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Global health
Original research
Community knowledge, perceptions and practices around COVID-19 in Sierra Leone: a nationwide, cross-sectional survey
  1. Paul Sengeh1,
  2. Mohammad B Jalloh2,
  3. Nance Webber3,
  4. Ibrahim Ngobeh1,
  5. Thomas Samba4,
  6. Harold Thomas4,
  7. Helena Nordenstedt5,
  8. Maike Winters5
  1. 1Research and Evaluation, FOCUS1000, Freetown, Sierra Leone
  2. 2Office of the Chief Executive Officer, FOCUS1000, Freetown, Sierra Leone
  3. 3Communications Programme, FOCUS1000, Freetown, Sierra Leone
  4. 4Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
  5. 5Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Maike Winters; maike.winters{at}ki.se

Abstract

Objectives To assess the public’s knowledge, attitudes and practices about the novel coronavirus in Sierra Leone to inform an evidence-based communication strategy around COVID-19.

Design Nationwide, cross-sectional Knowledge, Attitudes and Practices survey.

Setting 56 randomly selected communities in all 14 districts in Sierra Leone.

Participants 1253 adults aged 18 years and older of which 52% were men.

Main outcome measures We calculated proportions of core indicators (awareness, knowledge, risk perception, practices). A composite variable for knowledge (based on seven variables) was created, and categorised into low (0–2 correct), medium (3–4) and high (5–7). Predictors of knowledge were analysed with multilevel ordinal regression models. Associations between information sources, knowledge and two practices (washing hands with soap and avoiding crowds) were analysed using multilevel logistic regression models.

Results We found that 75% of the respondents felt at moderate or great risk of contracting coronavirus. A majority (70%) of women did not know you can survive COVID-19, compared with 61% of men. 60% of men and 54% of women had already taken action to avoid infection with the coronavirus, mostly washing hands with soap and water (87%). Radio (73%) was the most used source for COVID-19 information, followed by social media (39%). Having a medium or high level of knowledge was associated with higher odds of washing hands with soap (medium knowledge: adjusted OR (AOR) 2.1, 95% CI 1.0 to 4.4; high knowledge: AOR 4.6, 95% CI 2.1 to 10.2) and avoiding crowds (medium knowledge: AOR 2.0, 95% CI 1.1 to 3.6; high knowledge: AOR 2.3, 95% CI 1.2 to 4.3).

Conclusions This study shows that in the context of COVID-19 in Sierra Leone, there is a strong association between knowledge and practices. Because the knowledge gap differs between genders, regions, educational levels and age, it is important that messages are specifically targeted to these core audiences.

  • public health
  • epidemiology
  • infection control
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-040328

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    Footnotes

    • Contributors PS, MBJ, NW, IN, TS and HT led the conception and design of the survey. PS, MBJ, NW and IN contributed to the training and supervision of the data collection teams. MW led the data analysis with support from PS and HN. All coauthors contributed to the interpretation of the results. PS, HN and MW contributed to the writing of the manuscript. All coauthors read and approved the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval The Sierra Leone Research and Scientific Review Committee granted ethical permission for this KAP study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. All requests to access the data must be processed through the multipartner data sharing mechanism. All data accessibility requests should be directed to the corresponding author: maike.winters@ki.se.