tayachew

Mesfin Wossen

Abduilhafiz Hassen

Shambel Habebe

Zewdu Assefa

Aschalew Abayneh

Ebba Abate

Getachew Tollera

Abstract

Coronavirus disease (COVID-19) is a highly transmittable virus that continues to disrupt livelihoods, particularly those of low-income segments of society, around the world. In Ethiopia, more specifically in the capital city of Addis Ababa, a sudden increase in the number of confirmed positive cases in high-risk groups of the community has been observed over the last few weeks of the first case. Therefore, this study aims to assess knowledge, practice and associated factors that can contribute to the prevention of COVID-19 among high-risk groups in Addis Ababa.

Methods

A cross-sectional in person survey (n = 6007) was conducted from 14–30 April, 2020 following a prioritization within high-risk groups in Addis Ababa. The study area targeted bus stations, public transport drivers, air transport infrastructure, health facilities, public and private pharmacies, hotels, government-owned and private banks, telecom centers, trade centers, orphanages, elderly centers, prison, prisons and selected slum areas where the people live in a crowded areas. A questionnaire comprised of four sections (demographics, knowledge, practice and reported symptoms) was used for data collection. The outcomes (knowledge on the transmission and prevention of COVID-19 and practice) were measured using four items. A multi variable logistic regression was applied with adjustment for potential confounding.

Results

About half (48%, 95% CI: 46–49) of the study participants had poor knowledge on the transmission mode of COVID-19 whereas six out of ten (60%, 95% CI: 58–61) had good knowledge on prevention methods for COVID-19. The practice of preventive measures towards COVID-19 was found to be low (49%, 95% CI: 48–50). Factors that influence knowledge on COVID-19 transmission mechanisms were female gender, older age, occupation (health care and grocery worker), lower income and the use of the 8335 free call centre. Older age, occupation (being a health worker), middle income, experience of respiratory illness and religion were significantly associated with being knowledgeable about the prevention methods for COVID-19. The study found that occupation, religion, income, knowledge on the transmission and prevention of COVID-19 were associated with the practice of precautionary measures towards COVID-19.

Conclusion

The study highlighted that there was moderate knowledge about transmission modes and prevention mechanisms. Similarly, there was moderate practice of measures that contribute towards the prevention of COVID-19 among these priority and high-risk communities of Addis Ababa. There is an urgent need to fill the knowledge gap in terms of transmission mode and prevention methods of COVID-19 to improve prevention practices and control the spread of COVID-19. Use of female public figures and religious leaders could support the effort towards the increase in awareness.

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SciScore for 10.1101/2020.08.14.20172429: (What is this?)

Please note, not all rigor criteria are appropriate for all manuscripts.

Table 1: Rigor

Institutional Review Board Statement	not detected.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.
Sex as a biological variable	The largest city in the country, with a total population of 4,793,699 (52% Female Vs 48% Male).

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

Strengths and limitations: Our study was large and had a broad scope with several strengths. It was based on a large sample size and focused on participants from areas that were likely to be high risk; therefore, the findings can be generalized across the city’s population. Unlike other studies, we did face-to-face interviews in this challenging situation, which is another strength. However, it has also limitations. The study did not gather important characteristics of the study participants, such as educational status, marital status and visiting public places, smoking etc that could affect knowledge on COVID19. Further, the initial assessment was done as part of the routine COVID-19 response rather than specifically for this study. Conclusion: The study pointed out that respondents had moderate knowledge about transmission modes, preventions mechanisms and practice on the prevention of COVID-19 areas of high risk in Addis Ababa. Awareness creation programs on more targeted groups, such as men, youth and those with higher incomes are required in order to improve the knowledge and practices on the prevention of COVID 19. Advocacy of the hand hygiene, physical distancing, use of mask and others strategies should fulfil the characteristics of the targeted individuals.

Results from TrialIdentifier: No clinical trial numbers were referenced.

Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

Results from JetFighter: We did not find any issues relating to colormaps.

Results from rtransparent:

Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
No funding statement was detected.
No protocol registration statement was detected.

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