Research Article

Knowledge and Attitudes towards COVID-19 Prevention Measures among Residents of Lusaka District in Zambia

Steward Mudenda 1 * , Monica Botha 1, Moses Mukosha 1, Victor Daka 2, Misheck Chileshe 3, Kennedy Mwila 4, Michelo Banda 1, Ruth Lindizyani Mfune 2, Webrod Mufwambi 1, Martin Kampamba 1, Christabel Nang’andu Hikaambo 1
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1 Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, ZAMBIA2 Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, ZAMBIA3 MaryBegg Health Services, Northrise, Ndola, ZAMBIA4 Graduate School of Education, Peking University, Beijing, CHINA* Corresponding Author
Aquademia, 6(1), 2022, ep22005, https://doi.org/10.21601/aquademia/12210
Published: 02 July 2022
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ABSTRACT

Improved knowledge and attitude towards COVID-19 preventive measures have been shown to slow down transmission rates and improve public health outcomes. Yet, there is a lack of information regarding knowledge and attitudes towards COVID-19 prevention measures among the general population in Zambia. This study assessed the knowledge and attitudes towards COVID-19 prevention measures among residents of the Lusaka District, Zambia. This cross-sectional study involved 453 participants from 20th August to 10th October 2021 using previously validated questionnaires. Data were analyzed using Stata 16.1 (Stata Corp, College Station, TX, United States). Structural equation modelling (SEM) was used to analyze relationships between latent variables (knowledge and attitude). Of the 453 participants, 52.3% were female. Overall knowledge of COVID-19 prevention measures was 85.2% while attitude was 46.2%. SEM showed no evidence of an association between knowledge of COVID-19 preventive measures and attitudes towards the preventive measures (r=0.01, p=0.071). However, there was a significant association between young adults vs adults and the frequency of hand sanitizing using alcohol-based hand rub (p=0.036). Additionally, there was evidence of a difference between the frequency of covering the mouth with a bent elbow when coughing or sneezing and the age group, with adults doing this practice more often than young adults (p=0.011). Finally, young adults had the highest average scores for attitude; 2.54 (SD=1.39), compared to adults; 2.22 (SD=1.43) (p=0.027). Despite knowledge of COVID-19 prevention measures being relatively high among Lusaka residents, their attitudes towards these measures were sub-optimal and can potentially affect preventive measures currently in place.

CITATION (APA)

Mudenda, S., Botha, M., Mukosha, M., Daka, V., Chileshe, M., Mwila, K., Banda, M., Mfune, R. L., Mufwambi, W., Kampamba, M., & Hikaambo, C. N. (2022). Knowledge and Attitudes towards COVID-19 Prevention Measures among Residents of Lusaka District in Zambia. Aquademia, 6(1), ep22005. https://doi.org/10.21601/aquademia/12210

REFERENCES

  1. Abdelhafiz, A. S., Mohammed, Z., Ibrahim, M. E., Ziady, H. H., Alorabi, M., Ayyad, M., & Sultan, E. A. (2020). Knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19). Journal of Community Health, 45(5), 881-890. https://doi.org/10.1007/s10900-020-00827-7
  2. Abeya, S. G., Barkesa, S. B., Sadi, C. G., Gemeda, D. D., Muleta, F. Y., Tolera, A. F., Ayana, D. N., Mohammed, S. A., Wako, E. B., Hurisa, M. B., Bayisa, D. A., Sarbesa, M. K., Yesuf, E. Y., & Tufa, A. A. (2021). Adherence to COVID-19 preventive measures and associated factors in Oromia regional state of Ethiopia. PLoS ONE, 16(10), e0257373. https://doi.org/10.1371/journal.pone.0257373
  3. Alahdal, H., Basingab, F., & Alotaibi, R. (2020). An analytical study on the awareness, attitude and practice during the COVID-19 pandemic in Riyadh, Saudi Arabia. Journal of Infection and Public Health, 13(10), 1446-1452. https://doi.org/10.1016/j.jiph.2020.06.015
  4. Albassam, A., Alshammari, S., Ouda, G., Koshy, S., & Awad, A. (2018). Knowledge, perceptions and confidence of physicians and pharmacists towards pharmacogenetics practice in Kuwait. PLoS ONE, 13(9), e0203033. https://doi.org/10.1371/journal.pone.0203033
  5. Al-Hanawi, M. K., Angawi, K., Alshareef, N., Qattan, A. M. N., Helmy, H. Z., Abudawood, Y., Alqurashi, M., Kattan, W. M., Kadasah, N. A., Chirwa, G. C., & Alsharqi, O. (2020). Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: A cross-sectional study. Frontiers in Public Health, 8, 217. https://doi.org/10.3389/fpubh.2020.00217
  6. Alqudeimat, Y., Alenezi, D., Alhajri, B., Alfouzan, H., Almokhaizeem, Z., Altamimi, S., Almansouri, W., Alzalzalah, S., & Ziyab, A. H. (2021). Acceptance of a COVID-19 vaccine and its related determinants among the general adult population in Kuwait. Medical Principles and Practice, 30(3), 262-271. https://doi.org/10.1159/000514636
  7. Al-Wutayd, O., Mansour, A. E., Aldosary, A. H., Hamdan, H. Z., & Al-Batanony, M. A. (2021). Handwashing knowledge, attitudes, and practices during the COVID-19 pandemic in Saudi Arabia: A non-representative cross-sectional study. Scientific Reports, 11(1), 1-12. https://doi.org/10.1038/s41598-021-96393-6
  8. Apanga, P. A., & Kumbeni, M. T. (2021). Adherence to COVID-19 preventive measures and associated factors among pregnant women in Ghana. Tropical Medicine and International Health, 26(6), 656-663. https://doi.org/10.1111/tmi.13566
  9. Azlan, A. A., Hamzah, M. R., Sern, T. J., Ayub, S. H., & Mohamad, E. (2020). Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLoS ONE, 15(5), e0233668. https://doi.org/10.1371/journal.pone.0233668
  10. Blendon, R. J., Benson, J. M., DesRoches, C. M., Raleigh, E., & Taylor-Clark, K. (2004). The public’s response to severe acute respiratory syndrome in Toronto and the United States. Clinical Infectious Diseases, 38(7), 925-931. https://doi.org/10.1086/382355
  11. Carcelen, A. C., Prosperi, C., Mutembo, S., Chongwe, G., Mwansa, F. D., Ndubani, P., Simulundu, E., Chilumba, I., Musukwa, G., Thuma, P., Kapungu, K., Hamahuwa, M., Mutale, I., Winter, A., Moss, W. J., & Truelove, S. A. (2021). COVID-19 vaccine hesitancy in Zambia: a glimpse at the possible challenges ahead for COVID-19 vaccination rollout in sub-Saharan Africa. Human Vaccines and Immunotherapeutics, 18(1), 1-6. https://doi.org/10.1080/21645515.2021.1948784
  12. CDC. (2021). How to protect yourself and others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention-H.pdf
  13. Chileshe, M., Mulenga, D., Mfune, R. L., Nyirenda, T. H., Mwanza, J., Mukanga, B., Mudenda, S., & Daka, V. (2020). Increased number of brought-in-dead cases with COVID-19: Is it due to poor health-seeking behaviour among the Zambian population? Pan African Medical Journal, 37, 136. https://doi.org/10.11604/pamj.2020.37.136.25967
  14. Chileshe, M., Mupeta, G., Kasanga, M., Lindizyani Mfune, R., Mudenda, S., Biemba, M., Shimaponda-Mataa, N. M., Sinkala, M., & Daka, V. (2021). Prevalence of adverse events post-COVID-19 vaccination amongst the adult Zambian population. Journal of Biomedical Research & Environmental Sciences, 2(12), 1315-1321. https://doi.org/10.37871/jbres1389
  15. Chirwa, G. C. (2020). “Who knows more, and why?” Explaining socioeconomic-related inequality in knowledge about HIV in Malawi. Scientific African, 7(3), e00213. https://doi.org/10.1016/j.sciaf.2019.e00213
  16. Chung, P. C., & Chan, T. C. (2021). Impact of physical distancing policy on reducing transmission of SARS-CoV-2 globally: Perspective from government’s response and residents’ compliance. PLoS ONE, 16(8), e0255873. https://doi.org/10.1371/journal.pone.0255873
  17. Cucinotta, D., & Vanelli, M. (2020). WHO declares COVID-19 a pandemic. Acta Biomedica, 91(1), 157-160. https://doi.org/10.23750/abm.v91i1.9397
  18. Denford, S., Morton, K., Horwood, J., de Garang, R., & Yardley, L. (2021). Preventing within household transmission of COVID-19: Is the provision of accommodation to support self-isolation feasible and acceptable? BMC Public Health, 21(1), 1-13. https://doi.org/10.1186/s12889-021-11666-z
  19. Desai, A. N., & Aronoff, D. M. (2020). Masks and coronavirus disease 2019 (COVID-19). JAMA–Journal of the American Medical Association, 323(20), 2103. https://doi.org/10.1001/jama.2020.6437
  20. Ditekemena, J. D., Nkamba, D. M., Muhindo, H. M., Siewe, J. N. F., Luhata, C., Van den Bergh, R., Tshefu Kitoto, A., Van Damme, W., Muyembe, J. J., & Colebunders, R. (2021). Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): Results of an online survey. BMJ Open, 11(1), e043356. https://doi.org/10.1136/bmjopen-2020-043356
  21. Feleke, B. T., Wale, M. Z., & Yirsaw, M. T. (2021). Knowledge, attitude and preventive practice towards COVID-19 and associated factors among outpatient service visitors at Debre Markos compressive specialized hospital, north-west Ethiopia, 2020. PLoS ONE, 16(7), e0251708. https://doi.org/10.1371/journal.pone.0251708
  22. Ferdous, M. Z., Islam, M. S., Sikder, M. T., Mosaddek, A. S. M., Zegarra-Valdivia, J. A., & Gozal, D. (2020). Knowledge, attitude, and practice regarding COVID-19 outbreak in Bangladesh: An onlinebased cross-sectional study. PLoS ONE, 15(10), e0239254. https://doi.org/10.1371/journal.pone.0239254
  23. Guner, R., Hasanoglu, I., & Aktas, F. (2020). COVID-19: Prevention and control measures in community. Turkish Journal of Medical Sciences, 50(SI-1), 571-577. https://doi.org/10.3906/sag-2004-146
  24. Gupta, M. K., & Lipner, S. R. (2020). Hand hygiene in preventing COVID-19 transmission. Cutis, 105(05), 1-2.
  25. Halperin, D. T., Hearst, N., Hodgins, S., Bailey, R. C., Klausner, J. D., Jackson, H., Wamai, R. G., Ladapo, J. A., Over, M., Baral, S., Escandón, K., & Gandhi, M. (2021). Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here. BMC Public Health, 21(1), 2084-2084. https://doi.org/10.1186/s12889-021-12082-z
  26. Hernández-García, I., & Giménez-Júlvez, T. (2020). Assessment of health information about COVID-19 prevention on the internet: Infodemiological study. JMIR Public Health and Surveillance, 6(2), e18717. https://doi.org/10.2196/18717
  27. Hikaambo, C. N., Kampamba, M., Bwalya, F., Mweemba, M., Siamutwe, C., Mufwambi, W., Chimombe, T., Banda, M., & Mudenda, S. (2021). A review of the antiviral activity of ivermectin and its use in the treatment of coronavirus disease-2019. Epidemiology–Open Journal, 6(1), 35-40. https://doi.org/10.17140/epoj-6-125
  28. Ho, H. S. W. (2012). Use of face masks in a primary care outpatient setting in Hong Kong: Knowledge, attitudes and practices. Public Health, 126(12), 1001-1006. https://doi.org/10.1016/j.puhe.2012.09.010
  29. Izzetti, R., Nisi, M., Gabriele, M., & Graziani, F. (2020). COVID-19 transmission in dental practice: Brief review of preventive measures in Italy. Journal of Dental Research, 99(9), 1030-1038. https://doi.org/10.1177/0022034520920580
  30. Javid, B., Weekes, M. P., & Matheson, N. J. (2020). COVID-19: Should the public wear face masks? BMJ, 369, m1442. https://doi.org/10.1136/bmj.m1442
  31. Júnior, A., Dula, J., Mahumane, S., Koole, O., Enosse, S., Fodjo, J. N. S., & Colebunders, R. (2021). Adherence to COVID-19 preventive measures in Mozambique: Two consecutive online surveys. International Journal of Environmental Research and Public Health, 18(3), 1-9. https://doi.org/10.3390/ijerph18031091
  32. Khasawneh, A. I., Humeidan, A. A., Alsulaiman, J. W., Bloukh, S., Ramadan, M., Al-Shatanawi, T. N., Awad, H. H., Hijazi, W. Y., Al-Kammash, K. R., Obeidat, N., Saleh, T., & Kheirallah, K. A. (2020). Medical students and COVID-19: Knowledge, attitudes, and precautionary measures. A descriptive study from Jordan. Frontiers in Public Health, 8, 253. https://doi.org/10.3389/fpubh.2020.00253
  33. Kumar, J., Katto, M. S., Siddiqui, A. A., Sahito, B., Jamil, M., Rasheed, N., & Ali, M. (2020). Knowledge, attitude, and practices of healthcare workers regarding the use of face mask to limit the spread of the new coronavirus disease (COVID-19). Cureus, 12(4), e7737. https://doi.org/10.7759/cureus.7737
  34. Larebo, Y. M., & Abame, D. E. (2021). Knowledge, attitudes, and practices of face mask utilization and associated factors in COVID-19 pandemic among Wachemo University Students, Southern Ethiopia: A cross-sectional study. PLoS ONE, 16(9), e0257609. https://doi.org/10.1371/journal.pone.0257609
  35. Lau, L. L., Hung, N., Go, D. J., Ferma, J., Choi, M., Dodd, W., & Wei, X. (2020). Knowledge, attitudes and practices of COVID-19 among income-poor households in the Philippines: A cross-sectional study. Journal of Global Health, 10(1), 011007. https://doi.org/10.7189/JOGH.10.011007
  36. Lazarus, J. V., Ratzan, S. C., Palayew, A., Gostin, L. O., Larson, H. J., Rabin, K., Kimball, S., & El-Mohandes, A. (2021). A global survey of potential acceptance of a COVID-19 vaccine. Nature Medicine, 27(2), 225-228. https://doi.org/10.1038/s41591-020-1124-9
  37. Liu, C., Liu, C., Wang, D., & Zhang, X. (2019). Knowledge, attitudes and intentions to prescribe antibiotics: A structural equation modeling study of primary care institutions in Hubei, China. International Journal of Environmental Research and Public Health, 16(13), 2385. https://doi.org/10.3390/ijerph16132385
  38. Lufungulo, E. S., Mwila, K., Mudenda, S., Kampamba, M., Chulu, M., & Hikaambo, C. N. (2021). Online teaching during COVID-19 pandemic in Zambian universities: Unpacking lecturers’ experiences and the implications for incorporating online teaching in the University Pedagogy. Creative Education, 12(12), 2886-2904. https://doi.org/10.4236/ce.2021.1212216
  39. Matovu, J. K. B., Kabwama, S. N., Ssekamatte, T., Ssenkusu, J., & Wanyenze, R. K. (2021). COVID-19 awareness, adoption of COVID-19 preventive measures, and effects of COVID-19 lockdown among adolescent boys and young men in Kampala, Uganda. Journal of Community Health, 46(4), 842-853. https://doi.org/10.1007/s10900-021-00961-w
  40. Matuschek, C., Moll, F., Fangerau, H., Fischer, J. C., Zänker, K., Van Griensven, M., Schneider, M., Kindgen-Milles, D., Knoefel, W. T., Lichtenberg, A., Tamaskovics, B., Djiepmo-Njanang, F. J., Budach, W., Corradini, S., Häussinger, D., Feldt, T., Jensen, B., Pelka, R., Orth, K., … Haussmann, J. (2020). Face masks: Benefits and risks during the COVID-19 crisis. European Journal of Medical Research, 25(1), 32. https://doi.org/10.1186/s40001-020-00430-5
  41. Mohamed, N. A., Solehan, H. M., Mohd Rani, M. D., Ithnin, M., & Isahak, C. I. C. (2021). Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. PLoS ONE, 16, e0256110). https://doi.org/10.1371/journal.pone.0256110
  42. Mudenda, S., Chileshe, M., Mukosha, M., Hikaambo, C. N., Banda, M., Kampamba, M., Mwila, K., Banda, D. C., Mufwambi, W., & Daka, V. (2022a). Zambia’s response to the COVID-19 pandemic: Exploring lessons, challenges and implications for future policies and strategies. Pharmacology & Pharmacy, 13(01), 11-33. https://doi.org/10.4236/pp.2022.131002
  43. Mudenda, S., Hikaambo, C. N., Daka, V., Chileshe, M., Mfune, R. L., Kampamba, M., Kasanga, M., Phiri, M., Mufwambi, W., Banda, M., Phiri, M. N., & Mukosha, M. (2022b). Prevalence and factors associated with COVID-19 vaccine acceptance in Zambia: A web-based cross-sectional study. Pan African Medical Journal, 41, 112. https://doi.org/10.11604/PAMJ.2022.41.112.31219
  44. Mukanu, M. M., Zulu, J. M., Mweemba, C., & Mutale, W. (2017). Responding to non-communicable diseases in Zambia: A policy analysis. Health Research Policy and Systems, 15(1), 1-9. https://doi.org/10.1186/s12961-017-0195-7
  45. Mulenga, L. B., Hines, J. Z., Fwoloshi, S., Chirwa, L., Siwingwa, M., Yingst, S., Wolkon, A., Barradas, D. T., Favaloro, J., Zulu, J. E., Banda, D., Nikoi, K. I., Kampamba, D., Banda, N., Chilopa, B., Hanunka, B., Stevens, T. L., Shibemba, A., Mwale, C., … Malama, K. (2021). Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: A cross-sectional cluster sample survey. The Lancet Global Health, 9(6), e773-e781. https://doi.org/10.1016/S2214-109X(21)00053-X
  46. Mutale, W., Bosomprah, S., Shankalala, P., Mweemba, O., Chilengi, R., Kapambwe, S., Chishimba, C., Mukanu, M., Chibutu, D., & Heimburger, D. (2018). Assessing capacity and readiness to manage NCDs in primary care setting: Gaps and opportunities based on adapted WHO PEN tool in Zambia. PLoS ONE, 13(8), e0200994. https://doi.org/10.1371/journal.pone.0200994
  47. Mwila, K., Kalolo, F., Mudenda, S., & Hikaambo, C. N. (2021). Impact of COVID-19 on academic activities of final year nursing students: A Zambian reflection. International Journal of Basic & Clinical Pharmacology, 10(7), 806. https://doi.org/10.18203/2319-2003.ijbcp20212377
  48. Nguyen, N. P. T., Hoang, T. D., Tran, V. T., Vu, C. T., Fodjo, J. N. S., Colebunders, R., Dunne, M. P., & van Vo, T. (2020). Preventive behavior of Vietnamese people in response to the COVID-19 pandemic. PLoS ONE, 15(9), e0238830. https://doi.org/10.1371/journal.pone.0238830
  49. Pengpid, S., & Peltzer, K. (2020). Prevalence and correlates of multiple non-communicable disease risk factors among adults in Zambia: Results of the first national steps survey in 2017. Pan African Medical Journal, 37(265), 1-12. https://doi.org/10.11604/pamj.2020.37.265.25038
  50. Petherick, A., Goldszmidt, R., Andrade, E. B., Furst, R., Hale, T., Pott, A., & Wood, A. (2021). A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue. Nature Human Behaviour, 5(9), 1145-1160. https://doi.org/10.1038/s41562-021-01181-x
  51. Popp, M., Stegemann, M., Metzendorf, M. I., Kranke, P., Meybohm, P., Skoetz, N., & Weibel, S. (2021a). Ivermectin for preventing and treating COVID-19. Cochrane Database of Systematic Reviews, 2021(4), CD015017. https://doi.org/10.1002/14651858.CD015017.pub2
  52. Popp, M., Stegemann, M., Riemer, M., Metzendorf, M. I., Romero, C. S., Mikolajewska, A., Kranke, P., Meybohm, P., Skoetz, N., & Weibel, S. (2021b). Antibiotics for the treatment of COVID-19. Cochrane Database of Systematic Reviews, 2021(10), CD015025-CD015025. https://doi.org/10.1002/14651858.CD015025
  53. Reuben, R. C., Danladi, M. M. A., Saleh, D. A., & Ejembi, P. E. (2021). Knowledge, attitudes and practices towards COVID-19: An epidemiological survey in North-Central Nigeria. Journal of Community Health, 46(3), 457-470. https://doi.org/10.1007/s10900-020-00881-1
  54. Romney, M. G. (2001). Surgical face masks in the operating theatre: Re-examining the evidence. Journal of Hospital Infection, 47(4), 251-256. https://doi.org/10.1053/jhin.2000.0912
  55. Saadatjoo, S., Miri, M., Hassanipour, S., Ameri, H., & Arab-Zozani, M. (2021). Knowledge, attitudes, and practices of the general population about coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis with policy recommendations. Public Health, 194, 185-195. https://doi.org/10.1016/j.puhe.2021.03.005
  56. Salman, M., Mustafa, Z. U., Asif, N., Zaidi, H. A., Hussain, K., Shehzadi, N., Khan, T. M., & Saleem, Z. (2020). Knowledge, attitude and preventive practices related to COVID-19: A cross-sectional study in two Pakistani university populations. Drugs and Therapy Perspectives, 36(7), 319-325. https://doi.org/10.1007/s40267-020-00737-7
  57. Scampoli, P., Di Giovanni, P., Cedrone, F., D’Addezio, M., Di Martino, G., Meo, F., & Staniscia, T. (2021). Attitudes towards COVID-19 preventive measures: An Italian cross-sectional study. European Journal of Public Health, 31(Supplement_3), 373-373. https://doi.org/10.1093/eurpub/ckab165.093
  58. Sialubanje, C., Sitali, D. C., Mukumbuta, N., Liyali, L., Sumbwa, P. I., Kamboyi, H. K., Ng’andu, M., & Goma, F. M. (2022). Perspectives on factors influencing transmission of COVID-19 in Zambia: A qualitative study of health workers and community members. BMJ Open, 12(4), e057589. https://doi.org/10.1136/bmjopen-2021-057589
  59. Singh, B., Ryan, H., Kredo, T., Chaplin, M., & Fletcher, T. (2021). Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19. Cochrane Database of Systematic Reviews, 2(2), CD013587. https://doi.org/10.1002/14651858.CD013587.pub2
  60. Sohrabi, C., Alsafi, Z., O’Neill, N., Khan, M., Kerwan, A., Al-Jabir, A., Iosifidis, C., & Agha, R. (2020). World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery, 76, 71-76. https://doi.org/10.1016/j.ijsu.2020.02.034
  61. Sreshtaa, S. V., Geetha, R. V., & Anjaneyulu, K. (2021). Role of handwashing and hand sanitising in preventing infection. Annals of the Romanian Society for Cell Biology, 25(3), 724-737.
  62. Ssebuufu, R., Sikakulya, F. K., Mambo, S. B., Wasingya, L., Nganza, S. K., Ibrahim, B., & Kyamanywa, P. (2020). Knowledge, attitude, and self-reported practice toward measures for prevention of the spread of COVID-19 among Ugandans: A nationwide online cross-sectional survey. Frontiers in Public Health, 8, 890. https://doi.org/10.3389/fpubh.2020.618731
  63. Sun, C., & Zhai, Z. (2020). The efficacy of social distance and ventilation effectiveness in preventing COVID-19 transmission. Sustainable Cities and Society, 62, 102390. https://doi.org/10.1016/j.scs.2020.102390
  64. Taghrir, M. H., Borazjani, R., & Shiraly, R. (2020). COVID-19 and Iranian medical students; A survey on their related-knowledge, preventive behaviors and risk perception. Archives of Iranian Medicine, 23(4), 249-254. https://doi.org/10.34172/aim.2020.06
  65. Talic, S., Shah, S., Wild, H., Gasevic, D., Maharaj, A., Ademi, Z., Li, X., Xu, W., Mesa-Eguiagaray, I., Rostron, J., Theodoratou, E., Zhang, X., Motee, A., Liew, D., & Ilic, D. (2021). Effectiveness of public health measures in reducing the incidence of COVID-19, SARS-CoV-2 transmission, and covid-19 mortality: Systematic review and meta-analysis. BMJ, 375, e068302.
  66. Taylor, S., & Asmundson, G. J. G. (2021). Negative attitudes about facemasks during the COVID-19 pandemic: The dual importance of perceived ineffectiveness and psychological reactance. PLoS ONE, 16(2), e0246317. https://doi.org/10.1371/journal.pone.0246317
  67. Van Den Berg, P., Schechter-Perkins, E. M., Jack, R. S., Epshtein, I., Nelson, R., Oster, E., & Branch-Elliman, W. (2021). Effectiveness of 3 versus 6 ft of physical distancing for controlling spread of coronavirus disease 2019 among primary and secondary students and staff: A retrospective, statewide cohort study. Clinical Infectious Diseases, 73(10), 1871-1878. https://doi.org/10.1093/cid/ciab230
  68. Viana, R., Moyo, S., Amoako, D. G., Tegally, H., Scheepers, C., Althaus, C. L., Anyaneji, U. J., Bester, P. A., Boni, M. F., Chand, M., Choga, W. T., Colquhoun, R., Davids, M., Deforche, K., Doolabh, D., du Plessis, L., Engelbrecht, S., Everatt, J., Giandhari, J., … de Oliveira, T. (2022). Rapid epidemic expansion of the SARS-CoV-2 omicron variant in southern Africa. Nature, 603(7902), 679-686. https://doi.org/10.1038/s41586-022-04411-y
  69. Yehualashet, S. S., Asefa, K. K., Mekonnen, A. G., Gemeda, B. N., Shiferaw, W. S., Aynalem, Y. A., Bilchut, A. H., Derseh, B. T., Mekuria, A. D., Mekonnen, W. N., Meseret, W. A., Tegegnework, S. S., & Abosetegn, A. E. (2021). Predictors of adherence to COVID-19 prevention measure among communities in North Shoa Zone, Ethiopia based on health belief model: A cross-sectional study. PLoS ONE, 16(1), e0246006. https://doi.org/10.1371/journal.pone.0246006
  70. Zamil, J., Atrooz, F., Majd, Z., Zeidat, S., Alrousan, G., Abughosh, S., & Salim, S. (2022). Perception regarding knowledge of COVID-19 prevention in a sample of a Middle Eastern and North African (MENA) community in Houston, Texas, USA. International Journal of Environmental Research and Public Health, 19(1), 524. https://doi.org/10.3390/ijerph19010524
  71. Zegarra-Valdivia, J., Chino Vilca, B. N., & Ames-Guerrero, R. J. (2020). Knowledge, perception and attitudes in regard to COVID-19 pandemic in Peruvian population. https://doi.org/10.31234/osf.io/kr9ya
  72. Zhong, B. L., Luo, W., Li, H. M., Zhang, Q. Q., Liu, X. G., Li, W. T., & Li, Y. (2020). 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. International Journal of Biological Sciences, 16(10), 1745-1752. https://doi.org/10.7150/ijbs.45221
  73. Zipprich, H. M., Teschner, U., Witte, O. W., Schönenberg, A., & Prell, T. (2020). Knowledge, attitudes, practices, and burden during the COVID-19 pandemic in people with Parkinson’s disease in Germany. Journal of Clinical Medicine, 9(6), 1643. https://doi.org/10.3390/jcm9061643