Determinants of knowledge, attitudes, and practices of front-line health workers during the first wave of COVID-19 in Africa: a multi-center online cross-sectional study

Abstract

Abstract Background: During its first wave of COVID-19 infection in sub-Saharan Africa, there was insufficient understanding of the pandemic among front-line health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risk of contracting and spreading the disease. This study was carried out to determine the Knowledge, attitude, and practices (KAP) of front-line health workers (HWs) towards COVID-19 in Africa and their related factors. Methods: This was a multi-centers online cross-sectional study conducted over a 3-months study-period using a google survey link among front lines HWs involved in the COVID-19 response in 26 African countries. Chi-square test & logistic regression were used in the bivariate and multivariate analysis respectively to assess determinants of KAP. Statistical analysis was done using STATA version 16; all tests were two-sided with 95% confidence interval. Results: Five hundred and seventeen (517, 96.3%) consented to participate in this study from 26 African countries; 289 (55.9%) were male and 228 (44.1%) female. Overall, most of HWs, 379 (73.3%) showed poor knowledge about COVID-19 infection and preventive measures. In contrast, majority of them showed good attitude (89%) and practice (90.3%) towards prevention of COVID-19 infections. Knowledge varied among countries; Uganda had the greatest number of HWs with good knowledge. (OR = 28.09, p <0.0001) followed by Ghana (OR=10.92, p=0.001) and DRC (OR: 4.59, p=0.015). The cadre of HWs also influenced knowledge; doctors were the most knowledgeable as compared to other cadres (OR: 3.4, p= 0.005). Additionally, knowledge increased with increasing HWs’ education level (p=0.011).Attitude and practice were both influenced by HWs country of workplace (p=0.05 & p< 0.0001 respectively) and their cadre (p = 0.025 & p < 0.0001 respectively). Conclusions: Majority of the front-line HWs in the African region had an overall good attitude and practice towards COVID-19 infection and practice measures despite relatively poor Knowledge. The KAP is influenced by HWs country of workplace, their cadre and level of education.