A total number of 825 participants completed the survey questionnaire. After excluding 119 respondents who live outside Syria, the final sample consisted of 706 participants. Among the final sample, 444 (62.9%) were female, 405 (57.4%) aged between 16-29 years, 642 (90.9 %) were either at higher education level or above, 316 (44.8%) were employed in private or public occupations and 516 (73.1%) had residents in their houses aged above 60 and/ or younger than 6 years. Demographic characteristics are shown in Table 2.
This study shows that the Syrians’ Basic knowledge of COVID-19 is moderate. The correct answer rates of the 6 questions on the COVID-19 knowledge questions ranged between 22.7-85% (Table 1). The mean knowledge score was 3.54 (SD: 1.207, range: 0-6) suggesting an overall 59% (3.54/6*100) correct rate on this knowledge test. Knowledge scores significantly differed across age groups (P<0.05), education levels (P=0.001), and occupations (P<0.05) (Table 2). Knowledge regarding COVID-19 symptoms was the highest (85.1%), whereas perception of the severity of COVID-19 was the lowest (22.7%). Having a child under 16 or aged persons above 60 did not make a statistical difference in the COVID-19 knowledge. Furthermore, no statistical difference was found between genders with regard to Knowledge scores (Table 2).
Table 2 Demographic characteristics of participants and the score of COVID-19 knowledge by demographic variables
Characteristics
|
|
Number of participants (%)
|
Knowledge score (mean ± standard deviation)
|
P value
|
Gender
|
Male
|
262(37.1)
|
3.46±1.251
|
>0.05
|
|
Female
|
444(62.9)
|
3.59±1.179
|
Age-group (years)
|
16-29
|
405(57.4)
|
3.43±1.166
|
<0.05
|
|
30-49
|
204(28.9)
|
3.71±1.294
|
|
50+
|
97(13.7)
|
3.62±1.150
|
Education
|
Elementary School
|
3(0.4)
|
2.00±1.732
|
0.001
|
|
High school
|
61(8.6)
|
3.08±1.269
|
|
Degree
|
642(90.9)
|
3.59±1.187
|
Occupation
|
Unemployed
|
62 (8.8)
|
3.54±1.363
|
<0.05
|
|
student
|
253(35.8)
|
3.39±1.106
|
|
Free lancer
|
75(10.6)
|
3.76±1.250
|
|
Employed
|
316(44.8)
|
3.62±1.232
|
Residents above 60 or younger than 16 in the house
|
No
|
190(26.9)
|
3.52±1.120
|
>0.05
|
Yes
|
516(73.1)
|
3.55±1.238
|
Knowledge of COVID-19 score
|
|
706 (100)
|
3.54 ±1.207
|
|
For the attitudes, the majority of respondents believed that school closure and curfew were effective at controlling the spread of COVID-19; scores were 91.5% and 78.2%, respectively (Table 1). Only 15.4% of the respondents expected the pandemic to spread in Syria, whereas about 60% had confidence that COVID-19 will eventually controlled. Attitude scores were significantly different between males and females (P<0.05) (Table 3).
In addition, the mean practice score was 5.90 (SD: 1.529, range from 0-8). The highest practice score was 75% (6/8*100) in participants aged over 50 years. Practice scores varied significantly across gender (P<0.05), age groups (P=0.01), education levels (P=0.015), occupations (P<0.05), and according to knowledge score (P=0.000) (Table 4). More than 90% of participants avoided crowded places and practiced better hygiene after than before the quarantine, whereas only 27.9% of participants wore facemask during the quarantine (Table 1).
Table 3. Attitudes towards COVID-19 by demographic variables
Characteristics
|
|
Number of participants (%)
|
Practice score (mean ± standard deviation)
|
P value
|
Gender
|
Male
|
262(37.1)
|
2.54±.878
|
<0.05
|
|
Female
|
444(62.9)
|
2.40±.778
|
Age-group (years)
|
16-29
|
405(57.4)
|
2.49±.779
|
>0.05
|
|
30-49
|
204(28.9)
|
2.40±.851
|
|
50+
|
97(13.7)
|
2.40±.909
|
Education
|
Elementary School
|
3(0.4)
|
2.33±.577
|
>0.05
|
|
High school
|
61(8.6)
|
2.38±.933
|
|
Degree
|
642(90.9)
|
2.46±.809
|
Occupation
|
Unemployed
|
62 (8.8)
|
2.29±.876
|
>0.05
|
|
Student
|
253(35.8)
|
2.48±.769
|
|
Free lancer
|
75(10.6)
|
2.55±.827
|
|
Employed
|
316(44.8)
|
2.44±.843
|
Residents above 60 or younger than 16 in the house
|
No
|
190(26.9)
|
2.49±.761
|
>0.05
|
Yes
|
516(73.1)
|
2.44±.840
|
Attitude score
|
|
607(100)
|
2.45±.818
|
|
Table 4.The score of practices towards COVID-19 by demographic variables
Characteristics
|
|
Number of participants (%)
|
Practice score (mean ± standard deviation)
|
P value
|
Gender
|
Male
|
262(37.1)
|
5.75±1.646
|
<0.05
|
|
Female
|
444(62.9)
|
6±1.449
|
Age-group (years)
|
16-29
|
405(57.4)
|
5.76±1.557
|
0.01
|
|
30-49
|
204(28.9)
|
6.04±1.491
|
|
50+
|
97(13.7)
|
6.22±1.423
|
Education
|
Elementary School
|
3(0.4)
|
5.33±2.309
|
0.015
|
|
High school
|
61(8.6)
|
5.38±1.827
|
|
Degree
|
642(90.9)
|
5.96±1.487
|
Occupation
|
Unemployed
|
62 (8.8)
|
5.47±1.771
|
<0.05
|
|
Student
|
253(35.8)
|
5.81±1.552
|
|
Free lancer
|
75(10.6)
|
5.99±1.615
|
|
Employed
|
316(44.8)
|
6.04±1.420
|
Residents above 60 or younger than 16 in the house
|
No
|
190(26.9)
|
5.92±1.429
|
>0.05
|
Yes
|
516(73.1)
|
5.90±1.565
|
Practice score
|
|
607(100)
|
5.90±1.529
|
|
The results from multiple linear regression analysis of variables that score poor on KAP indicators show that the education level of elementary school (β: -1.698, P<0.05) is significantly associated with lower knowledge score, whereas females had lower attitude score (vs. males, β: -.143, P<0.05). Furthermore, male gender (vs. female, β: -.357, P<0.01) aged between 16-29 years (β: -.418, P=.000), and unemployed (β: -.657, P<0.01) were predictors of poor practice score (Table 5).
Table 5 Results of multiple linear regression on factors associated with poor COVID-19 knowledge, attitude and practice
Variable
|
Coefficients
|
Standard error
|
t
|
P
|
Knowledge
|
Age (16-29)
|
-.188-
|
.114
|
-1.653-
|
>0.05
|
Education (Elementary School)
|
-1.698-
|
.695
|
-2.443-
|
<0.05
|
Occupation (Students)
|
-.125-
|
.117
|
-1.063-
|
>0.05
|
Attitude
|
Gender (female)
|
-.143-
|
.064
|
-2.253-
|
<0.05
|
Practices
|
Gender (male)
|
-.357-
|
.120
|
-2.972-
|
<0.01
|
Age (16-29)
|
-.418-
|
.116
|
-3.589-
|
.000
|
Education (elementary school)
|
-.445-
|
.881
|
-.505-
|
>0.05
|
Occupation (unemployed)
|
-.657-
|
.207
|
-3.174-
|
<0.01
|
There were positive and significant correlation between knowledge-practice, knowledge-attitudes, and attitude-practice. The correlation coefficients were (.198, .204, and .210, respectively. P<0.01) as shown in (Table 6).
Table 6 correlations between scores of knowledge, attitudes and practices towards COVID-19
Variable(s)
|
Knowledge
|
Attitudes
|
Practices
|
Knowledge
|
1
|
--
|
--
|
Attitudes
|
.204**
|
1
|
--
|
Practices
|
.198**
|
.210**
|
1
|
**. Correlation is significant at the 0.01 level (2-tailed).