Abstract
COVID-19 remains a global public health emergency till date. It is eminent that the transmission of the disease is subjective to people
Author Contributions
Copyright© 2020
Obioma Azuonwu, et al.
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Introduction
A heavy devastating and death toll of the COVID-19 pandemic on Africa was severally and massively predicted by many scholars across the globe. These predictions were made from the stand point of our past experience of uncoordinated and scanty outbreak investigation pattern and several viewpoints of weakened health systems and paucity of critical health infrastructure. Remarkably, local expertise gathered from previous outbreaks and centralized public-health infrastructure with a clear action plan would help, in addition to favourable demographic structure and climate, have put many Africa countries head-on as COVID-19 is handled in right standing Nonetheless, the knowledge about COVID-19 is paramount in this period of the pandemic. General knowledge about COVID-19 and specific knowledge with regards to its risk factors, signs/symptoms, transmission and misconception amidst numerous information is of importance to everyone at this point. All guidelines are geared towards flattening the curve, combat spread of the novel Coronavirus and arrest a predicted overwhelming onslaught of cases. For Africa especially Sub Sahara countries, this was borne out of fear; seen the experience of the developed countries like Italy and the USA amidst the level of technological advancement. Noteworthy, is the public health preparedness of campaign regards knowledge, attitude and practice (KAP) because from past pandemics history has it that the effectiveness of policies to combat rapid transmission of a highly infectious disease rely partly, on the knowledge and awareness of the public. Knowledge and attitude to a large extent influences practice of an individual. Increased morbidity and mortality have made it to become progressively more imperative to appreciate public risk perception of the novel Coronavirus Furthermore, some studies have been able to reveal the relationship between COVID-19 and socio-demographics. Gender-based risk stratification suggests that males have a higher risk than female counterparts however, on the basis of mortality The novel coronavirus risk is attributed to lots of things which are a major challenge of infectious diseases. Weighed against risks from other domains, such as environmental risks, far less is known about how the public perceives risks associated with emerging infectious diseases according to a study This present study examined the influence of knowledge on the COVID-19 risk, the contribution of socio-demographics on the risk of COVID-19 and predicted synergistic effects of knowledge and socio-demographics on the risk of COVID-19, even as all measured was strictly perception. The selection of a synergistic approach to evaluate the interplay between various demographics variables, and different variables constituting knowledge about COVID-19 with regards to COVID-19 risk, was based on the fact that overreliance on just one paradigm, aids mitigates concerns about the uncertain dependability of single-item constructs. As a rule of thumb, several items are best used to measure a construct than a few or even one. This has also been adopted in recent studies of disease outbreaks Researchers’ framework (2020) presents the Correlation between COVID-19 Risk and variables of Demographics (socio-demographics) with Knowledge. The correlation designed study considered the COVID-19 risk as the outcome variable (Y) and Socio-demographics and Knowledge level as predictor variables (X). Socio-demographics (X) include;gender, age, education, marital status and location. While knowledge level considered cut across general knowledge, signs/symptoms, transmission, and misconceptions about the novel Coronavirus. The study investigation showed the correlation (r) and the coefficient of determination square (R2) as presented in the result section.
Results
The study which observed the probable relationship between COVID-19 risk exposure as a criterion variable predicted by synergic contributions of knowledge level about COVID-19 and Socio-demographics revealed a dramatic outcome. See detail below. Classification of study participants based on socio-demographic characteristics revealed that more females 204 (58.8%) participated compared to males 143 (41.2%). Age classes revealed 30 - 44 Years -140 (40.3%) as the highest participants whereas, Less than 15 Years- 2 (0.6%) were the lowest in number. The study participants were mainly single 187 (53.9%) and married 153 (44.1%) but Separated/Divorced was the least 3 (0.9%). Furthermore, tertiary 309 (89.0%) and primary 2 (0.6%) education were the highest and least respectively. Based on the location where the respondents reside as at the time of the data collection, urban residents 278 (80.1%) participated more while the rural residents 23 (6.6%) were the least in number. Correlation of COVID-19 Risk exposure and Socio-demographics with Knowledge was measured to evaluate the relationships between the variables studied. The relationship study affirms no statistical correlation between COVID-19 risk and variables of sex, (0.097, p=0.07) education (-0.057, p=0.29) and location (0.055, p=0.31) as hypothesized. On the contrary, age (0.220, p=0.00) and marital status (-0.158, p=0.00) reported a considerable correlation with COVID-19 risk. In addition, the relationship between COVID-19 Risk and Knowledge level with respect to general knowledge (r=0.499**, p=0.00), signs/symptoms (r=0.285**, p=0.00), transmission (r=0.532**, p=0.00), and misconceptions (r=0.108*, p=0.05) showed significant correlation at varying alpha levels (0.01 and 0.05). See .Correlation is significant at the 0.01 level (2-tailed); . Correlation is significant at the 0.05 level (2-tailed). Unless otherwise noted, bootstrap results are based on 1000 bootstrap samples The study separately investigated the relationship between COVID-19 risk and knowledge level about novel Coronavirus with a correlation (r) estimate of 0.356 showing a direct moderate relationship between the exposure to COVID – 19 associated risks and the knowledge level of the public. Further estimation revealed a direct non-significant weak correlation (r=0.0961) between socio-demographics and COVID-19 risk. Fisher Transformation was used to test the statistical significant difference of the two correlations obtained, a Z-value of 0.362 proved a statistically significant (p=0.00) difference between the correlation of knowledge and socio-demographics with respect to COVID-19 risk exposure. The regression model significantly predicted the synergic contributions of knowledge level and demographics to COVID-19 risk exposure. A comparable significant regression equation was found indicating a strong correlation from the output of the coefficient of determination (R=0.648). Result showed; R2=0.420 and adjusted R2=0.404, df=2, 336, F-value=27.012, p=0.00. Using the adjusted R2, the result reads that about 40% of the variance in the outcome variable, in essence, the probability of COVID-19 risk exposure can be explained by knowledge about COVID-19 and demographics. 40% is a marked significance. Since R2cannot be used to ascertain a biased model because R2 increases per time a predictor is added to the model. R2never decreases even when it is just a chance correlation, based on this the adjusted R2was used for interpretation, to compare the goodness-of-fit for the multiple predictor variables. The adjusted R increases only when the new term improves the model fit more than expected by chance alone and decreases when the term does not improve the model fit by a sufficient amount. See Predictor variables of the knowledge used here included knowledge about COVID general issue, signs/symptoms, transmission, and misconceptions about COVID-19. Also, the second predictor variable-socio-demographic variables constituted; sex, age, education, marital status and location. Coefficients of Regression for COVID-19 Risk result obtained in this study showed the predictor variables of knowledge and socio-demographics were regressed on COVID-19 risk outcome. The unstandardized beta (B) which represent the slope between predictors (knowledge and socio-demographics) and outcome variable being COVID-19 risk indicates that; a unit increase in the predictor variables results to an increase in the outcome of COVID-19 risk exposure by .287, .043, .378, .053, .052, .033, .000 and .005 for General Knowledge, Signs/Symptoms, Transmission, Misconception, sex, age, education and location respectively. Also, a unit increase in the predictor variables will cause a concomitant decrease in the outcome variable by -.022 for marital status. Furthermore, the t-test demonstrated statistical significant in just three areas namely general knowledge (t=6.535, p=0.00), transmission (t=7.347, p=0.00) and misconception (t=2.125, p=0.03).
Socio-demographics
Classification
Frequency (%)
Sex
Male
143 (41.2%)
Female
204 (58.8%)
15 - 29 Years
137 (39.5%)
30 - 44 Years
140 (40.3%)
45 - 59 Years
42 (12.1%)
60 - 74 Years
17 (4.9%)
Age
75 Years and Above
9 (2.6%)
Less than 15 Years
2 (0.6%)
Married
153 (44.1%)
Separated/Divorced
3 (0.9%)
Single
187 (53.9%)
Widow/ered
4 (1.2%)
Education
No Formal Education
31 (8.9%)
Primary
2 (0.6%)
Secondary
5 (1.4%)
Tertiary
309 (89.0%)
Location
Rural
23 (6.6%)
Semi-Urban
46 (13.3%)
Urban
278 (80.1%)
Variable
Correlation
SEM
BCa 95% Confidence Interval
p-value
Lower
Upper
COVID-19 Risk and Socio-demographics
Sex
0.097
0.052
-0.004
0.194
0.07
Age
0.220
0.049
0.121
0.314
0.00
Marital Status
-0.158
0.050
-0.255
0.057
0.00
Education
-0.057
0.049
-0.155
0.046
0.29
Location
0.055
0.042
-0.027
0.135
0.31
COVID-19 Risk and Knowledge
General knowledge
0.499
0.069
0.370
0.621
0.00
Signs/symptoms
0.285
0.064
0.160
0.419
0.00
Transmission
0.532
0.062
0.408
0.641
0.00
Misconceptions
0.108
0.058
0.000
0.218
0.05
Predictor Variables
N
R
Z
p-value
Knowledge Level
347
Socio-demographics
347
3.62
0.00
R
R2
Adjusted R2
S.E of the Estimate
Change Statistics
R2 Change
F Change
F-value
df1
df2
p-value
0.648
0.420
0.404
0.258
0.420
27.012
27.012
9
336
0.00
Predictors
Unstandardized Coefficients
Standardized Coefficients
T
Sig.
B
Std. Error
Beta
(Constant)
.532
.201
2.648
.008
General Knowledge
.287
.044
.325
6.535
.000
Signs/Symptoms
.043
.031
.062
1.359
.175
Transmission
.378
.051
.357
7.347
.000
Misconception
.053
.025
.096
2.125
.034
Sex
.052
.029
.077
1.806
.072
Age
.033
.019
.096
1.710
.088
Education
.000
.018
-.001
-.022
.982
Location
.005
.025
.009
.204
.838
Marital Status
-.022
.017
-.065
-1.289
.198
Discussion
This study examined the perception of the public about COVID-19 risk exposure and its relationship with other factors like socio-demographics and COVID-19 knowledge as previous studies tried to highlight some of these issues, but it has remained ambiguous to appreciate the prevailing interplay. Based on knowledge level about COVID-19, this study is consistent with a review on risk perceptions of COVID-19 around the world confirming that knowledge was significantly associated with COVID risk perception, in addition to a gender effect. It showed that the determinants of knowledge predicted the influence of COVID-19 risk exposure. Similarly, knowledge level which correlated with COVID-19 risk was observed by Dryhurst and colleagues (2020) However, behavioural patterns of individuals can basically influence and alter the exposure including a spread in pandemic The role of socio-demographic variables in COVID-19 infection risk and management still has some grey spots awaiting scientific clarification. Age, sex, and chronic diseases have been implicated as high risk to COVID-19 infection including difficult management insights. Nevertheless, de Lusignan and colleague (2020) in a report The outcome of this study showed no indication of a relationship between sex and COVID-19 risk, but sex-related risk perception has been reported previously. Maleness was uniformly associated with lower risk perceptions in several nations In addition, finding from this study is backed up by similar observations seen in preceding works. de Lusignan and colleagues (2020) established a relationship between COVID-19 and socio-demographic determinants In a nutshell, the findings from this study suggest marked association between COVID-19 and knowledge with respect to general knowledge about COVID-19 pandemic, signs/symptoms, transmission and misconception. Age and marital status were the only socio-demographics which proved evidence of relationship with COVID-19 risk exposure. More so, synergistic approach revealed a combined prediction of COVID-19 risk when modelled with multiple regression, as predicted by COVID-19 knowledge indicators and socio-demographic variables. These findings share similarity and discrepancy with others. This variation may perhaps be due to some extraneous factors, geographic variability, cultural as well as traditional plus religious perceptions which make up an individuals view.
Conclusion
On a daily basis, knowledge of COVID- 19 improves, due to the influx of findings. Despite the massive research about COVID-19, community transmission has remained an aspect with a grey line. It is vital to understand the effect of the perceived risk of COVID-19 based on Knowledge and socio-demographics, as it could serve as a useful tool in prevention strategy toolkits. This study has provided an important input which has broadened the understanding of how COVID-19 risk exposure is perceived by the public based on knowledge level and demographic indicators. Knowledge level has an effect on risk likewise age and marital status. Traditional factor like age should be decidedly considered and attention should be drawn towards good knowledge about COVID-19, especially in its signs and symptoms plus transmission pattern. “What is fundamentally clear is that whatever the specific risk factors may be, the COVID-19 pandemic exacerbates existing socioeconomic inequalities, and this needs both exploration and mitigation in the coming months and years”. Rachel Jordan