|Year : 2020 | Volume
| Issue : 4 | Page : 276-281
Knowledge and perception regarding coronavirus disease-19 among the nurses in Kebbi State North-west Nigeria
Kehinde Fasasi Monsudi1, Abayomi O Ayodapo2, OO Deji-Dada3, AA Bioku4, Fahd M Moshood5
1 Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi, Nigeria
2 Department of Family Medicine, University College Hospital, Ibadan, Nigeria
3 Department of Family Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
4 Department of Psychiatry, Federal Medical Centre, Birnin Kebbi, Nigeria
5 Department of Laboratory Science, Usmanu Danfodio University Teaching Hospital, Sokoto, Nigeria
|Date of Submission||22-Jun-2020|
|Date of Decision||04-Sep-2020|
|Date of Acceptance||18-Feb-2021|
|Date of Web Publication||8-Apr-2021|
Kehinde Fasasi Monsudi
Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi
Source of Support: None, Conflict of Interest: None
Background: The world is presently faced with a coronavirus disease-19 (COVID-19) pandemic which has overwhelmed countries health systems and has had an enormous toll on human lives. Health-care workers of all levels are primarily involved in taking care of patients with COVID-19, and this has posed serious occupational health risk to this important workforce. Aim: The aim of this study is to assess the knowledge and perception regarding COVID-19 among the nurses in Kebbi State. Materials and Methods: This was a hospital-based, descriptive, cross-sectional study conducted among the nurses working in the only tertiary hospital in Kebbi State using self-administered questionnaires. Information obtained from the participants includes sociodemographic characteristics, knowledge, and perception on COVID-19. The data were analyzed using the Statistical Package for the Social Sciences software version 21. Results: Of the 170 nurses that were given the questionnaires, 161 returned it. There were 61 (37.9%) males. The mean age of the participants was 36.1 years (standard deviation = 9.3), and the age range was between 20 years and 57 years. Majority of the respondents were in the age group of 31-“40 years (41.6%), married 128 (79.5%), Hausa 84 (55.2%), Muslim 103 (64%), registered nurse/registered Midwives 111 (88.9%), and 97 (60.2%) have been practicing nursing profession between 1 year and 10 years. Slightly more than half (51.6%) of the respondents have poor knowledge of COVID. While majority 98% have the high level of perception on COVID-19. Conclusion: Nurses in our hospital have poor knowledge of COVID-19 but good perception of the disease. Internet/social media remains the sources of information on the disease. The importance of creating more awareness of the disease among the health workers is underscored.
Keywords: Coronavirus disease-19, Kebbi state, knowledge, nurses, perception
|How to cite this article:|
Monsudi KF, Ayodapo AO, Deji-Dada O O, Bioku A A, Moshood FM. Knowledge and perception regarding coronavirus disease-19 among the nurses in Kebbi State North-west Nigeria. CHRISMED J Health Res 2020;7:276-81
|How to cite this URL:|
Monsudi KF, Ayodapo AO, Deji-Dada O O, Bioku A A, Moshood FM. Knowledge and perception regarding coronavirus disease-19 among the nurses in Kebbi State North-west Nigeria. CHRISMED J Health Res [serial online] 2020 [cited 2022 May 16];7:276-81. Available from: https://www.cjhr.org/text.asp?2020/7/4/276/313179
| Introduction|| |
Coronavirus disease-19 (COVID-19) is a contagious deadly infectious disease caused by a newly discovered virus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV 2). It belongs to the CoV family, causes acute and severe respiratory syndrome in humans. It is a single-stranded enveloped RNA virus similar phylogenetically to SARS-COV-1. It has been reported that the virus spread through birds and mammals, although humans are mostly susceptible to this virus. There were previous reported cases of outbreak of coronaviruses such as SARS-CoV and Middle East Respiratory Syndrome-CoV (MERS-CoV) in 2003 and 2015, respectively, but the global impact of the COVID-19 is unprecedented. Low pathogenicity and high transmissibility are the two important features reported in the literature that differentiate 2019-nCov from SARS-CoV and MERS-CoV.
The first case of COVID-19 was reported on December 12, 2019, in Wuhan, China, with the symptoms of dyspnea, fever, and cough. Since then, this deadly disease has spread worldwide mostly through airline travelers leading to World Health Organization (WHO) pronouncement of COVID-19 as a disease of public health emergency of International concern, hence becoming a global emergency pandemic., At present, COVID-19 has spread to 213 countries, and as at June 19, 2020, Center for Disease Control reported over 8.7 million cases with a death toll of over 460,000.
The incubation period of COVID-19 is between 2 and 14 days. The route of transmission is through contact with infected person droplet and contaminated fomites. Although the virus has being isolated in blood and feces, transmission through these routes has not been reported.
The disease is asymptomatic in 80% of affected people, whereas 20% shows symptoms and 2% out of the symptomatic population results in death. The symptoms of this deadly disease include cough, sneezing, dyspnea, fever, myalgia, headache, sore throat, abdominal pain, and diarrhea. Redness and conjunctivitis have been reported in few infected individual in China. COVID-19 is severe in the elderly and individual with underlying medical health condition such as diabetes, hypertension, heart diseases, and chronic kidney diseases.
Nigeria recorded the first case of COVID-19 on February 27, 2020, and as of today June 19, 2020, Nigeria has recorded 18,480 confirmed cases of COVID-19 with 475 deaths and 6307 discharged from different isolation centers.
At present, COVID-19 has no cure and no vaccine. Hence, the prevention is the best way to mitigate the spread of this disease. These measures include social distance, isolating the infected person, lockdown of the affected community, frequent hand washing with soap or hand sanitizer, use of face mask, and personal protective equipment (PPE) in the treatment of infected person., Health-care workers and other frontline workers are at risk of contracting the disease while evacuating the infected individual to the hospital or during treatment of the confirmed cases. The nurses play an important role in attending to suspected and confirmed COVID-19 patient, and this increases the risk of infection with this virus if precautionary measures are not taken; hence, a good knowledge of COVID-19 by nurses will help in mitigating the spread of this highly contagious disease among hospital community. Therefore, this study aims at identifying the current status of knowledge and perception regarding COVID-19 among the nurses in Kebbi State.
| Materials and Methods|| |
This was a hospital-based, descriptive, cross-sectional study that was conducted between May and June 2020 among the nurses working in the only tertiary hospital in Kebbi State (Federal Medical Centre). The hospital provides health services to state inhabitant of population of about 4 million and surrounding states (Niger, Kaduna, Sokoto, and Zamfara) and countries (Niger and Benin republics). The study was done using self-administered questionnaires that was given to all the 170 nurses working in the hospital during the study period. The questionnaires were divided into three sections.
Section A obtained the information on sociodemographics characteristics of the participants (age, sex, education, year of practice, tribe, and religion); Section B gathered information on knowledge of COVID-19 (sources of coronavirus, transmission, symptoms, sign, prevention, and treatment), and information on perception of COVID-19 (fatality, economic impact, and anxiety) was in Section C. Each response in Section B was scored as “true,” “false,” or “I do not know.” This was assessed by given 1 to the correct answer and 0 to wrong answer. Each response in Section C required “Yes” or “No” answer.
Each correct answer in relation to the knowledge of COVID-19 in Section B was given one point. The total knowledge of COVID-19 scored varied between 0 (with no correct answer) and 33 (for all correct answers), and a cutoff level of <28 was evaluated as poor knowledge, and a score of more than 28 indicate good knowledge of COVID-19. While the total perception scored varied between 0 and 5 a cutoff <2 was considered as poor perception and >2 indicated good perception.
The pilot study was done among 20 nurses in a General Hospital Birnin Kebbi. The questionnaires were adjusted appropriately before been administered to the nurses in Federal Medical Center. The nurses used in the pilot test were not included in the main study.
The data were double entered and analyzed using the Statistical Package for the Social Sciences (SPSS for Windows version 21 IBM, Chicago, IL, USA). Means and standard deviation (SD) were used to describe the continuous variable, whereas percentages were used to describe the categorical variable.
P < 0.05 in considered statistically significant.
Ethical approval for this study was obtained from Ethical Research Committee of Federal Medical Centre Birnin Kebbi. Furthermore, the individual participants' written informed consent was also obtained. The study was done in accordance with tenets of the declaration of Helsinki.
| Results|| |
Of the 170 nurses that were given the questionnaires, 161 returned it. The response rate was 94.7%. There were 61 (37.9%) males. The mean age of the participants was 36.1 years (SD = 9.3), and the age range was between 20 years and 57 years.
Majority of the respondents were in the age group of 31-“40 years (41.6%), married 128 (79.5%), Hausa 84 (55.2%), Muslim 103 (64%), registered nurse/registered Midwives 111 (88.9%), and 97 (60.2%) have been practicing nursing profession between 1 year and 10 years. [Table 1] shows sociodemographics characteristics of the participants.
About general knowledge on coronavirus disease-19
Majority 149 (92.5%) of the respondents knew that virus caused the COVID-19, however about 1/3 (31.7%) knew that coronavirus is genetically RNA type of virus. Most of the participants 143 (88.8%) knew that COVID-19 started in Asia continent in China, 156 (96.9%), COVID-19 was a pandemic infection158 (98.1%) and health-care workers 152 (94.4%) were at higher risk of contracting the disease [Table 2].
|Table 2: Responses to the questionnaires on knowledge of coronavirus disease 2019|
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Regarding knowledge on coronavirus disease-19 transmission
Vast majority of the nurses agreed that COVID-19 is transmitted through droplet 152 (94.4%) and man to man contact 144 (89.4%). However, about half (53.4%) of the participants knew that disease was transmitted from animal to human and less than half (49.1%) through infected fomites.
Majority 147 (91.3%) of the respondents knew that the incubation period of COVID-19 was between 2 and 14 days [Table 2].
About the knowledge of coronavirus disease-19 presentation
Vast majority of the respondents knew that cough 155 (96.3%), sneezing 155 (96.3%), fever 155 (96.3%), and difficulty in breathing 151 (93.6%) were the symptoms of COVID-19. While the respondents have less knowledge that diarrhea 49 (30.4%), redness of the eye 62 (38.5%), and conjunctivitis 42 (26.1%) were the symptoms of the disease [Table 2]
Regarding knowledge of prevention and control of coronavirus disease-19
Almost all the participants knew that social distance 151 (93.8%), uses of face mask 155 (96.3%), frequent hands washing with soap 156 (96.9%), hands sanitizer 156 (96.9%), uses of PPE 158 (98.1%), contact tracing 158 (98.1%), avoid hand shaking 157 (97.5%), self-isolation 160 (99.4%), lockdown of infected community 154 (95.7%), enforcement of stay at home 149 (92.5%), and nonrelease of dead body of COVID-19 patient to the family 141 (87.6%) help in the mitigating against the spread and control of the disease.
As regard treatment of coronavirus disease-19
About half (55.9%) of the participants knew that COVID-19 has no cure, but the majority agreed that there was no vaccine 144 (89.4%) for the disease and the treatment for the infected individual was supportive 155 (96.3%).
Although there was no significant association observed between sociodemographics characteristics of the nurses and knowledge on COVID-19 apart from age. The respondents who were above the age of 30 years had more knowledge than those below the age of 30 years. [Table 3] showed the association between the sociodemographic variables and knowledge.
|Table 3: The association between the sociodemographic variables and knowledge|
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With regard to perceptions of coronavirus disease-19
Almost all the respondents knew that COVID-19 can result in death 159 (98.8%). All the respondents 161 (100%) are anxious/afraid because of the possibility of contracting the disease and 160 (99.4%) feared infecting their relative/family. The willingness to go into isolation center if they were positive for COVID-19 was shown by the majority 132 (82%) [Table 4].
|Table 4: Responses to the questionnaires on perceptions of coronavirus disease 2019|
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Furthermore, majority of the participants knew that COVID-19 has great national and global negative economic impact.
Sources of information on coronavirus disease-19
The main sources of information on COVID-19 by the respondents were internet/social media 23.6% and Television 18% [Figure 1].
|Figure 1: Sources of paticipants in information on coronavirus disease 2019|
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Overall about half (51.6%) of the respondents has poor knowledge of COVID-19 and 48.4% had good knowledge. [Table 5] showed the respondents total knowledge of COVID-19
However, almost all the participants 98.7% have good perception of COVID-19.
| Discussion|| |
In this study, most of the respondents were female nurses, which is similar to studies from Iranian and Ethiopian nurses. In our study, the majority of the nurses were Muslim; this was different from COVID-19 knowledge study from Ethiopian nurses who were mostly Christians. The difference may be because our study area was mainly predominant by Muslims.
In our study, slightly more than half (51.6%) of the respondents have poor knowledge of COVID-19. This was different from high/good knowledge reported from previous studies from Iran, Ethiopia, China,, and Nigeria. The reason for the difference may be because of poor awareness campaigned by the government, political ego, and also denial of the COVID-19 among the populace. This poor knowledge of COVID-19 among the nurses may have a serious impact in the control and prevention of the spread of COVID-19 because the nurses are among the frontline health workers who were expected to have a sound and good knowledge of COVID-19 pandemic. Furthermore, the poor knowledge showed the poor information on COVID-19 in various media in the country and Kebbi State in general. Therefore, the Ministry of Health (Federal and State), WHO, and others stakeholder should improve the awareness campaign of the disease through hospital presentation, social, and mass media.
Almost all (98.8%) of the participants agreed that COVID-19 is a deadly disease with high fatality which was in agreement with previous studies.,
In our study, there was anxiety among the participants that they may get the disease (100%) and may infect their family (99.4%). This was higher than what was reported from Iran, Ethiopia, China,, Saudi Arabia, and Hong Kong. The difference might be because of the previous experiences of health workers in the management of Lassa fever, where quite a number were infected with Lassa fever in our hospital during in 2019 Lassa fever epidemic.
In our study, Internet/social media 23.4% and television (18%) are the main sources of information of COVID-19 among the respondents similar to previous studies.,,,
This was different from studies by Olapegba et al. and Albarrak et al. who reported mass media, seminar, and workshop, respectively, as the main sources of information on COVID-19. The reason why internet/social media was the main source of information in our study might be because of availability of free internet services in our hospital and social medial (WhatsApp) as the main of communication among the hospital health workers.
In our study, the total knowledge score on COVID-19 was not affected by education level, and this was in agreement with previous studies among Iranian nurses and Saudi Arabian medical students. However, with respect to age, the respondents who were above the age of 30 years had more knowledge than those below the age of 30 years. This may be as a result of training and awareness gained from previous epidemic diseases such as Ebola and Lassa fever in Nigeria.
| Conclusion|| |
Nurses in our hospital have poor knowledge and good perception of COVID-19. Internet/social media remains the sources of information on the disease. Without neglecting the Internet/social media where nurses get information on COVID-19, the nurses should be given in-service education or continuing nursing education by the hospital management, ministry of health, and other relevant health stakeholder regarding COVID-19 as the nurses are the frontline workers.
| Acknowledgment|| |
The authors acknowledged Mr. Dantani Dejo Chairman National Association of Nigeria Nurses and Midwives FMC Birnin Kebbi Chapter.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al
. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270-3.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al
. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al
. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1-3.
Schoeman D, Fielding BC. Coronavirus envelope protein: Current knowledge. Virol J 2019;16:69.
Jiang S, Shi Z, Shu Y, Song J, Gao GF, Tan W, et al
. A distinct name is needed for the new coronavirus. Lancet 2020;395:949.
Du Toit A. Outbreak of a novel coronavirus. Nat Rev Microbiol 2020;18:123.
Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses' knowledge and anxiety toward COVID-19 during the current outbreak in Iran. Arch Clin Infect Dis.2020;15:e102848. Available from: https:// doi.org/10.5812/archcid.102848
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;25:pii=200131e. Available from: https://doi.org/10.2807/1560-7917.ES.2020.25.5.200131e
. [Last accessed on 2020 Jun 05].
Del Rio C, Malani PN. COVID-19-New insights on a rapidly changing epidemic. JAMA 2020;323:1339-40.
Bowale A, Abayomi A, Idris J, Omilabu S, Abdu-Salam I, Adebayo B, et al
. Clinical presentation, case management and outcomes for the first 32 COVID-19 patients in Nigeria. Pan Afr Med J. 2020:35:24 doi:10.11604/pamj.2020.35.2.23262
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020;395:e39.
Nigeria Centre for Disease Control (NCDC). COVID-19 Case Update. Available from: https://twitter.com/NCDCgov/
. [Last accessed on 2020 May 27].
Fasasi KM, Ayanniyi AA. Evaluating resource for cataract surgical services in Kebbi, Nigeria. Taiwan J Ophthalmol 2018;8:87-92.
] [Full text]
Taghrir MH, Borazjani R, Shiraly R. COVID-19 and Iranian Medical Students; A survey on their related-knowledge, preventive behaviors and risk perception. Arch Iran Med 2020;23:249-54.
Huynh G, Nguyen TN, Tran VK, Vo KN, Vo VT, Pham LA. Knowledge and attitude toward COVID 19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pac J Trop Med. 2020;13:260-5. [doi: 10.4103/19957645.280396].
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.
Peter OO, Ayandele O, Kolawole SO, Oguntayo R, Gandi JC, Dangiwa AL, et al
. COVID-19 Knowledge and Perceptions in Nigeria. PsyArXiv.2020 April 12. doi:10.31234/osf.io/j356x.
Degena BT, Gebremeskel TG, Gebre TD. Knowledge, Attitude, Practice and Psychological Response toward COVID 19 among Nurses during the COVID 19 Outbreak in Northern Ethiopia; 2020. Available from: https://www.researchgate.net/ publication/3410670355
. [Last accessed on 2020 Jun 05].
Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID 19 epidemic in China: A web based cross sectional survey Psychiatry Res. 2020:288:112954 doi: 10.1016/j.psychres.2020.112954.
Al-Rabiaah A, Temsah MH, Al-Eyadhy AA, Hasan GM, Al-Zamil F, Al-Subaie S, et al
. Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia. J Infect Public Health 2020;13:687-91.
Kwok KO, Li KK, Chan HH, Yi YY, Tang A, Wei WI, et al
. Community responses during the early phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures. Emerging Infectious Diseases 2020 doi: https://doi.org/10.1101/2020.02.26.20028217
Tork HM, Mersal FA .Middle East Respiratory Syndrome -“ Coronavirus: Knowledge and attitude of Qassim University students, KSA. Glob Adv Res J Med Med Sci 2018;7:90-7.
Kim JS, Choi JS. Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception among nursing students during outbreak. J Clin Nurs 2016;25:2542-9.
Albarrak AI, Mohammed R, Al Elayan A, Al Fawaz F, Al Masry M, AlShammari M, et al
. Middle East Respiratory Syndrome (MERS): Comparing the knowledge, attitude and practices of different health care workers. J Infect Public Health 2019;17.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]