Greener Journal of Epidemiology and Public Health

Vol. 8(1), pp. 24-30, 2020

ISSN: 2354-2381

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Knowledge, Attitudes and Behaviors of Healthcare Workers on COVID 19 in State Specialist Hospital Gombe (SSHG)

¹Lynn Maori; ¹Maikudi Haruna; ²Kabilis D.E; ³Emmanuel Peter; ⁴Dr. Lamingo John; ⁵Zainab Agabus; ⁶Dr Japhet Joel Kalang; ⁷Grace Audu; ⁸Zainab Umar

1. Microbiology Department, State Specialist Hospital Gombe

2. General Outpatient Department, State Specialist Hospital Gombe

3. Gombe State College of Health Sciences and Technology, Kaltungo.

4. State Specialist Hospital, Gombe

5. General Hospital Talasse, Balanga, Gombe State

6. Department of Veterinary Medicine, Surgery and Radiology, University of Jos Plateau State

7. Snakebite Treatment and Research Hospital Kaltungo, Gombe State

8. General Hospital Talasse, Microbiology Department

ARTICLE INFO

ABSTRACT

Article No.: 052620076

Type: Research

Background: Healthcare workers (HCWs) form a significant risk group for infection of Corona virus. Objectives: The aim of this survey was to assess the knowledge, attitude and behavior of HCWs in the State Specialist Hospital Gombe on coronavirus. Methods: 44 HCWs from different department in the State Specialist Hospital Gombe were randomly invited to fill a questionnaire developed to cover the survey objectives from 23rd March to 6^th April 2020. The response rate was 100%. Descriptive statistics was used to summarize the responses. Results: A total of 38.6% were Medical Laboratory Scientist, 36.6% were Nurses and 9.09% were Pharmacists. The most common sources of Coronavirus (COVID-19) information were the Main stream Media (TV) which have 20.5% and 18.2% of Social media (Facebook, WhatsApp etc.). Only 59.1% of HCWs are aware of the Infection Prevention and Control program in the Hospital. About 97.7% agreed that HCWs are at greater risks of been infected by the novel corona virus. 95.5% of HCWs reported that they are worried that one of their family members may get infected. Conclusions: The knowledge about emerging infectious diseases was poor and there is need for further education and re-training programs particularly in the use of personal protective equipment, the operations of the quarantine and isolation unit and infection control measures. The self-reported infection control practices were sub-optimal and seem to be overestimated.

Accepted: 27/05/2020

Published: 27/06/2020

*Corresponding Author

Lynn Maori

E-mail: lynnmaori@ gmail. com

Keywords: Corona Virus; Attitudes; Behaviors; Emerging Infectious Diseases; Health Care Workers; Knowledge; Practice

Human coronaviruses were discovered in the 1960s [5]. The earliest ones studied were from human patients with the common cold, which were later named human coronavirus 229E and human coronavirus OC43 [6]. They were first imaged by Scottish virologist June Almeida at St. Thomas Hospital in London [7]. Other human coronaviruses had since been identified, including SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 in 2019. Most of these have involved serious respiratory tract infections [8], [9].

Multiple epidemic outbreaks occurred during 2002 (SARS) with ~800 deaths and 2012 (Middle East Respiratory Syndrome: MERS-CoV) with 860 deaths [10], [11]. Approximately eight years after the MERS-CoV epidemic, the current outbreak of novel coronavirus (COVID-19) in Wuhan City, Hubei Province of China, has emerged as a global outbreak and significant public health issue [12]. On 30 January 2020, the World Health Organization (WHO) declared COVID-19 as a public health emergency of international concern (PHEIC) [13]. Astonishingly, in the first week of March, a devastating number of new cases have been reported globally, emerging as a pandemic. As of 9 March 2020, more than 110,000 confirmed cases across 105 countries and more than 3800 deaths have been reported [14].

The COVID-19 is spread by human-to-human through droplets, feco-oral, and direct contact, with an incubation period of 2-14 days [14]. So far, no antiviral treatment or vaccine has been recommended explicitly for COVID-19. Therefore, applying the preventive measure to control COVID-19 infection is the utmost critical intervention. Healthcare workers (HCWs) are the primary section in contact with patients and are an important source of exposure to the infected cases in the healthcare settings, thus, expected to be at a high risk of infections. By the end of January, the WHO and CDC (Centers for Disease Control and Prevention) published recommendations for the prevention and control of COVID-19 for HCWs [15], [16].

METHODOLOGY

Sample

This cross-sectional, descriptive study of a representative sample of HCWs (Medical Laboratory Staff, Pharmacists and Nurses) in State specialist Hospital Gombe. The survey was conducted between 23rd March to 6^th April 2020. The sample size for the study is 44. The factors taken into consideration were the age, sex, department, source of information and relative number and sufficient knowledge of corona virus.

The study followed the principles of the Helsinki Declaration and ethical approval was obtained and written consent was obtained from all participants.

Questionnaire interview

A standardized questionnaire was developed, distributed and completed by all participants inside their department during the period of study. [16],[17].

The questionnaire comprised of 2 parts addressing knowledge and attitude of HCWs regarding COVID 19. The first part covered demographic data such as age, sex, department and participants’ source of knowledge on COVID 19. The second part assessed the knowledge of HCWs by asking questions about the viral infection, mode of transmission, symptoms, incubation period, hand hygiene and risk of infection. The third part of the questionnaire assessed the attitude of HCWs regarding COVID 19 using a set of 5 yes/no questions.

Statistical analysis

Data were coded, validated and analyzed using SPSS, version 23. Frequencies and proportions were used to present the data obtained.

FINDINGS

Table 1. Baseline characteristics of health care workers in State Specialist Hospital Gombe (SSHG)

Characteristics	Participants
Sex
Male	14(13.8%)
Female	30(68.2%)
Age
25-30	16(36.4%)
31-35	6(13.6%)
36-40	6(13.6%)
41-45	5(11.4%)
46above	11(25.0%)
Department
Laboratory	19(43.2%)
Nursing	19(43.2%)
Pharmacy	6(13.6%)
Source of Information/Knowledge on COVID 19
TV	9(20.5%)
NCDC website	6(13.6%)
Social media	8(18.2%)
Radio	3(6.8%)
All	18(40.9%)
Sufficient Knowledge on COVID 19
No	7(15.9%)
Yes	37(84.1%)

Table 2. Knowledge about COVID 19 among health care workers in SSHG

Question (correct answer)	Yes	No
COVID 19 is a viral infection (yes)	44(100%)	0(0.0%)
COVID 19 is transmitted by close contact with infected person (yes)	44(100%)	0(0.0%)
Fever, cough and shortness of breath are symptoms of COVID 19 (Yes)	42(95.5%)	2(5.5%)
Diarrhea is a symptom of COVID 19 (Yes)	7(15.9%)	37(84.1%)
Incubation period is 14 days (Yes)	41(93.2%)	3(6.8%)
Washing hands with soap and water can prevent COVID 19 infection (Yes)	44(100%)	0(0.0%)
Health care workers are at high risk of infection (Yes)	43(97.7%)	1(2.3%)
Patients with underlying chronic disease are at high risk of infection(yes)	39(88.6%)	5(11.4%)
COVID 19 infection can be fatal (Yes)	43(97.7%)	1(2.3%)
The COVID 19 has been declared pandemic? (yes)	44(100%)	0(0.0%)

Table 3. Distribution of knowledge among health care workers in SSHG

Sufficient knowledge	Yes	No	P value
Sex
Male	11(25%)	3(6.8%)	0.00
Female	26(59%)	4(9%)
Age
25-30	14	2	0.326
31-35	4	2
36-40	6	0
41-45	5	0
46 Above	8	3
Department
Laboratory	17 (38.6%)	2	0.00
Nursing	16 (36.6%)	3
Pharmacy	4 (9.09%)	2

93.2% of the HCW are of the opinion that the prevalence of COVID 19 can be reduced by actively participating in the hospital infection control program. 42(95.5%) of HCWs are worried that a family of theirs may be infected with COVID 19. All the respondents 44(100%) agreed that transmission of COVID 19 can be prevented using standard and isolation precaution. 26(59.1%) of HCWs are not aware of the presence of infection control program in Gombe State while 18(40.9%) agreed to the fact that they are aware of the infection control program in the State. All the correspondents have also agreed that they would have taken vaccine for COVID 19 had it been is available as shown in Table 4

DISCUSSION

The findings in our study showed that HCWs had a high level of knowledge and a positive attitude towards the COVID-19 outbreak. We found that the majority of the respondents know the COVID19 is a global issue and gathered their information through a variety of media such as television (79.2%), social media (91.1%), the website of hospital/Health Ministry (82.6%). Currently, COVID-19 is a global discussion topic in the media and among the public, especially among HCWs and patients. With current mounting of COVID-19 transition raised tensions on everyone, including health officials and health system. For this reason, we investigated HCWs knowledge, attitude and knowledge towards the prevention and control of COVID-19 during a global epidemic.

Knowledge of COVID-19 varied across different categories of HCWs. Our study revealed that HCWs have insufficient knowledge about COVID-19 but showed positive perceptions to prevent COVID-19 transmission. We also found that more than 33% of the HCWs use official government websites as a primary source of information about COVID19. This indicates that COVID-19 related updates posted online by the official government health authorities had shown to have a positive implication for improving HCWs knowledge levels. Relying on authentic sources is a key factor to believe the transparent information about the emerging COVID-19 infection and is essential for HCWs preparedness and response. However, a finding of considerable concern is that most HCWs (60%) used social media as the major source of information. The health authorities and scientists particularly warned on the wide-spread misinformation of COVID-19 as a serious concern causing xenophobia across the world [12], [17], [18]. In this regard, HCWs are expected to practice with careful evaluation of COVID-19 related information and should use scientific and authentic information sources.

The findings of this study suggest significant knowledge gaps between the amount of information available about COVID-19 and the depth of knowledge among HCWs, particularly about the mode of transmission and incubation period of COVID-19. Also, many allied health workers had inadequate knowledge. This is unfortunate, as the surge of COVID-19 is devastating globally, and a large number of resources are provided to the healthcare authorities to educate HCWs to improve their knowledge about COVID-19 was immense.

Generally, most participants had no idea about the existence of infection prevention and control program of COVID19. However, discrepancies were identified across different categories of HCWs in their perceptions. For instance, only half (52%) of the HCWs aged between 45-65 years old perceived that the symptoms of COVID-19 appear as early as 2 to 14 days (p<0.05) and more than a quarter of the medical students though that eating meat during the outbreak is not safe.

Around 20% of the allied health workers believed that the flu vaccine is sufficient for COVID-19 prevention. Finally, a vast majority of HCWs strongly agreed that maintaining hygiene activities, reporting the recent travel history when individuals are sick, and cleaning the equipment used in the wet markets are strongly recommended in the control and prevention of COVID-19.

LIMITATIONS

We used WHO training material for detection, prevention, response, and control of COVID19 to develop a validated questionnaire. The developed questionnaire used was not an open-ended question.

However, the study has some limitations that should be considered. This is a cross-sectional study conducted online among HCWs during alarming cases reported globally in the first week of March 2020. Besides, the data presented in this study are self-reported partly depending on respondents' honesty and ability to recall.

CONCLUSION

We identified a significant gap constituting the source of information, poor knowledge levels, and discrepancies in the perceptions about COVID-19 among our study participants. As the global threat of COVID-19 continues to emerge, greater efforts through educational campaigns targeting HCWs and a wide reach population beyond the borders are urgently needed.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest. This work is self-funded and there is no competing financial interest of the authors.

ACKNOWLEDGMENT

We thank all the study participants for their voluntary participation and providing the essential information.

REFERENCES

1 "Il était une fois les coronavirus". Réalités Biomédicales (in French). 2020-03-27. Retrieved 2020-04-18.

2 Kahn JS, McIntosh K (November 2005). "History and recent advances in coronavirus discovery". The Pediatric Infectious Disease Journal. 24 (11 Suppl): S223–7, discussion S226. doi:10.1097/01.inf.0000188166.17324.60. PMID 16378050.

3 World Health Organization. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected: interim guidance, January 2020. World Health Organization; 2020. Available: https://www.who.int/publications-detail/infectionprevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-issuspected-20200125 (Accessed on 12 February 2020).

4 Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agent. 2020:105924. Doi:10.1016/j.ijantimicag.2020.105924

5 Sturman LS, Holmes KV (1983-01-01). Lauffer MA, Maramorosch K (eds.). "The molecular biology of coronaviruses". Advances in Virus Research. 28: 35–112. doi:10.1016/s0065-3527(08)60721-6. ISBN 9780120398287. PMC 7131312. PMID 6362367. [T]hese viruses displayed a characteristic fringe of large, distinctive, petal-shaped peplomers or spikes which resembled a crown, like the corona spinarum in religious art; hence the name coronaviruses.

6 Estola T (1970). "Coronaviruses, a New Group of Animal RNA Viruses". Avian Diseases. 14 (2): 330–336. doi:10.2307/1588476. ISSN 0005-2086. JSTOR 1588476.

7 Fabricant J (1998). "The Early History of Infectious Bronchitis". Avian Diseases. 42 (4): 648–650. doi:10.2307/1592697. ISSN 0005-2086. JSTOR 1592697.

8 Decaro N (2011). "Gammacoronavirus". In Tidona C, Darai G (eds.). Gammacoronavirus‡: Coronaviridae. The Springer Index of Viruses. Springer. pp. 403–413. doi:10.1007/978-0-387-95919-1_58. ISBN 978-0-387-95919-1. PMC 7176155.

9 McIntosh K (1974). "Coronaviruses: A Comparative Review". In Arber W, Haas R, Henle W, Hofschneider PH, Jerne NK, Koldovský P, Koprowski H, Maaløe O, Rott R (eds.). Current Topics in Microbiology and Immunology / Ergebnisse der Mikrobiologie und Immunitätsforschung. Current Topics in Microbiology and Immunology / Ergebnisse der Mikrobiologie und Immunitätsforschung. Berlin, Heidelberg: Springer. p. 87. doi:10.1007/978-3-642-65775-7_3. ISBN 978-3-642-65775-7.

10 Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KS, Lau EH, Wong JY, Xing X. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New Engl J Medi. 2020 Jan 29. Doi: 10.1056/NEJMoa2001316.

11 Bhagavathula AS, Shehab A. The story of mysterious pneumonia and the response to deadly novel coronavirus (2019-nCoV): So far!. Emirates Med J 2020;1:7-10.

12 Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agent. 2020:105924. Doi:10.1016/j.ijantimicag.2020.105924.

13 Eurosurveillance Editorial Team. Note from the editors: World Health Organization declares novel coronavirus (2019-nCoV) sixth public health emergency of international concern. Euro Surveill. 2020 Feb;25(5):200131e.

14 World Health Organization. Novel coronavirus (COVID-19) situation. Available online:https://https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd

15 Chapter 24 - Coronaviridae". Fenner's Veterinary Virology (Fifth ed.). Academic Press. 2017. pp. 435–461. doi:10.1016/B978-0-12-800946-8.00024-6. ISBN 978-0-12-800946-8.

16 Centers for disease control and prevention. Update and interim guidelines on outbreak of 2019 Novel coronavirus (2019-nCoV). Available online: https://emergency.cdc.gov/han/han00427.asp.

17 Thomas Z. Misinformation on coronavirus causing 'infodemic'. https://www.bbc.com/news/technology-51497800 (Accessed 09 March 2020).

18 Mejova Y, Kalimeri K. Advertisers Jump on Coronavirus Bandwagon: Politics, News, and Business. arXiv preprint arXiv 2020:2003.00923.

Question (correct answer)	Yes	No
Prevalence of COVID 19 can be reduced by active participatory in hospital infection control program? (Yes)	41(93.2%)	3(6.8%)
Are you worried one of your family members may get infection? (Yes)	42(95.5%)	2(4.5%)
If vaccine is available, would you have taken it?	44(100%)	0(0.0%)
Transmission can be prevented by standard and isolation precaution? (yes)	44(100%)	0(0.0%)
Do you know the presence of infection control program?	26(59.1%)	18(40.9%)