Bernadine N. Ekpenyong
1 
, Emmanuel K Abu
2, Raymond Langsi
3, Uchechukwu L Osuagwu
4,5,6* , Richard Oloruntoba
7, Godwin Ovenseri-Ogbomo
8, Chikasirimobi G. Timothy
9, Deborah D Charwe
10, Obinna Nwaeze
11, Christopher P Goson
12, Chundung A Miner
13, Tanko Ishaya
14, Khathutshelo P Mashige
5, Kingsley E. Agho
4,5,151 Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Cross River State, Nigeria
2 Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
3 Health Division, University of Bamenda, Bambili, Cameroon
4 Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
5 African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban, 3629, South Africa
6 Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst 2795 NSW, Australia
7 School of Management and Marketing, Curtin Business School, Curtin University, Kent Street , Bentley, WA,Australia
8 Department of Optometry, Centre for Health Sciences, University of the Highlands and Islands, Inverness, IV2 3JH, United Kingdom
9 Department of Optometry and Vision Science, Faculty of Health Sciences, Mzuzu University, Mzuzu, Malawi
10 Tanzania Food and Nutrition Center, P.O.Box 977 Dar es Salaam, Tanzania
11 Vancouver Island Health Authority (VIHA), Vancouver, BC, Canada
12 Department of Psychiatry, College of Health Sciences, University of Jos, Jos, Nigeria
13 Department of Community Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
14 Department of Computer Science, University of Jos, Jos, Nigeria
15 School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
Abstract
Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries.
Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors’ networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions.
Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient β=-0.83 95% CI: -1.19, -0.48) and Southern Africa (β=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [β=-6.57, 95% CI: -7.53, -5.62], East [β=-6.24: 95% CI: -8.34,-4.15], Central [β=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [β=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19.
Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19.