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      Knowledge, Attitude, and Practices Among the General Population During the Later Stage of the COVID-19 Pandemic in Malaysia: A Cross-Sectional Study

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          Abstract

          Purpose

          A different pattern of mental health issues was reported during the later stage of the COVID-19 pandemic; however, few studies have examined Malaysians’ knowledge, attitudes, and practices (KAP) prevalent during this time.

          Patients and Methods

          A nationwide online cross-sectional study was conducted in Malaysia from June 1, 2021 to June 14, 2021, ie, 18-months from the first reported COVID-19 case in the country. Citizens aged 18 years and above were recruited by means of the snowball sampling method. ANOVA, Pearson correlation, and linear regression tests were used.

          Results

          Of the 2168 respondents, most were young adults (62.7%), females (62.4%), tertiary educated individuals (84%), non-health care workers (85.9%), and individuals who knew someone diagnosed with COVID-19 (75.2%). The mean score for knowledge was 10.0 ± 1.52 (maximum score = 12); correct response rate for each question ranged from 54.2% to 99%. The mean score in terms of attitude was 1.3 ± 0.85 (maximum score = 2); 68.7% respondents agreed that control over COVID-19 would finally be achieved; and 62.3% believed that Malaysia could conquer COVID-19. The mean score for practices was 5.1 ± 1.10 (maximum score = 6); 81.5%, 88.1%, and 74.1% respondents avoided crowded places, confined spaces, and conversations in close physical proximity, respectively. Furthermore, 94.2% wore masks when leaving home; 89.0% practiced hand hygiene; and 83.8% adhering to COVID-19 warnings. Small but significant correlations were found between knowledge and attitude ( r = 0.078, p < 0.001) as well as between knowledge and practices ( r = 0.070, p = 0.001).

          Conclusion

          Malaysians exhibited sound knowledge but negative attitudes and inadequate practices pertaining to COVID-19 during the pandemic’s later stage. At this phase, unlike at the early stage, the public’s sound knowledge ensured little improvement in their attitudes and practices. Therefore, health education at the later pandemic stage should focus on promoting positive attitudes and developing better practices.

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          Most cited references44

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              The species Severe acute respiratory syndrome-related coronavirus : classifying 2019-nCoV and naming it SARS-CoV-2

              The present outbreak of a coronavirus-associated acute respiratory disease called coronavirus disease 19 (COVID-19) is the third documented spillover of an animal coronavirus to humans in only two decades that has resulted in a major epidemic. The Coronaviridae Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is responsible for developing the classification of viruses and taxon nomenclature of the family Coronaviridae, has assessed the placement of the human pathogen, tentatively named 2019-nCoV, within the Coronaviridae. Based on phylogeny, taxonomy and established practice, the CSG recognizes this virus as forming a sister clade to the prototype human and bat severe acute respiratory syndrome coronaviruses (SARS-CoVs) of the species Severe acute respiratory syndrome-related coronavirus, and designates it as SARS-CoV-2. In order to facilitate communication, the CSG proposes to use the following naming convention for individual isolates: SARS-CoV-2/host/location/isolate/date. While the full spectrum of clinical manifestations associated with SARS-CoV-2 infections in humans remains to be determined, the independent zoonotic transmission of SARS-CoV and SARS-CoV-2 highlights the need for studying viruses at the species level to complement research focused on individual pathogenic viruses of immediate significance. This will improve our understanding of virus–host interactions in an ever-changing environment and enhance our preparedness for future outbreaks.
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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                05 March 2022
                2022
                : 15
                : 389-401
                Affiliations
                [1 ]Department of Medicine, Faculty of Medicine and Health Science of University Malaysia Sarawak , Kota Samarahan, Sarawak, Malaysia
                [2 ]Department of Medicine, Faculty of Medicine of University of Malaya , Kuala Lumpur, Malaysia
                [3 ]Department of Primary Care Medicine, Faculty of Medicine of University of Malaya , Kuala Lumpur, Malaysia
                [4 ]Department of Internal Medicine, Faculty of Medicine of University Technology MARA , Sungai Buloh, Selangor, Malaysia
                [5 ]Department of Primary Care Medicine, Faculty of Medicine of University Technology MARA , Sungai Buloh, Selangor, Malaysia
                Author notes
                Correspondence: Diana-Leh-Ching Ng, Department of Medicine, Faculty of Medicine and Health Science, University Malaysia Sarawak , Kota Samarahan, Sarawak, Malaysia, Tel +60 19-8198265, Email diananglehching@gmail.com
                Seng-Beng Tan, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia, Tel +60 12-3263128, Email pramudita_1@hotmail.com
                Author information
                http://orcid.org/0000-0002-4277-6152
                http://orcid.org/0000-0002-0649-0739
                Article
                349798
                10.2147/RMHP.S349798
                8906877
                35283653
                7eea48d2-a640-434c-81fc-6892717298cc
                © 2022 Chai et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 19 November 2021
                : 22 February 2022
                Page count
                Figures: 0, Tables: 8, References: 54, Pages: 13
                Funding
                Funded by: funded;
                This study was not funded.
                Categories
                Original Research

                Social policy & Welfare
                knowledge,attitude,practices,covid-19 pandemic,pandemic fatigue,late pandemic
                Social policy & Welfare
                knowledge, attitude, practices, covid-19 pandemic, pandemic fatigue, late pandemic

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