Document Type : Original Article

Authors

1 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

2 Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Statistics, Shahid Bahonar University, Kerman, Iran

4 Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran

5 Aging Health Department, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran

6 Department of Epidemiology and Biostatistics, School of Health and Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

7 Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background and aims: The novel coronavirus (COVID-19) epidemic has far been the biggest global health threat of the 21st century. Protective measures are still one of the most effective methods for controlling COVID-19. Practicing hygiene and control measures are largely influenced by knowledge and attitude towards COVID-19. This study aimed to investigate the knowledge, attitude, and practice of Iranians towards COVID-19 as well as the demographic factors related to it in April and May, 2020.

Methods: The study population in this cross-sectional, descriptive-analytical, and web-based study included 3736 Iranian individuals who were collected via convenience sampling method. A validated Iranian knowledge, attitude, and practices (KAP) Questionnaire about COVID-19 was used for collecting the required data. Ordinal multivariate generalized estimating equations (GEEs) were applied to analyze data.

Results: The majority of participants (88.1%) had considerable knowledge, the right attitude (91%), and good practices (90.3%). In the multivariate models, factors related to greater knowledge were age > 20 years (P < 0.001), living in the urban area (P = 0.030), holding a master’s or doctoral degree (P = 0.044), and a moderate financial status (P = 0.001). Females displayed mor positive attitude (P = 0.035). Variables related to more favorable practices were age > 20 years (P < 0.001), and having a good (P = 0.003) or moderate (P = 0.038) financial status.

Conclusion: It was concluded that the participants had good knowledge and a positive attitude, as well as adopted sound practices regarding COVID-19. However, this conclusion might not have been generalizable to entire Iranian community; therefore, it was recommended that preventive measures against COVID-19 should receive continued monitoring and emphasis.

Keywords

1. Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S, et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol. 2020;49(3):717-26. doi: 10.1093/ije/dyaa033. 
2. WHO. Coronavirus Disease (COVID-19) Pandemic. 2020. Available from: https://www.who.int/emergencies/diseases/ novel-coronavirus-2019. 
3. Rabaan AA, Al-Ahmed SH, Al-Malkey M, Alsubki R, Ezzikouri S, Al-Hababi FH, et al. Airborne transmission of SARS-CoV-2 is the dominant route of transmission: droplets and aerosols. Infez Med. 2021;29(1):10-9. 
4. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-92. doi: 10.1016/j.cell.2021.02.029. 
5. Çalıca Utku A, Budak G, Karabay O, Güçlü E, Okan HD, Vatan A. Main symptoms in patients presenting in the COVID-19 period. Scott Med J. 2020;65(4):127-32. doi: 10.1177/0036933020949253. 
6. CDC. Key Things to Know About COVID-19 Vaccines. Available from: https://www.cdc.gov/coronavirus/2019-ncov/ vaccines/keythingstoknow.html. Updated March 13, 2021 
7. WHO. COVID-19 Vaccines Offer Hope, Other Prevention Measures Must Continue. Available from: https://www.who. int/westernpacific/news/commentaries/detail-hq/covid-19- vaccines-offer-hope-but-other-prevention-measures-must-continue. Updated February 12, 2021. 
8. Ajilore K, Atakiti I, Onyenankeya K. College students’ knowledge, attitudes and adherence to public service announcements on Ebola in Nigeria: Suggestions for improving future Ebola prevention education programmes. Health Educ J. 2017;76(6):648-60. doi: 10.1177/0017896917710969. 
9. Tachfouti N, Slama K, Berraho M, Nejjari C. The impact of knowledge and attitudes on adherence to tuberculosis treatment: a case-control study in a Moroccan region. Pan Afr Med J. 2012;12:52. 
10. Zhong BL, Luo W, Li HM, Zhang QQ, Liu XG, Li WT, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. Int J Biol Sci. 2020;16(10):1745-52. doi: 10.7150/ijbs.45221. 
11. MoHME website. Available from: http://behdasht.gov.ir/. 
12. Blendon RJ, Benson JM, DesRoches CM, Raleigh E, Taylor- Clark K. The public’s response to severe acute respiratory syndrome in Toronto and the United States. Clin Infect Dis. 2004;38(7):925-31. doi: 10.1086/382355. 
13. Muhammad K, Saqlain M, Hamdard A, Naveed M, Umer MF, Khan S, et al. Knowledge, attitude, and practices of community pharmacists about COVID-19: a cross-sectional survey in two provinces of Pakistan. medRxiv [Preprint]. May 26, 2020. Available from: https://www.medrxiv.org/ content/10.1101/2020.05.22.20108290v1. 
14. Narli S. An alternative evaluation method for Likert type attitude scales: rough set data analysis. Sci Res Essays. 2010;5(6):519- 28. doi: 10.5897/sre.9000150. 
15. Chao EC. Generalized estimating equations. Technometrics. 2003;45(4):363-4. doi: 10.1198/tech.2003.s165. 
16. Mancl LA, Leroux BG. Efficiency of regression estimates for clustered data. Biometrics. 1996;52(2):500-11. 
17. Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E. Public knowledge, attitudes and practices towards COVID-19: a cross-sectional study in Malaysia. medRxiv [Preprint]. May 5, 2020. Available from: https://www.medrxiv.org/ content/10.1101/2020.04.29.20085563v1. 
18. Lincango-Naranjo E, Espinoza-Suarez N, Solis-Pazmino P, Vinueza-Moreano P, Rodriguez-Villafuerte S, Lincango- Naranjo J, et al. Paradigms about the COVID-19 pandemic: knowledge, attitudes and practices from medical students. medRxiv [Preprint]. June 9, 2020. Available from: https://www. medrxiv.org/content/10.1101/2020.05.21.20105858v2. 
19. Tomar BS, Singh P, Suman S, Raj P, Nathiya D, Tripathi S, et al. Indian community’s knowledge, attitude & practice towards COVID-19. medRxiv [Preprint]. May 9, 2020. Available from: https://www.medrxiv.org/ content/10.1101/2020.05.05.20092122v1.full. 
20. Lee M, Kang BA, You M. Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea. BMC Public Health. 2021;21(1):295. doi: 10.1186/ s12889-021-10285-y. 
21. Olum R, Chekwech G, Wekha G, Nassozi DR, Bongomin F. Coronavirus disease-2019: knowledge, attitude, and practices of health care workers at Makerere University Teaching Hospitals, Uganda. Front Public Health. 2020;8:181. doi: 10.3389/fpubh.2020.00181. 
22. Giao H, Han NTN, Van Khanh T, Ngan VK, Van Tam V, Le An P. Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pac J Trop Med. 2020;13(6):260-5. doi: 10.4103/1995- 7645.280396. 
23. Kumbeni MT, Apanga PA, Yeboah EO, Lettor IBK. Knowledge and preventive practices towards COVID-19 among pregnant women seeking antenatal services in Northern Ghana. PLoS One. 2021;16(6):e0253446. doi: 10.1371/journal. pone.0253446. 
24. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/s0140- 6736(20)30566-3. 
25. Gao H, Hu R, Yin L, Yuan X, Tang H, Luo L, et al. Knowledge, attitudes and practices of the Chinese public with respect to coronavirus disease (COVID-19): an online cross-sectional survey. BMC Public Health. 2020;20(1):1816. doi: 10.1186/ s12889-020-09961-2. 
26. Souli D, Dilucca M. Knowledge, attitude and practice of secondary school students toward COVID-19 epidemic in Italy: a cross selectional study. bioRxiv [Preprint]. May 9, 2020. Available from: https://www.biorxiv.org/ content/10.1101/2020.05.08.084236v1. 
27. Ferdous MZ, Islam MS, Sikder MT, Mosaddek ASM, Zegarra-Valdivia JA, Gozal D. Knowledge, attitude, and practice regarding COVID-19 outbreak in Bangladesh: An online-based cross-sectional study. medRxiv [Preprint]. June 3, 2020. Available from: https://www.medrxiv.org/ content/10.1101/2020.05.26.20105700v2.