Knowledge, attitudes and practices (KAP) on COVID-19 among the general population in most affected districts of Nepal

Abstract

The COVID-19 pandemic has become one of the global health challenges in the current context. In Nepal, the first confirmed case was reported on 23 January 2020, and since then, it has resulted in several negative impacts, including economic disruption and deterioration of physical and mental health. In such a pandemic, it is indispensable to understand the knowledge and behavioral patterns of the general population regarding COVID-19. Therefore, our study aimed to assess the knowledge, attitudes and practices on COVID-19 among the general population in most affected districts and its relationship with socio-demographic conditions. The cross-sectional study was conducted among the general population above the age of 18 years from eight districts of Nepal including Kathmandu, Bhaktapur, Lalitpur, Morang, Sunsari, Rupandehi, Chitwan, and Kaski. A convenient non-probability sampling method was considered with total sample size of 702. The questionnaire survey was conducted to collect data. Descriptive statistics, non-parametric statistical tests, and a logistic regression model were used for analysis. The study showed that 93.3% of respondents had knowledge of overall preventive practices, whereas only 32% had knowledge of overall symptoms of COVID-19. Regarding attitudes, only 14.3% strongly believed that the COVID-19 pandemic would end soon. The preventive practice was reduced after the lockdown compared to that of during the lockdown. The respondents with white-collar occupations, high-income, and unmarried were good at KAP. Similarly, highly educated and those residing in urban areas had good knowledge and practice. The study findings will help in the development of targeted programs to improve the general population's knowledge, attitudes and practices on COVID-19, which is paramount to dealing with the existing pandemic and also such possible future waves of the pandemic.

Fig 1. Location of the selected districts (Bhaktapur, Chitwan, Kaski, Kathmandu, Lalitpur, Morang, Rupandehi, and Sunsari).

The darkest grey thick lines covering the grey area represent the country boundary of Nepal and the soft grey line inside represent the administrative boundaries of Nepal separating different districts. The Location of different districts is presented by rectangles in Nepal. Country boundary and Administrative boundaries shape file of Nepal, retrieved from Administrative Boundaries Reference (view layer) of FAO (https://data-in-emergencies.fao.org/datasets/hqfao::administrative-boundaries-reference-view-layer/explore?layer=0), under an open license (CC BY 4.0): https://data-in-emergencies.fao.org/datasets/hqfao::administrative-boundaries-reference-view-layer/about?layer=0. Figure created with QGIS software version 3.28, an open source Geographic Information System (GIS) licensed under the GNU General Public License (https://bit.ly/2BSPB2F).

Fig 2. Knowledge of symptoms of the COVID-19 pandemic among the respondents.

Fig 3. Knowledge of prevention on COVID-19 among the respondents.

Fig 4. Knowledge of pre-condition to stay in quarantine among the respondents if come into contact with infected person.

Fig 5. Knowledge of respondents regarding increase in risk of death due to co-morbidities among the COVID-19 infected person.