The Nigerian youth knowledge, Attitude and Practice (KAP) towards the national drive against the Spread of COVID-19: An online cross-sectional Survey

Introduction

Coronavirus disease 2019 (COVID-19) has evolved into a major global public health concern (Habib et al., 2021). Since the 31st of December 2019, there has been over 209 million cases of COVID-19 reported worldwide, including a death toll of over 4.2 million in 220 countries (European Centre for Disease Prevention and Control, 2021). The pandemic has had devastating effects on both public health and societal life (Rahman & Sathi, 2020; Cori et al., 2020; Parikh et al., 2020). In Africa, about 7,043,648 cases have been reported, with Nigeria accounting for over 183,000 cases and over 2000 in deaths (Worldometer, 2021). In order to curtail the spread of the virus, the government raised public awareness on preventative health practices, enforced closure of volatile public and private facilities, enforced small-sized gathering with adequate spacing in public spaces, enforced stay at home order in flag point areas and inter and intra-border mobility to put national population statistics under check (Egbi et al., 2020). Aronu et al. (2021) in a cross-sectional study on COVID-19 knowledge and preventive practices among college adolescents in Nigeria, reported that the study participants had a low compliance rate with the enforcements. Many of the young adolescents acknowledged that only the aged and patients with comorbidity are at the high-risk end of COVID-19 mortality. In a study that was conducted in Ethiopia by Kebede et al. (2020), they identified that adolescents were less likely to practice preventive measures, and in turn, such behaviours would pose more problems in the preventive processes for COVID-19. Kebede et al. (2020b) in another study also stated that the transmission rate of the disease has increased rapidly. In spite of the available vaccines against the virus, the emergence of new strains and variants of the virus continues to pose global health challenges (Mohammed et al., 2022; van Beek, 2023). According to Bates et al. (2021) preventive measures must be adopted to curb the spread of COVID-19. However, it is also important to note that only sufficient knowledge can prompt behavioural changes needed to curb the spread of the COVID-19 (Van Nhu et al., 2020; Belete et al., 2021; Khattak et al., 2022). This is especially true in respect to the knowledge, attitude and practice towards the prevention of COVID-19 among the youths (Umeizudike et al., 2021). However, the effects of reported knowledge have not been seen in the attitude and safety practices of some of the youths in South-West Nigeria. Several studies have shown satisfactory levels of knowledge but all these studies are among the adult population (Kebede et al., 2020b; Abdelhafiz et al., 2020; Centers for Disease Control and Prevention, 2021). Several studies also reported, that those with medical-related occupations were more likely to have better knowledge that would also spill into an appropriate preventive attitude and practice (Noreen et al., 2020; Shi et al., 2020). Some studies also considered the limited facts about adherence to the practice of preventive measures of Covid-19 (Alzoubi et al., 2020; Nazli et al., 2020; Rahman & Sathi, 2020; Kebede et al., 2020a, 2020b; Feyisa, 2021). Another study noted that people with underlying health conditions generally felt the need to take greater preventive approach and attitude towards the virus (Adesegun et al., 2020; Belete et al., 2021).

In the context of the ongoing COVID-19 pandemic, it is evident that this global public health crisis continues to exert a profound and extensive influence on a global scale (Ataguba, 2020; Napitu & Sipayung, 2023). The available global statistical data underscores the significant ramifications of the virus, both in terms of its widespread incidence and the lamentable loss of human lives. As nations and regions grapple with the manifold challenges presented by this pandemic, it is pertinent to accord due recognition to the pivotal role played by informed knowledge, attitudes, and preventative practices across various demographic strata globally (Rahman & Sathi, 2020; Mahfouz & AlQahtani, 2023; Sun et al., 2023). While governmental bodies and health agencies have implemented a spectrum of measures aimed at curbing the virus’s dissemination (Wang et al., 2023; Kim et al., 2023), encompassing public awareness initiatives (Yanti et al., 2020) and constraints on mobility (Zhou et al., 2020), the efficacy of these interventions is fundamentally contingent upon the willingness of individuals, especially the youth demographic, to embrace and steadfastly adhere to the prescribed behavioural protocols. Therefore, there is an urgent need to facilitate more studies on COVID-19 health promotion among Nigerian youths due to paucity of data on the compliance rate of COVID-19 preventative measures.

Methods

Results

A total of 1,529 respondents with the age ranges from 15–26 years voluntarily participated in the study (Jaiyesimi et al., 2022a). Most of the respondents (76.6%) fall within the category of 15–17 years. More females were involved in the study (59.1%) than male (40.9%). Most of the respondents were from nuclear (87%) and perceived middle-class family social status (79.2%), with a range of 5–10 family members (76.3%), lived in metropolitan cities (52.2%) within southern region of Nigeria (70.7%) (Table 1).

Discussion

This research was carried out among Nigerian educated youth in order to find out their perception towards COVID-19 mode of transmission, symptoms, risk factors, treatments, preventive measures, and challenges. The study examined the knowledge, attitude, and practice towards COVID-19 and their association with the selected sociodemographic variables of the respondents.

In the perception domain, the participants showed good knowledge about the mode of transmission of the virus as well as the incubation period. This finding was similar to a study carried out by Peng et al. (2020) among undergraduates in China, who also demonstrated good knowledge of mode of transmission and incubation period of COVID-19 infection. However, this finding was in contrast with a similar study carried out in Congo, where respondents demonstrated poor knowledge of COVID-19 mode of transmission (Carsi Kuhangana et al., 2020). The difference in socio-economic status and educational level were identified as key factors as the latter was conducted among sellers and customers who patronised some big public markets in Congo, unlike the current study where the respondents were entirely young students. The majority of the respondents were familiar with the symptoms of COVID-19 and also reported the elderly as the most vulnerable group, followed by individuals with co-morbid medical conditions. This finding was similar to a study that was conducted in Jimma town, Ethiopia, where larger percentage of the participant were aware of the key clinical symptoms and the groups at high risk of developing a severe form of the disease (Kebede et al., 2020b). The similarity in findings could be as a result of the efforts of the health and educational agency of the government and access to information from social (WhatsApp and Telegram) and broadcast media (television and radio) by the study participants as reported in the current study.

Most of the respondents identified that vaccination, followed by supportive treatment have important roles to play in the management of COVID-19 disease. This was in marked contrast to the findings of (Ferdous et al., 2020) where only 1% of the participant reported vaccination as having a role in the prevention of COVID-19 infection. This disparity could be due to the fact that vaccine development was still at a rudimentary stage around the end of first quarter of 2020 when the study was conducted. However, in a similar study conducted around the same time, Srichan et al. (2020) found that 31.2% were aware of the vaccine as a potential option. Most of the respondents recognized home-based handwashing with soap and water, followed by restriction of visitors as measures to protect the family against COVID-19 virus. They also identified social distancing and use of face masks as preventive measures. These findings agree with that of many other studies which reported good perception of hand hygiene, social distancing, wearing face mask and avoiding crowded areas (Akalu et al., 2020; Asmelash et al., 2020; Kassie et al., 2020; Tamire et al., 2020). However, in an earlier study, Ferdous, et al. (2020) reported that most of the respondents indicated negligence about the severity of the disease, reluctance to use face mask and not being able to control going out of the house. Understandably, this study was conducted immediately after lockdown was instituted in the study area and the populace could still be struggling with the physical, social and emotional barriers and limitations posed by the lockdown.

The respondents reportedly have sufficient knowledge of the virus because of exposure to the media and internet, coupled with some health-related courses in the university that focused mainly on trending public health issues. A similar result was carried out by Salman et al. (2020) among Pakistani University students in May 2020. The study found out that the students had sufficient knowledge and a positive attitude towards COVID-19. They are knowledgeable of the causative agent, incubation period, the spread, and preventive measures (Salman et al., 2020). The depth of the knowledge can also be associated with the fact that the respondents in their study and the current study were students. According to the current study, knowledge of COVID-19 could be a possible determinants of respondents’ attitude and practice towards the disease. This is unlike the study that was carried out by Bhagavathula et al. (2020), where it was discovered that the students had insufficient knowledge about the virus although they had a positive attitude towards the prevention of the spread of the virus.

A positive attitude was also exhibited by the majority of our respondents, they indicated that they were willing to adhere to the various measures put in place by various units or groups to curb the spread of the infection. A notable measure is their responsibility towards the University Hospital isolation centre, students have continued to be very observant and helpful in assisting the University to report any suspected cases to the isolation centre for clinical testing. A similar positive attitude was observed in researches carried out in Malaysia and China (Azlan et al., 2020; Zhong et al., 2020). Positive attitude towards hand hygiene, social distancing, use of face masks and avoiding crowded area prevented the spread of the virus (Umeizudike et al., 2021). Most of the respondents (70.3%) in this study reported that they adhere to the Government rules on the prevention of COVID-19 (see Table 5). In the current study, participants from middle-class families were more engaged in preventive practices than other categories of family social status (upper and lower). Due to the homogeneity of the selected sample (students of the same university) and the selected age category, the study cannot be generalised for the entire population.

Conclusions

This study showed evidence of high prevalence of knowledge related to COVID-19 in majority of the study participants. A significant proportion of the respondents understood the basic information, possessed positive attitude and demonstrated proactive practices towards COVID-19 infection. This is a pointer to the efficacy and success of present public health campaigns. However, male respondents showed poorer COVID-19 preventive practices compared to their female counterpart, and respondents from upper and lower socio-economic class demonstrated less-than-adequate knowledge, attitude and practices towards COVID-19. Public health interventions should therefore be tailored along these lines.

Data availability

Ethical approval

Ethical approval was obtained from the Health Research Ethics Committee (ABUAD/HREC/04/10/829). The participants under the age of 18 (duly registered as undergraduate student of the university) are covered by the institutional policy to voluntarily participate in this study with due consideration of no physical harm to the participants.

Consent to participate

All respondents gave written informed consent to participate in the research through informed written consent.