This study investigated the knowledge, attitudes and practices of Ghanaians towards the novel coronavirus disease through an online survey. Averagely, participants of this study showed a high knowledge of the disease. This finding was not different from a similar study conducted among the Egyptian population (12). Additionally, an extremely higher mean score of knowledge was recorded in a study conducted among Chinese residents (15). All these results show the concern that was attached to the disease. Besides, the high COVID-19 knowledge level may also have resulted from the educational level of participants took part in the study (16).
Again, our study revealed that health workers had significantly higher knowledge score compared to non-health workers. This result is expected since health workers are the front-liners in the fight against the coronavirus pandemic. However, a study conducted by Yue et al. showed that being a health care worker had a significant impact on COVID-19 knowledge, but there was no significant difference in knowledge of health workers and non-health care workers (17). Significant differences in COVID-19 knowledge rather existed in age groups, marital status, gender and educational level (17).
The findings of our study depicted a high mean percentage attitude score of almost 90%. Similar result was reported in a population based study done in Iran (18). Further, both recent and previous studies conducted within Africa and other parts of the world within this pandemic period have reported high positive attitudes towards the novel coronavirus disease (15–17, 19). Knowledge is usually associated with attitudes. Therefore, the high COVID-19 knowledge among participants from different countries may have influenced the general attitude of people worldwide. A study conducted in Nigeria confirms a significant relationship between COVID-19 knowledge level and attitudes towards COVID-19 preventive practices (16).
Earlier modelling studies had predicted the severity of the novel coronavirus pandemic globally; the severity is expected to be intense in low-income settings and among people earning low income (20, 21). In our study, we found that attitudes towards COVID-19 was significantly associated with income level of participants. And, it was confirmed in our study that positive attitude towards the COVID-19 was significantly higher among participants who received higher income compared to those who received lower income. Also, positive attitudes towards COVID-19 were found among majority of above ¢1000 income earners. Therefore, it is obvious that negative attitudes among low-income earners may be the reason why the severity of the COVID-19 preventive items, such as nose masks and sanitizers.
In a study (22) conducted among ethnic minorities in Hong Kong, participants expressed some misconceptions on the prevention of novel coronavirus disease; however, they had positive attitudes towards the approved preventive measures of the infection including wearing of masks and social distancing. Though in our study, ethnicity was not associated with attitudes towards COVID-19, significant differences in attitude was among ethnic groups, implying that an ethnic group had better attitudes towards COVID-19 compared to the others. These findings are expected because earlier studies (23) have reported a relationship between ethnicity and spread of COVID-19 disease. This observation suggests that the cultural and socio-economic characteristics of an ethnic group significantly affects their attitudes toward a disease; whether positive or negative.
The mean percentage of COVID-19 preventive practices in our study was found to be 69.2%. This outcome was similar to a recent research in Nigeria that depicted an average percentage of 68.0% (16). Nonetheless, a study published after some few months of the COVID-19 pandemic revealed that over 95.0% of study participants engaged in all COVID-19 preventive practices (15). The discrepancies in the average practices may be due to the period, and countries where the studies were conducted. The earlier study (16) and our study were conducted in West African countries during the national lockdown, which was many months into the COVID-19 pandemic; however, the latter was conducted in the early period of the epidemic in China.
Also, in this study, practices towards the novel coronavirus was significantly associated with gender. Besides, although our study found that majority of males were found to be involved in good practices of COVID-19, female participants significantly adhere to COVID-19 preventive measures compared to their male counterparts. The findings of this study synchronizes with another, which revealed that men were associated with lower practice of COVID-19 preventive measures, including wearing nose masks and going to crowded places (15). A study by Erfani et al. also confirms the high practice of COVID-19 preventive measures among females compared to males (18). Additionally, a research (24) conducted to study gender differences in COVID-19 linked beliefs and behaviour revealed that, generally, females perceived the pandemic as a serious health issue and subsequently comply with all the preventive measures compared to males. This accounts for the considerable difference in COVID-19 mortality cases between women and men.
This study found occupation and income level of study participants to be significantly associated with COVID-19 preventive practices. As expected, health workers practiced COVID-19 preventive measures compared to non-health workers. Erfani et al. study (18) on COVID-19 found results similar to our study, where being a health care provider was associated with adequate knowledge, attitude and preventive practices towards COVID-19 infection. The population working in health care related facilities are the forefront of the coronavirus virus pandemic; therefore, it is highly expected of these workers to practice COVID-19 preventive measures. According to a recent Chinese study, COVID-19 preventive measures were practiced by participants who earned higher income (22). However, the results of this study revealed that participants who earned between ¢500–1000 as income practiced COVID-19 preventive measures compared to those received less than 500 and above ¢1000. Furthermore, our study showed a strong association between income level of above ¢1000 and lower practice score. These results suggest the unpredictability of human behaviour, which may be affected by factors such as knowledge and complacency.
This study, finally, found out that being within the age category of 42–64 years and belonging to a Ga ethnic group are associated with higher COVID-19 preventive practice score. The numerous data that churned out at the early stage of the COVID-19 pandemic revealed that the older age group were at a high risk compared to the youth (25). So, educational and preventive campaigns were all targeted at this age bracket. This may be the reason for the higher practice score among them (26). The Ga ethnic group are inhabitants of Accra, the epicenter of the novel coronavirus in Ghana. In essence, it was expected that this group may adhere more to the preventive measures compared to the other ethnic groups in Ghana.
Limitation of the study
Due to the COVID-19 pandemic, the study was limited to only participants who could read and write, since the survey was made available on solely social media platforms.