COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia

Figures & data

Table 1 Socio-Demographic of HTN and DM Patients and Categorization of Study Participants’ Score on KAP Domains Based on Socio-Demographics of HTN and DM Patients, West Shoa, Ethiopia, 2020 (N=423)

Variables	Category	Knowledge Level			P-value	Practice			P-value	Attitude			P-value
		Poor	Moderate	Good		Poor	Moderate	Good		Poor	Moderate	Good
Sex	Male	72	71	92	0.76	103	107	25	0.77	13	98	124	0.203
	Female	61	60	67		89	80	19		7	94	87
Age	18–40	39	67	72	0.001	80	84	14	0.166	5	73	100	0.000
	41–60	60	48	65		74	74	25		7	73	93
	>60	34	16	22		38	29	5		8	46	18
Religion	Orthodox	64	59	76	0.422	95	80	24	0.35	12	102	85	0.033
	Protestant	58	58	74		83	91	16		7	75	108
	Muslim	6	6	1		8	4	1		0	9	4
	Wakeffata	5	8	8		6	12	3		1	6	14
Residence	Rural	66	59	55	0.028	95	76	9	0.002	12	91	77	0.023
	Urban	67	72	104		97	111	35		8	101	134
Ethnics	Oromo	117	113	140	0.674	168	164	38	0.535	20	166	184	0.019
	Amhara	11	12	16		16	19	4		0	23	16
	Tigre	4	6	2		7	4	1		0	1	11
	Gurage	1	0	1		1	0	1		0	2	0
Educational level	No formal education	47	29	25	0.000	57	38	6	0.000	11	64	26	0.000
	Grades 1–6	38	33	31		48	44	10		3	60	39
	Grades 7–12	24	39	49		57	49	6		3	42	67
	Diploma	13	11	23		17	22	8		1	13	33
	First degree and above	11	19	31		13	34	14		2	13	46
Marital status	Single	13	24	31	0.188	32	34	2	0.034	0	27	41	0.069
	Married	114	101	123		157	142	39		19	154	165
	Divorce	6	6	5		3	11	3		1	11	5
Occupation	Private	49	48	57	0.000	75	62	17	0.001	7	72	75	0.000
	Farmer	62	48	32		75	60	7		11	82	49
	Public servant	16	26	57		27	55	17		2	24	73
	Others	6	9	13		15	10	3		0	14	14
Type of disease	HTN	67	81	79	0.018	110	97	20	0.262	13	99	115	0.376
	DM	40	42	55		56	67	14		3	63	71
	Both	26	8	25		26	23	10		4	30	25

Abbreviations: SD, standard deviation; HTN, hypertension; DM, diabetes mellitus.

Table 2 Knowledge About COVID-19 Among HTN and DM Patient at AURH and AGH, West Shoa, Ethiopia, 2020 (N=423)

Knowledge-Related Questions	Response
Questions Related to Knowledge	Yes (N, %)	No (N, %)	I Do not Know (N, %)
Covid-19 is a contiguous disease	416 (98.3)	6 (1.4)	1 (0.3)
Covid-19 exist in Ethiopia	411 (97.1)	3 (2.8)	9 (2.1)
The perception causes of COVD-19 virus	268 (63.4)	31 (36.6)	124
the incubation period of the diseases is 2 days to 14 days	338 (79.9)	1 (0.2)	84 (19.8)
COVID-19 had no effective treatments and vaccine currently	266 (62.9)	113 (26.7)	44 (10.4)
COVID-19 is more dangerous with people age >50 years old	268 (63.4)	149 (35.2)	6 (1.4)
Is fever a symptom of COVID-19	371 (87.7)	51 (12.1)	1 (0.2)
Is cough a symptom of COVID-19	380 (89.8)	43 (10.2)	0
Is sore throat is a symptom of COVID-19	194 (45.9)	229 (54.1)	0
Is body pain a symptom of COVID-19	134 (31.7)	289 (68.3)	0
Headache is a symptom of COVID-19	247 (58.4)	176 (41.6)	0
Is diarrhea a symptom of COVID-19	82 (19.4)	341 (80.6)	0
Constipation is a symptom of COVID-19	86 (20.3)	337 (79.7)	0
The prevalence of COVID-19 increases in Ethiopia	391 (92.4)	14 (3.3)	18 (4.3)
The disease is transmitted directly through cough	355 (83.9)	68 (16.1)	0
The disease is transmitted directly through sneezing	328 (77.5)	95 (22.5)	0
The disease is transmitted directly through talking with infected individuals	344 (81.3)	78 (18.5)	1 (0.2)
The disease is transmitted directly through contacts with an infected surface	336 (79.4)	86 (20.4)	1 (0.2)
The disease is transmitted directly through hugging	336 (79.4)	87 (20.6)	0
The disease is transmitted directly through kissing	295 (69.7)	128 (30.3)	0
COVID-19 is more dangerous in HTN patients	385 (91)	38 (9)	0
COVID-19 is more dangerous in DM patients	370 (87.5)	53 (12.5)	0
COVID-19 is more dangerous in elderly patients	328 (77.5)	95 (22.5)	0
COVID-19 more dangerous in immune-compromised patients	268 (63.4)	155 (36.6)	0
COVID-19 is more dangerous for cancer patients	229 (54.1)	193 (45.6)	1 (0.2)
COVID-19 is more dangerous in patients with respiratory problems	248 (58.6)	175 (41.4)	0

Figure 1 Overall level of knowledge and preventive practice about COVID-19 among HTN and DM patients at AURH and AGH, West Shoa, Ethiopia.

Table 3 Attitude/Perception of Hypertensive and DM Patients Towards COVID-19, AURH and AGH, West Shoa, Ethiopia, 2020 (N=423)

Attitude-Related Questions	Response
	Most Certainly (N, %)	Probably Yes (N, %)	Probably Not (N, %)	Certainly Not (N, %)
Did your belief that COVID-19 is a serious disease?	288 (68.1)	123 (29.1)	10 (2.4)	2 (0.5)
Do you think your chance of getting COVID-19 high?	134 (31.7)	227 (53.7)	59 (13.9)	3 (0.7)
Do you think that you will manage to carry out prevention measures recommended by the authority?	1 (0.2)	9 (2.1)	216 (51.1)	197 (46.6)
Do you think that early diagnosis of COVID-19 can enhance treatment outcomes?	306 (72.3)	103 (24.3)	12 (2.8)	2 (0.5)
Do you believe that COVID-19 can be managed at home?	151 (35.7)	116 (27.4)	67 (15.8)	89 (21)
Do you believe that health education can help in the prevention of COVID-19 spreading?	288 (68.1)	129 (30.5)	6 (1.4)	0 (0%)
Did you agree that COVID-19 is a curable disease	87 (20.6)	257 (60.8)	65 (15.4)	14 (3.3)
Did you think that COVID-19 results in death	9 (2.1)	46 (10.9)	167 (39.5)	201 (47.5)
In my opinion household pets can transmit COVID-19 to humans	28 (6.6)	53 (12.5)	147 (34.8)	195 (46.1)
As to my opinion, the concerned body should quarantine patients with COVID-19 in a special quarantine center	280 (66.2)	126 (29.8)	15 (3.5)	2 (0.5)
Do you think a patient with a chronic disease like HTN, DM, and others are more vulnerable to the effect of COVID-19 than other people	335 (79.2)	70 (16.5)	18 (4.3)	0 (0%)

Table 4 Frequency of Practice-Related Response by HTN and DM Patients at AURH and AGH, West Shoa Ethiopia, 2020 (N=423)

Practice-Related Questions	Response
	Yes	No
	(N, %)	(N, %)
I will visit the health facility in suspecting infection with COVID-19	407 (96.2)	16 (3.8)
I avoid going out of my home to prevent spreading COVID-19	299 (70.7)	124 (29.3)
I wash my hands often using soap for at least 20 seconds	140 (33.1)	283 (66.9)
I avoid touching nose, eyes, and mouth with hand ahead of washing	140 (33.1)	283 (66.9)
Covering mouth and nose after coughing/sneezing and washing your hands	388 (91.7)	35 (8.3)
I avoid close contact with anyone with flu or cold symptoms such as cough, fever, or sneezing	398 (94.1)	25 (5.9)
Clean frequently touched objects and surfaces	359 (84.9)	64 (15.1)
I disinfect frequently touched surfaces and objects	273 (64.5)	150 (35.5)
I stay at home if sick, except to get medical care	323 (76.4)	100 (23.6)
I avoid large gatherings	327 (77.3)	96 (22.7)
To prevent spreading COVID-19, I avoid consuming food outside	289 (68.3)	134 (31.7)
I avoid public transportations to prevent spreading COVID-19	137 (32.4)	286 (67.6)
To prevent the spreading of COVID-19, I avoid going to work	141 (33.3)	282 (66.7)
Did you perform physical exercise regularly than before COVID-19?	142 (33.6)	281 (66.4)
Did you visit your doctor or health care facility for refill frequently similar to before the report of COVID-19 in Ethiopia	323 (76.4)	100 (23.6)
To prevent the spreading of COVID-19, I use herbal products and traditional medicine	272 (64.3)	151 (35.7)
To prevent contracting COVID-19, I take fruit and vegetables	178 (42.1)	245 (57.9)

Table 5 Factors Associated with Poor Knowledge Among HTN and DM Patients in Logistic Regression Analyses, at AURH and AGH, West Shoa, Ethiopia, 2020 (N=423)

Variables	Category	Poor Knowledge		95% C.I.		COR	P-value	95% C.I.		AOR	P-value
				Lower	Upper			Lower	Upper
		Yes	No
Age	Age	44.6±16.8		0.959	0.984	0.971	0.000	0.965	0.998	0.982	0.028*
Residence	Rural	66	114
	Urban	67	176	1.006	2.300	1.52	0.047	0.413	1.613	0.816	0.559
Educational level	No formal education	47	54
	Grades 1–6	38	64	0.837	2.567	1.466	0.181	0.643	2.349	1.229	0.532
	Grades 7–12	24	88	1.756	5.798	3.191	0.000	0.810	3.671	1.724	0.158
	Diploma	13	34	1.076	4.815	2.276	0.031	0.243	2.065	0.708	0.528
	First degree and above	11	50	1.849	8.467	3.956	0.000	0.423	3.550	1.226	0.707
Marital status	Single	13	55
	Married	114	224	0.244	0.885	0.464	0.020	0.347	1.798	0.790	0.574
	Divorce	6	11	0.135	1.388	0.433	0.159	0.209	3.080	0.803	0.749
Occupation	Private	49	105
	Farmer	62	80	0.375	0.968	0.602	0.036	0.315	1.431	0.671	0.302
	Public servant	16	83	1.285	4.561	2.421	0.006	1.300	7.600	3.143	0.011
	Others	6	22	0.652	4.488	1.711	0.275	0.329	2.883	0.973	0.961
From where did you hear it for the first time?	Social media	12	52
	Mass media	90	141	0.183	0.714	0.362	0.003	0.224	0.990	0.471	0.047
	Family/friend	19	70	0.379	1.905	0.850	0.693	0.625	3.709	1.522	0.355
	Health care professionals	12	27	0.206	1.310	0.519	0.165	0.303	2.361	0.846	0.749
How frequently did you use this source of information?	Daily	113	267
	Weekly	16	18	0.234	0.967	0.476	0.040	0.209	0.995	0.456	0.049
	Monthly	4	5	0.139	2.006	0.529	0.349	0.117	2.245	0.513	0.375

Note: *Significance value at P-value less than 0.05.

Table 6 Factors Associated with Poor Practice on COVID-19 Prevention Among Hypertensive and DM Patients on Chronic Follow-Up at AURH and AGH, West Shoa, Ethiopia, 2020 (N=423)

Variables	Category	Poor Practice		95% C.I.		COR	P-value	95% C.I.		AOR	P-value
				Lower	Upper			Lower	Upper
		Yes	No
Residence	Rural	95	85
	Urban	97	146	1.140	2.483	1.68	0.009	0.658	2.078	1.170	0.593
Educational level	No formal education	57	44
	Grades 1–6	48	54	0.838	2.534	1.457	0.182	0.679	2.247	1.235	0.489
	Grades 7–12	57	55	0.728	2.146	1.250	0.418	0.580	2.139	1.114	0.747
	Diploma	17	30	1.120	4.665	2.286	0.023	0.523	3.641	1.380	0.515
	First degree and above	13	48	2.309	9.907	4.783	0.000	1.169	8.031	3.064	0.023*
Marital status	Single	32	36
	Marriage	157	181	0.608	1.727	1.025	0.927	0.472	1.649	0.882	0.694
	Divorce	3	14	1.092	15.759	4.148	0.037	0.916	15.86	3.811	0.066
Occupation	Private	75	79
	Farmer	75	67	0.537	1.339	0.848	0.479	0.675	2.555	1.313	0.423
	public servant	27	72	1.470	4.360	2.532	0.001	0.718	3.249	1.528	0.271
	Others	15	13	0.367	1.844	0.823	0.636	0.290	1.731	0.708	0.450
Poor Knowledge	Yes	75	58
	No	117	173	1.262	2.896	1.912	0.002	1.056	2.597	1.656	0.028*
How frequently did you use this source of information?	Daily	161	219
	Weekly	25	9	0.120	0.582	0.265	0.001	0.143	0.743	0.326	0.008*
	Monthly	6	3	0.091	1.492	0.368	0.161	0.123	2.170	0.518	0.368

Note: *Significance value at P-value less than 0.05.