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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 343-347

Knowledge, attitude, and practices toward COVID-19 among the college students in a southern city of Karnataka


1 Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Department of Community Medicine, School of Public Health, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India

Date of Submission24-Apr-2020
Date of Decision02-May-2020
Date of Acceptance07-Jul-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. Chandana Hombaiah
Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Bannimantap, Mysuru - 570 015, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_58_20

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  Abstract 


BACKGROUND: The new coronavirus disease COVID-19 has been spreading from Wuhan city to other cities in China and worldwide since December 2019. It was declared a pandemic by the World Health Organization on March 11, 2020. To guarantee the final success, people's adherence to the control measures is essential, which is greatly influenced by their knowledge, attitude, and practices toward COVID-19. Hence, the study was taken up to assess the knowledge, attitude, and practices among law college students.
MATERIALS AND METHODS: A cross-sectional study was conducted in Mysore in March 2020 among the students of Law College. Students who were not interested in taking up the study were not included in the study. A total of 256 study participants were included in the study. Data were collected using a pretested and self-administered questionnaire about knowledge-, attitude-, and practice-based questions on COVID-19. Data were entered in Microsoft Excel and were analyzed using SPSS V.23.
RESULTS: Among 256 study participants, 130 were female (50.8%) and 126 were male (49.2%). The main sources of information for the study participants are online newspapers/channels (n = 70) and social media (n = 55). The median score of knowledge, attitude, and practices is 5, 4, and 8, respectively. A comparison of the scholastic year with knowledge scores was found to be statistically significant at aP < 0.05.
CONCLUSION: The knowledge and attitude scores were low, but it was found that the study participants were following appropriate practices regarding COVID-19.

Keywords: Attitude, COVID-19, knowledge, pandemic, practices


How to cite this article:
Shabadi N, Hombaiah C, Thomas JJ, Mathews NA, Khanum RS, Shwethashree M, Murthy M R. Knowledge, attitude, and practices toward COVID-19 among the college students in a southern city of Karnataka. Int J Health Allied Sci 2020;9:343-7

How to cite this URL:
Shabadi N, Hombaiah C, Thomas JJ, Mathews NA, Khanum RS, Shwethashree M, Murthy M R. Knowledge, attitude, and practices toward COVID-19 among the college students in a southern city of Karnataka. Int J Health Allied Sci [serial online] 2020 [cited 2020 Oct 21];9:343-7. Available from: https://www.ijhas.in/text.asp?2020/9/4/343/298122




  Introduction Top


The new coronavirus disease COVID-19 has been spreading from Wuhan city to other cities in China and worldwide since December 2019.[1] COVID-19 is a highly infectious and emerging respiratory disease; its main clinical symptoms are fever, dry cough, fatigue, myalgia, and dyspnea.[2] It was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. As of April 4, 2020, 976,249 cases have been confirmed globally, 2650 confirmed cases in India, and 128 cases in Karnataka with 3 dead and 12 cured of the disease.[3],[4]

The COVID-19 affects different people in different ways.[5] Most infected people will develop mild-to-moderate symptoms and recover without requiring special treatment.[5] The primary means of spreading the disease is through respiratory droplets.[5] Individuals who have underlying medical conditions and those aged over 60 years have a higher risk of developing severe illness and death.[5] There is no evidence that current medications can prevent or cure the disease although a few western, traditional, or home remedies can provide comfort and relief of symptoms of COVID-19.[6] To date, COVID-19 cannot be prevented with a vaccine or treated with appropriate antiviral drugs.[6] However, care should be taken to relieve symptoms for those affected. Most patients recover by supportive treatment.[6]

Students are powerful agents of change.[7] Any crisis presents an opportunity to help them understand, cultivate compassion, and create a safer and compassionate community.[7] Creating awareness can encourage students to become advocates for disease prevention and control at home and in their community by communicating with others about how to prevent the spread of viruses.[7] Simple steps can prevent infection and slow the transmission of COVID-19.[5] They are as follows: wash your hands regularly with soap and water, or clean them with alcohol-based hand rub; maintain at least 1-m distance between you and people coughing or sneezing; avoid touching your face; cover your mouth and nose when coughing or sneezing with a tissue which should be discarded immediately; stay home if you feel unwell; refrain from smoking and other activities that weaken the lungs; practice physical distancing by avoiding unnecessary travel; and staying away from large groups of people.[5]

As was shown in China and some other countries, COVID-19 outbreaks can be contained and prevent transmission.[6] Unfortunately, new outbreaks can emerge rapidly.[6] To guarantee the final success, people's adherence to the control measures is essential, which is greatly influenced by their knowledge, attitude, and practices toward COVID-19. Hence, the study was taken up to assess the knowledge, attitude, and practices among the law college students.


  Materials and Methods Top


A cross-sectional study was conducted in Mysore in March 2020 among the students of Law College. Law College was selected arbitrarily. Using consecutive sampling technique, students who were present and provided informed consent on the day of the study were included in the study. Around 256 study participants took part in the study. Students who were not interested in taking up the study were excluded.

Data were collected using a pretested and self-administered questionnaire about knowledge-, attitude-, and practice-based questions on COVID-19. The questionnaire was developed using the information from the WHO;[8] before being used, it was tested for internal consistency among 20 students from the same law college.

The survey instrument had 10 items to assess knowledge, 5 items for attitude, and 5 items to assess practices regarding COVID-19. The knowledge part of the questionnaire had questions regarding the organism causing the disease, how the disease is transmitted, who are at more risk of developing the disease, about usage of mask, antibiotics, vaccine, quarantine period, pet animals, package from China, and about the main source of information about COVID-19. The attitude section of the questionnaire had scenarios such as hoarding sanitary items, reporting to the doctor if had come in contact with a suspected person, preferring Ayurveda or other non-allopathic treatment, about isolation, and personal hygiene to assess the attitude of the students. The attitude section was measured using a 5-point Likert scale. Practice section had questions about the usage of hand sanitizer, maintaining cough hygiene, forwarding the social media messages without fact-checking, have they attended any mass gathering, and whether they follow the WHO or Ministry of Health and Family Welfare in any social media. Scores ranged from 1 to 10 for each knowledge, attitude, and practice section of the questionnaire. Personal information such as gender and the scholastic year was also collected.

Knowledge, attitude, practice scoring

For every correct answer, a score of 1 was given and score of 0 for every wrong answer, and the median score was calculated for knowledge, attitude, and practice. The participants who had score more than median were considered as good and less than score were considered poor.

Statistical analysis

Data were entered in Microsoft Excel and were analyzed using SPSS V.23. The analysis was done using descriptive statistics such as percentages, median, and interquartile range (IQR) and inferential statistics such as Mann–Whitney U-test for gender with knowledge, attitude, and practice scores, as well as Kruskal–Wallis test for the scholastic year with knowledge, attitude, and practice scores.


  Results Top


Among 256 study participants, 130 were female (50.8%) and 126 were male (49.2%). 50 students (19.5%) are in their 1st year, 52 students (20.3%) in the 2nd year, 85 students (33.2%) in the 3rd year, and 69 students (27%) in their 4th year of law college. The main sources of information for the study participants are online newspapers/channels (n = 70) and social media (n = 55) [Figure 1] (mixed responses were taken from the study participants).
Figure 1: Main source of information regarding COVID-19 (n = 256)

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[Table 1] shows that the median score (IQR) of knowledge is 5 (4–6), attitude is 4 (2–5), and practice is 8 (6–8) regarding COVID-19. This shows that knowledge is good, attitude is poor, and practice is good regarding COVID- 19.
Table 1: Distribution of knowledge, attitude, and practice scores of study participants

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Comparison of gender and knowledge scores was done using the Mann–Whitney U-test; the median score for both males and females is 5 and the IQR ia 4–5 and 4–6 for males and females, respectively. This was not statistically significant at a P = 0.057. Comparison of scholastic year and knowledge scores was done using the Kruskal–Wallis test; the median scores for the 1st, 2nd, 3rd, and 4th year is 5, 4, 5, and 5, respectively. The IQR for the 1st, 2nd, 3rd, and 4th year are 4–5.25, 3–5, 4–6, and 4–6, respectively. This was found to be statistically significant at a P < 0.05 [Table 2].
Table 2: Comparison of gender and scholastic year with knowledge scores

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A comparison of gender and attitude scores was done using the Mann–Whitney U-test; this was found to be not statistically significant at a P = 0.699. Comparison of scholastic year and attitude scores was done using the Kruskal–Wallis test; this was found to be not statistically significant at a P = 0.593 [Table 3].
Table 3: Comparison of gender and scholastic year with attitude scores

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A comparison of gender and practice scores was done using the Mann–Whitney U-test; this was found to be not statistically significant at a P = 0.447. Comparison of scholastic year and practice scores were done using the Kruskal–Wallis test; this was found to be not statistically significant at a P = 0.721 [Table 4].
Table 4: Comparison of gender and scholastic year with practice scores

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  Discussion Top


The knowledge, attitude, and practices for a particular infectious illness can be influenced by various factors, namely, the severity of illness, the severity of its spread, and the fatality rate.[9] COVID-19 is an emerging, rapidly evolving situation; people need to know the coping strategy regarding the pandemic and should take necessary measures accordingly.[10]

The median scores of knowledge, attitude, and practice regarding COVID-19 are low among the present study participants. The median score of knowledge about the disease among the study participants 5 out of 10 with an IQR of 4–6. The scores of attitude were lower among the study participants with a median score of 4 and the IQR of 2–5.

An initial study from China by Zhong et al. analyzed the knowledge, attitude, and practice of the Chinese residents regarding COVID-19 through an online survey during the outbreak.[2] Very good knowledge with 90% correct responses was observed in China in the study. Similarly, high level of good attitude and practice also was observed in the study.[2] The higher prevalence and impact of the disease in China compared to that in India could be the reason for the major difference in the scores. Although health authorities and ministry have been consistently disseminating COVID-19 information even before the disease first appeared in India, there has also been a surge in false and inaccurate information. The overload of information may have caused confusion and difficulty in understanding the right information.

The sources of information for majority of the students were social media and online media. This has been responsible for dissemination of both right information and myths among public regarding the new viral disease. Same time, with this result, the online and social media platform can be utilized effectively for giving health education as well as preventing the misconception regarding prevention and control of disease.

Even though the scores of knowledge and attitude were low among college students, the practices were scored higher with a median of 8 and an IQR of 6–8. This is could be due to the fact that these practices were emphasized under hygiene and sanitation programs since decades to the people.

In the present study, the comparison of scholastic year and knowledge scores was done using Kruskal–Wallis test, which was found to be statistically significant at a P < 0.05. The similar results were found in a study done by Rugarabamu et al. among Tanzanian residents; overall, 84.4% of the participants had good knowledge which was significantly associated with education level (P = 0.001).[11] The study also showed the significant association between gender and knowledge score, which is in contrast to the current study where the difference is statistically not significant.

Another study done in Malaysia by Azlan et al. showed that knowledge scores were significantly different across genders, age groups, regions, occupation groups, and income categories. Higher knowledge scores were obtained among female participants, those above the age of 50, people residing in Central Malaysia, and those in the higher income category.[12]

The current study was conducted at a stage where the disease was not prevalent in India and only a few cases where tested positive among the people traveled from the affected area. The media coverage of the COVID-19 was also less, and the disease was not prevalent in the study area. Even, the government had not released much guidelines at the time of our study This could be a reason for the low scores in knowledge and attitude.

The strength of the study is that it was done in the early stage of the COVID-19 outbreak in India, especially in Karnataka. The results of the study can be used for implementing the preventive strategies at the earliest.


  Conclusion Top


Although the knowledge and attitude scores were low, it was found that the study participants were following appropriate practices regarding COVID-19.

Recommendation

Public preparedness: Pandemic preparedness is the need of the hours in the current era of emerging and re-emerging diseases; therefore, emphasis needs to be given at adequate health education to the public at all sectors of the society.

Limitation

The disease being a new event, no much literature is available for a comparison of our study results, and since the study was done in a college, convenient sampling and sample size were used; hence, the results cannot be generalized.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Shi Y, Wang J, Yang Y, Wang Z, Wang G, Hashimoto K, et al. Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19. Brain Behav Immun Health 2020;4:100064.  Back to cited text no. 1
    
2.
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;16:1745-52.  Back to cited text no. 2
    
3.
Coronavirus. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. [Last accessed on 2020 Apr 04].  Back to cited text no. 3
    
4.
COVID19 Statewise Status; 2020. Available from: https://mygov.in/corona-data/covid19-statewise-status/. [Last accessed on 2020 Apr 04].  Back to cited text no. 4
    
5.
Coronavirus. Available from: https://www.who.int/westernpacific/health-topics/coronavirus. [Last accessed on 2020 Apr 04].  Back to cited text no. 5
    
6.
Available from: https://www.mohfw.gov.in/pdf/FAQ.pdf. [Last accessed on 2020 Apr 04].  Back to cited text no. 6
    
7.
Key Messages and Actions for COVID-19 Prevention and Control in Schools. Available from: https://www.who.int/docs/default-source/coronaviruse/key-messages-and-actions-for-covid-19-prevention-and-control-in-schools-march-2020.pdf?sfvrsn=baf81d52_4. [Last accessed on 2020 Apr 04].  Back to cited text no. 7
    
8.
Q&A on Coronaviruses (COVID-19). Available from: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses. [Last accessed on 2020 May 19].  Back to cited text no. 8
    
9.
Alzoubi H, Alnawaiseh N, Al-Mnayyis A, Mohammad Abu- Lubada A, Aqel A, Al-Shagahin H. COVID-19-Knowledge, attitude and practice among medical and non-medical university students in Jordan. J Pure Appl Microbiol 2020;14:17-24.  Back to cited text no. 9
    
10.
Knowledge, Attitude and Practices (KAP) Towards COVID-19 and Assessment of Risks of Infection by SARS-CoV-2 among the Bangladeshi Population: An Online Cross-Sectional Survey; 2020. Available from: https://www.researchsquare.com/article/rs-24562/v1. [Last accessed on 2020 May 19].  Back to cited text no. 10
    
11.
Rugarabamu S, Ibrahim M, Byanaku A. Knowledge, attitudes, and practices (KAP) towards COVID-19: A quick online cross-sectional survey among Tanzanian residents. [doi.org/10.1101/2020.04.26.20080820].  Back to cited text no. 11
    
12.
Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E. Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLoS One 2020;15:e0233668.  Back to cited text no. 12
    


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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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