key: cord-317349-c8nrd4h9 authors: OLAPEGBA, Peter O; AYANDELE, Olusola; KOLAWOLE, Samson Olowo; OGUNTAYO, Rotimi; GANDI, Joshua Chiroma; DANGIWA, Abdullahi Lawal; OTTU, Iboro Friday Akpan; IORFA, Steven Kator title: A Preliminary Assessment of Novel Coronavirus (COVID-19) Knowledge and Perceptions in Nigeria date: 2020-04-15 journal: nan DOI: 10.1101/2020.04.11.20061408 sha: doc_id: 317349 cord_uid: c8nrd4h9 This study assessed knowledge and perceptions about COVID-19 among the general public in Nigeria during the initial week of the pandemic lockdown in the country. From March 28 to April 4, 2020, this cross-sectional survey used an anonymous online questionnaire to collect data from respondents within Nigeria. Purposive and snowball sampling techniques were used to recruit 1357 respondents, aged 15-70 years, from 180 cities and towns within Nigeria. Study data were analyzed using descriptive statistics. Approximately more than half (57.02%) of the respondents were male with a high level of education (48.86% bachelor degree or higher). Approximately half of the respondents (46.94%) opined that COVID-19 was a biological weapon designed by the Chinese government. About 94% of the respondents identified contact with airborne droplets via breathing, sneezing, or coughing as the most common mode of transmission; most respondents associated COVID-19 with coughing (81.13%), shortness of breath (73.47%) and fever (62.79%). Regular hand washing and social distancing were selected by most respondents (94.25%) as a way of preventing infection whereas 11.86% reported consuming gins, garlic, ginger, herbal mixtures and African foods/soups as preventive measures against COVID-19. The majority of the respondents (91.73%) thought COVID-19 is deadly, and most respondents (84.3%) got 4 or more answers correctly. It was also observed that the traditional media (TV/Radio) is the most common source of health information about COVID-19 (93.5%). Findings revealed that Nigerians have relatively high knowledge, mostly derived from traditional media, about COVID-19. Their perceptions of COVID-19 bear implications across public health initiatives, compliance with precautionary behavior as well as bilateral relations with foreign nations. Evidence-based campaign should be intensified to remove misconceptions and promote precautionary measures. The novel Coronavirus disease 2019 (COVID-19), first identified in Wuhan China in December 2 2019, has rapidly spread to almost every region of the world. The disease is caused by a new and 3 severe type of Coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-4 CoV-2). The infection has no immediate treatment and vaccine, and it has according to World 5 Health Organization [1] become a worldwide pandemic causing significant morbidity and 6 mortality. There are 1,603,428 confirmed cases, 356,440 recoveries from the illness and 95,714 7 deaths worldwide as of April 9, 2020 [2]. On February 27, 2020, an Italian citizen became the 8 index case for COVID-19 in Nigeria and as at April 9, 2020, there were 288 laboratory-9 confirmed cases of COVID-19 in Nigeria with 51 discharges and 7 deaths [3] . 10 To prevent further spread of the virus, civil societies and government agencies embarked on 11 enlightenment campaigns for good hygiene and social distancing. Temperature screening was 12 conducted at airports and those returning from countries with numerous confirmed cases of 13 COVID-19 were implored to self-isolate. risks of infections in order to adopt the right precautionary measures [11] . 4 At early stages of a pandemic, precautionary measures are needed to protect against possible 5 danger and curtail the disease spread. In line with this therefore, the Nigerian government (just 6 like other governments around the world) introduced various containment strategies which have 7 interfered with individuals' daily lives and have led to severe economic loss and social 8 disruption. People were coerced to stay at home, businesses and offices were closed, exempting 9 healthcare facilities/workers and "essential" commercial establishments. For Nigerians making a 10 living in the informal economy, their livelihood is now threatened by the lockdown since much 11 of their activities and businesses involve face-to-face contact. . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . • What are the major sources of information about COVID-19 among Nigerians? 1 This cross-sectional survey used an anonymous online questionnaire to collect data from 4 respondents. Potential respondents were purposively sent the link via Social media (Whatsapp 5 and Facebook posts) and asked to participate in an online survey. A snowball sampling technique 6 was employed to recruit more Nigerians living in the country's six geopolitical zones during the 7 COVID-19 pandemic by encouraging those sent the link to kindly share with their contacts. The 8 online survey ran during the first week of the lockdown in Nigeria (March 28 to April 4, 2020) 9 and involved 1,357 respondents from 180 cities and towns in the country. 10 2.2. Procedure 11 Due to the Nigerian Government social distance rules and curfew/lockdown enforcement, 12 physical interaction was not possible, so online promotion of the survey was done and existing 13 study participants were urged to send the web link of the survey to potential respondents. Regarding knowledge about the most common perceived mode of transmission, almost all 8 (94.10%) selected "contact with droplets from an infected person/organism via breathing, 9 sneezing, or coughing" while a little above average (54.97%) picked "touching contaminated 10 objects or surfaces" as a mean of transmitting and contacting the virus ( fig. 2) . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint "Regular hand washing and social distancing" were selected by most respondents (94.25%) as a 7 way of preventing COVID-19 infection while about half (48.86%) supported "disinfecting 8 contaminated surfaces" and 40.01% supported "closing schools and cancelling mass gathering 9 events" whereas more than a tenth (11.86%) held "consuming gins, garlic, ginger, herbal 10 mixtures and African foods/soups" as preventive measures against COVID-19 ( fig. 4) . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.11.20061408 doi: medRxiv preprint 1 2 3 What are the major sources of information about COVID-19 among Nigerians? 4 The most common sources of information about COVID-19 were the mass media (radio, 5 television and newspapers) (81.5%) followed by social media (e.g. Whatsapp, Facebook, 6 Twitter, Instagram, etc.) and the Internet (61.53%) ( fig. 6) . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . (got more than 3 answers correctly) and 13.34% reported average knowledge (3 correct answers) 2 while 2.79% had low knowledge (less than 3 correct answers) about COVID-19. Respondents in 3 this sample had a mean total knowledge score of 4.17 (SD = 0.77) which is above the norm score 4 of 3. 5 the virus is. We caution that this perception has implications for bilateral relations between the 26 . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . Nigerian and the Chinese governments and may stand as a hindrance to Nigerians accepting 1 whatever form of aid may come from the Chinese government. It is important the government of 2 Nigeria and other stake holders embark on campaigns to raise awareness of the true sources of 3 the COVID-19 in order to curb a brewing stereotype and prejudice towards the Chinese. 4 Concerning the source of the COVID-19 also, our findings highlight implications for religious 5 leaders. A reasonable percentage of Nigerians also opined that the COVID-19 is a plague caused 6 by sins and unbelief of human beings. While this may be consistent with many religious beliefs, 7 we believe that it may foster carefree attitudes in Nigerians, making them relax and resort to only 8 prayers and spiritual healings without adhering to the prescribed hygiene practices [14] . We 9 therefore urge clerics at all levels to also educate members of their faiths about the COVID-19. 10 As expected, because Nigerians had relatively high knowledge of the COVID-19, even though 11 laden with several misconceptions, their knowledge of precautionary behavior was also high. For 12 instance, a good percentage agreed that a range of WHO approved and global practices such as 13 hand washing and social distancing, disinfecting contaminated surfaces, closing schools and 14 public events and fumigation of public places were key to preventing the spread of the virus. 15 Only a little percentage agreed relying on the hot weather in Africa, consumption of gins, herbs 16 and African foods as well as chloroquine and antibiotics as precautions to the spread of the 17 pandemic. 18 These findings are in consonance with previous studies such as [8, 9, 10] . These authors reported 19 that one's level of knowledge about an infectious disease can make one to behave in ways that 20 can prevent infection. Also, the study supported Richards [16] . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.11.20061408 doi: medRxiv preprint The time-sensitivity of the novel Coronavirus disease 2019 pandemic led to the adoption of the 2 snowball sampling strategy which might limit generalizability of the finding to the general 3 population. There was an oversampling of respondents from the Yoruba ethnic group, leading to 4 selection bias. Similarly the findings may not be generalizable to the less educated people. 5 Notwithstanding the above limitations, this study provides a baseline of information on 6 knowledge and perceptions about the ravaging COVID-19 from respondents across 180 7 municipalities in Nigeria. It is worthy of note that this study is an exploratory one and is part of a 8 larger study aimed at understanding and outlining how knowledge and awareness of COVID-19 9 among Nigerians is shaping their response to the pandemic and precautionary behavior. There is 10 need for further research to build the evidence base for the study of COVID-19 knowledge and 11 precautionary measures. 12 Due to the concern of everyone about COVID-19, the present study, in possibly, is the first 14 survey to assess the knowledge and perceptions about COVID-19 among Nigerians. This study 15 was significant because it studied knowledge about COVID-19 in Nigeria across different and 16 many cities in the country. The knowledge areas include source, transmission, symptoms, 17 sources of information and preventive behavior toward COVID-19. The findings tentatively 18 affirm that Nigerians are highly knowledgeable about COVID-19and their premier sources of 19 information about the pandemic are the traditional media. It is therefore recommended that all 20 stake holders should intensify their effort in sensitizing the general public to understand and 21 comply with all precautionary measures to curb COVID-19. 22 WHO Director-General's opening remarks at the media 24 briefing on COVID-19-11 COVID-19 case update COVID-19: How We Plan To Implement Social Distancing In Lagos Markets Radio Nigeria, President Buhari urges caution What Is Coronavirus? Risk perception related to SARS and avian influenza: theoretical 6 foundations of current behavioral research SARS risk 9 perception, knowledge, precautions, and information sources, the Netherlands. Emerg Perceived knowledge, attitude, and compliance with preventive 12 behavior on influenza A (H1N1) by university students Medical students' knowledge, perceptions, and 15 behavioral intentions towards the H1N1 influenza, swine flu Risk perceptions and behaviour: Towards pandemic 18 control of emerging infectious diseases: International research on risk perception in the 19 control of emerging infectious diseases Coronavirus: Catholic Church in Lagos suspends sprinkling of 'holy water', 25 handshakes during mass The other COVID-19 pandemic: Fake news