ORIGINAL RESEARCH

https://doi.org/10.54034/mic.e1547
Microbes, Infection and Chemotherapy

A cross-sectional study to assess knowledge, attitude and practice among

healthcare workers regarding COVID-19 at a National Institute of North India
1 2 3,* 3,%
Authors: Sushil Kumar-Munjal , Megh Singh-Dhakad , Manoj Kumar , Sanjib Gogoi

1
Abstract Department of Tuberculosis & Respiratory Diseases, National
Institute of Tuberculosis and Respiratory Diseases (NITRD), Sri
Background and Objectives. Healthcare workers (HCWs) are the frontline Aurobindo Marg, New Delhi, India. https://orcid.org/0000-0003-
warriors of the battle against COVID-19 and are at high risk of exposure to SARS- 0606-8009
CoV-2. Therefore, knowledge, attitude, and practice (KAP) among HCWs play a 2
vital role in preventing and spreading COVID-19. Hence, the current study aimed State-Viral Research and Diagnostic Laboratory (VRDL),
Department of Microbiology, Maulana Azad Medical College &
to assess KAP among HCWs regarding COVID-19. Methods. This descriptive,
Associated Lok Nayak Hospitals, New Delhi, India.
cross-sectional study enrolled 171 HCWs of a national institute in North India. A https://orcid.org/0000-0002-9624-1102
self-administered questionnaire was used to assess KAP among HCWs
regarding COVID-19. Descriptive statistical analysis was applied to compare and 3
Department of Microbiology, Lady Hardinge Medical College &
represent the level of association of KAP scores among HCWs. Results. Among Associated Hospitals, New Delhi, India.
%
HCWs (n=171), 106 (61.98%) were males, and 65 (38.01%) were females. Most https://orcid.org/0000-0003-0213-6676
(n=76; 44.44%) belonged to the 20-29 age group. The mean±S.D score of HCWs
Corresponding author:
for knowledge, attitude, and practice were 42.76±2.14, 28.91±1.59 and
*Dr. Manoj Kumar, MD (Microbiology), DTCD (TB & Respiratory
20.38±1.46, respectively. Excellent knowledge, attitude, and practice score Diseases), Professor, Department of Microbiology, Lady Hardinge
were found in 66.1%, 69.1%, and 97.1% of HCWs, respectively. Knowledge score Medical College
was maximum in resident doctors (44.09±1.13); however, multi-tasking staff Address: New Delhi- 110001, Tel: +91-7838358002.
(29.35±1.44), laboratory technicians (29.31±1.21), and ward boys (29.29±1.59) E-mail: [email protected]
had better attitude scores. Nurses (28.44±1.69) and safaikaramacharis ORCID: 0000-0002-8792-1261
(28.11±1.96) had low attitude scores. The practice score of nurses and multi- Copyright © 2022 the Author(s)
tasking staff fared well than resident doctors. Knowledge and attitude scores
Submitted: September 21, 2022
were statistically associated with the profession and higher level of education.
Reviewed : October 18, 2022
Conclusion. The study highlights that most HCWs have good KAP regarding
Approved: November 10, 2022
COVID-19. Continuous dissemination of education on the prevention of the
spread of COVID-19 is advised among HCWs to improve their knowledge. How to cite: Kumar-Munjal S, Singh-Dhakad M, Kumar M, Gogoi S. A
Hence, it will strengthen the health workforce in the battle against COVID-19. cross-sectional study to assess knowledge, attitude and practice
among healthcare workers regarding COVID-19 at a National
Key word: attitude, COVID-19, knowledge, healthcare workers, practice Institute of North India. Microbes Infect Chemother. 2022; 2: e1547

Introduction new type of Coronavirus (novel Coronavirus-2019), and the

illness it caused was designated as COVID-19 (5). The World
Coronaviruses (CoVs) cause pulmonary diseases in Health Organization (WHO) declared COVID-19 a public health
humans. Severe Acute Respiratory Syndrome (SARS) and emergency on January 30, 2020, and the outbreak was
Middle East Respiratory Syndrome (MERS) viruses belonging declared a pandemic on March 11, 2020. According to WHO,
to the Coronaviridae family are responsible for severe and approximately 52 Crores confirmed cases of COVID-19 were
sometimes fatal pulmonary diseases (1). SARS-CoV was first reported globally, including an estimated 6.2 million deaths
identified in 2002-03 in a case of pneumonia in Guangdong, (6).
China, which later turned into life-threatening respiratory
failure. Because of human-to-human transmission, the virus The total number of confirmed cases in India was
further infected about 8500 people, with a case fatality rate of approximately 4.3 Crores, and associated deaths were
10% (2,3). Similarly, in 2012, the MERS-CoV epidemic appeared approximately 5.2 Lakh on May 25, 2022 (7,8). Human-to-
in Saudi Arabia, where people experienced symptoms similar human transmission occurs through direct contact and
to SARS-CoV but with a very high case fatality rate of 36%. It respiratory droplets (6,9). The incubation period of COVID-19
was mainly transmitted to humans from camels (4). is 2–14 days (10,11), and the symptoms are fever, cough,
breathlessness, fatigue & myalgia (12,13). Standard
Similar cases of pneumonia were reported in Wuhan recommendations to prevent infection spread include
city, China, in December 2019. The virus was identified as a maintaining hand hygiene, covering mouth and nose; when

Microbes Infect Chemother, 2022, v.2, 1-8, e1457 1

Kumar-Munjal S, Singh-Dhakad M, Kumar M, Gogoi S

coughing or sneezing, avoid close contact with anyone Confidentiality of the study participants' identities was
showing symptoms of respiratory illness (14). maintained during the study. The participation was voluntary
and non-compensated. All participants were explained in
During the pandemic, accelerated emergency detail about the study and informed signed consent was
vaccine development led to using different vaccine platforms taken from each participant.
such as inactivated, virus-like particles, viral vectors, mRNA,
self-amplifying RNA, DNA, and live attenuated vaccines (15). Sample Size. The sample size was calculated by following the
In India, Covishield, Covaxin, Sputnik, Moderna, Johnson & exact binomial confidence limit method:–
Johnson, and ZyCoV-D have been given approval for
emergency use. India began the administration of COVID-19 N = Z² x (p) x (1-p)/C² = (1.96)2 (0.8) (0.2) / (0.06)2 =170.66
vaccines on January 16, 2021. As of May 23, 2022, India has
administered over 192.5 crores, including the first and second Where N = Sample size, Z = value corresponding to a given
doses of the currently-approved vaccines (16). confidence level (1.96 for a confidence level of 95%-value
commonly used); p = Percentage of the prevalence,
In early March 2020, studies documented over 3300 expressed as a decimal (Prevalence of good KAP is 0.8 as in
confirmed healthcare workers cases in China met as high as previous studies Bloom's cut-off of 80% was used to
19% in the USA. Infection and mortality of Healthcare workers determine sufficient knowledge, positive attitude and good
(HCWs) worldwide from COVID-19 are also very high. A global practice (20, 21)), C=Allowable absolute error expressed as a
study found 152888 infections and 1413 deaths among HCWs. decimal (0.06), after considering six percent allowable
Infections were mainly in women (71.6%) and nurses (38.6%), standard error. By this formula, the sample size was 170.66.
but deaths were mainly in men (70.8%) and doctors (51.4%) Therefore, we enrolled 171 participants in our study. Stratified
(17). Gholami et al. (2020) reported that 51.7% HCWs were random sampling was applied among different cadres of
found to be infected with COVID-19 during the first six months HCWs to have equitable distribution as maximum as possible.
of the COVID-19 pandemic, with a prevalence of
hospitalization of 15.1% and mortality of 1.5% (18). Procedure. A self-administered questionnaire was
used; it was developed after reviewing previously conducted
Guidelines for the prevention and control of COVID- research and visiting WHO websites for frequently asked
19 for HCWs were published by the WHO and the Ministry of questions (16, 22). The questionnaire had fifteen questions for
Health and Family Welfare (MoHFW, India) to strengthen knowledge (K1-K15), ten questions for attitude (A1-A10), and
further preventive strategies, including raising awareness and seven questions for practice (P1-P7) assessment. Each
training healthcare workers in preparedness activities. The knowledge, attitude, and practice item had three options in
WHO and MoHFW (India) have initiated several online training natural order (Ordinal categorical data). A Likert-type scale
sessions and materials on COVID-19 in various languages (6, was used to assess attitude and practice (23).
19).
These questions for knowledge, attitude, and
HCWs are the frontline workers and their knowledge, practice assessment were answered in the form of Yes, No, or
attitude, and practice (KAP) regarding the COVID-19 I don't know. Correct answers had 3 points, while incorrect
pandemic plays an essential role in managing COVID-19. answers were allocated 1 point, and no opinion answer had 2
Although many researchers have studied COVID-19 among points. Eventually, the overall knowledge score ranged from
HCWs, studies from different parts of the world on KAPs in 15 to 45. Individuals scoring less than 39 were categorized as
COVID-19 among HCWs are still needed. Therefore, we having low knowledge, 39 to 40 as having moderate
conducted this descriptive cross-sectional study to assess knowledge, and above 41 as enjoying high knowledge of
KAP among HCWs regarding the COVID-19 pandemic at a COVID-19. The total attitude score ranged from 10 to 30. A
National Institute of North India. score of under 26, 26 to 28, and above 28 was classified as low,
moderate, and high attitudes towards COVID-19, respectively.
Materials and methods The total practice score ranged from 07 to 21. Total scores of
fewer than 13, 13 to 15, and above15 were classified as weak,
This descriptive cross-sectional study was conducted moderate, and strong practices towards COVID-19,
from August 2020 to July 2021 at the Department of respectively (24).
Tuberculosis & Respiratory Diseases, National Institute of
Tuberculosis and Respiratory Diseases (NITRD). The study Data Collection Process. The questionnaire was
included HCWs of the national institute of North India, such as given to HCWs, who filled in the responses in the researcher's
safaikaramchari, multi-tasking staff (MTS), ward boys, presence. After the completion of responses, questionnaires
laboratory technicians, pharmacists, nurses, and resident were collected within fifteen minutes. The questionnaire was
doctors. HCWs working in the institute aged between 20-60 pretested on 20 HCWs who were excluded from the analysis;
years were included in the study. HCWs that refuse to the internal consistency of the study questionnaire was
participate were excluded from the study. assessed by calculating the Cronbach alpha.

Ethics Statement. Approval for the study was Data Analysis. Once all necessary data were
obtained from the Institutional Ethics Committee (IEC). obtained, they were checked for completeness, and normal

2 Microbes Infect Chemother, 2022, v.2, 1-8, e1457

 KAP among HCWs regarding COVID-19

distribution was assessed by using the skewness and kurtosis Table 1

test. Data were coded and analyzed using Statistical Package Demographic Profile of study participants (n = 171).
for Social Sciences (SPSS) software version 20. The Chi-square
test was used to compare qualitative variables between Frequency Percentage
Characteristics
resident doctors and allied health workers. Comparison of (n=171) (%)
knowledge scores between two groups was made using Gender
student t-test and ANOVA test for more than two groups. Male 106 62
Pearson correlation was done to see a relation between Female 65 38
knowledge and attitude scores. Multivariate linear regression Age
analysis was used to measure the degree of association
20-29 76 44.4
between independent and dependent variables. All analyses
were two-sided, and a p-value <0.05 was considered 30-39 47 27.5
statistically significant. 40-49 28 16.4
>50 20 11.7
Results Level of Education
Among the enrolled HCWs, the mean age was Postgraduate 47 27.5
31.28±12.65 (SD). The majority of the HCWs (n=76; 44.44%) University 33 19.3
belonged to the 20-29 age group, followed by 47 (27.48 %) Intermediate 30 17.5
belonged to the 30-39 age group, 28 (16.37 %) to 40-49 age High School Education 39 22.8
group and 20 (11.69%) to above 50 years age group. Among
Less than high school
the HCWs, 106 (61.98%) were male and 65 (38.01%) were 22 12.9
education
female with male to female ratio of 1.63:1. Among the study
participants, 63.74% (109) were married and 36.25% (62) were Profession
unmarried. The age and sex distribution among study Resident Doctor 31 18.2
participants are summarized below in Table 1. Nurse 47 27.5
Pharmacist 1 0.6
The education of more than one-fourth of the
Participants (27.5%) was either continuing post-graduation or Laboratory Technician 22 12.9
postgraduates, 19.3% were University graduates, 17.5% had Ward Boy 47 27.5
education up to intermediate, and 22.8% had high school MTS 14 8.2
education. Only 12.9 % had education less than in high school. SafaiKaramchari 9 5.3

Table 2
Composite Level of KAP Score
Total score Level (%), n=171
Number of Range of
Variables
questions score (Mean ± SD*) Poor Moderate Excellent
Knowledge 15 32-45 42.76 ± 2.140 4(2.34%) 51(29.82%) 116(67.84%)
Attitude 10 22-30 28.91 ± 1.594 7(4.09%) 51(29.82%) 113(66.08%)
Practice 7 13-21 20.38 ± 1.468 0 6(3.51%) 165(96.49%)
*SD: Standard Deviation.

Among HCWs, 31(18.12%) were resident doctors, Knowledge score was maximum for resident doctors
47(27.48%) each were nurses & ward boys, 22(12.86%) were (44.09±1.13) compared to others. MTS (29.35±1.4), laboratory
laboratory technicians, 14(8.2%) were MTS, 9(5.3%) were technicians (29.31±1.21), and ward boys (29.29±1.55) had
safaikaramchari and 1(0.58%) was pharmacist. Most of the better attitude scores than resident doctors (28.74±1.50).
HCWs used Television (n=48; 28.07%), Newspaper & television Nurses and safaikaramacharis had low attitude scores of
(n=42; 24.56%), MoHFW& WHO website (n=21; 12.28%), and 28.44±1.69 and 28.11±1.96, respectively (Table 3).
social media (n=11; 6.43%) as the preferred main source of
information on COVID-19. Association of knowledge (P<0.001) and attitude
score (P=0.01) of HCWs with their profession were found to be
The mean score for knowledge, attitude, and statistically significant, whereas practice score with
practice for COVID-19 were 42.76±2.14 (range =0-45), profession was statistically non-significant. On subgroup
28.91±1.59 (range =0-30), and 20.38±1.46 (range =0-21), analysis, comparing resident doctors with respect to others, it
respectively. The cut-off for excellent knowledge score, was found that resident doctors' knowledge score was
attitude score &practice score was above 41, 28, & 15, significantly higher than all other professionals except MTS.
respectively. The knowledge score of 69.1%, attitude score of The attitude score of resident doctors did not differ
66.1%, and practice score of 97.1% were excellent among significantly compared to other professionals. However, for
HCWs (Table 2). practice, nurses and MTS fared well than resident doctors
significantly, with P=0.01 and P=0.03, respectively (Table 3).

Microbes Infect Chemother, 2022, v.2, 1-8, e1457 3

Kumar-Munjal S, Singh-Dhakad M, Kumar M, Gogoi S

Table 3
Effect of Profession on KAP score
# $
Profession Minimum Maximum Mean±SD* P P
Resident Doctor 41 45 44.09±1.13 NA
Nurse 39 45 43.34±1.63 0.002
Pharmacist 43 43 43 NA
Knowledge
laboratory technician 36 45 42.50±2.17 <0.001 0.002
score
Ward Boy 36 45 41.53±1.92 <.0001
MTS 41 45 43.85±1.29 0.53
SafaiKaramchari 32 45 40.44±3.84 <.0001
Resident Doctor 24 30 28.74±1.50 NA
NURSE 24 30 28.44±1.69 0.21
Pharmacist 30 30 30 NA
Attitude
Laboratory Technician 25 30 29.31±1.21 0.01 0.06
score
Ward Boy 22 30 29.29±1.55 0.06
MTS 26 30 29.35±1.44 0.2
SafaiKaramchari 24 30 28.11±1.96 0.3
Resident Doctor 13 21 19.83±2.20 NA
Nurse 16 21 20.70±.85 0.01
Pharmacist 21 21 21 NA
Practice
laboratory technician 14 21 20.13±1.80 0.09 0.3
score
Ward Boy 14 21 20.34±1.37 0.1
MTS 20 21 20.92±.267 0.03
SafaiKaramchari 18 21 20.44±1.13 0.13
*SD: Standard Deviation. #P<0.05 was considered to indicate significance (ANOVA Test applied).
$P<0.05 was considered to indicate significance (T-test applied). Bold values show significant differences.

Knowledge and attitude scores of HCWs were statistically score was not associated with the level of education. Age and
significantly associated with a higher level of education marital status did not affect KAP scores (Table 4).
(P<0.001) & (P=0.02), respectively. However, the practice
Table 4
Effect of Age, Marital status, and level of Education on KAP Score
Knowledge # Attitude # Practice #
Characteristics N (%) P P P
(Mean±SD*) (Mean±SD*) (Mean±SD*)
20-29 76 (44.4) 42.68±2.11 28.93±1.73 20.37±1.41
Age Group 30-39 47 (27.5) 43.26±1.76 29.11±1.37 20.28±1.87
(Years) 40-49 28 (16.4) 42.82±2.70 28.50±1.73 20.43±1.16
> 50 20 (11.7) 42.30±2.43 0.33 28.95±1.31 0.45 20.60±0.94 0.87
Marital Married 109 (64) 42.73±2.22 28.85±1.49 20.39±1.45
Status Unmarried 62 (36) 42.96±2.08 0.5 29.01±1.76 0.52 20.35±1.50 0.86
Postgraduate 47 (27.5) 43.85±1.25 28.49±1.76 20.21±1.74
University 33 (19.3) 43.09±1.40 29.18±1.10 20.42±1.45
Intermediate 30 (17.5) 42.77±1.97 28.50±1.87 20.47±0.93
Level of
Education High School
39 (22.8) 42.31±2.27 <0.001 29.49±1.25 0.02 20.44±1.68 0.92
Education
Less than high
22 (12.9) 41.18±3.36 28.95±1.67 20.45±1.05
school education
*SD: Standard Deviation. #P values were calculated using a student t-test between two groups and an ANOVA test for more than two groups. P<0.05 was
considered to indicate significance. Bold values show significant differences.
Superscripts

Multivariate linear regression reaffirms that knowledge and Practice sore of female HCWs was significantly
attitude scores were significantly associated with profession associated with their knowledge. In this study, we found a
(P <0.001 and P=0.04) and level of education (P value positive correlation between knowledge and attitude score,
<0.001and P=0.01), respectively. Gender was associated with and a significantly positive correlation was found (Figure 1).
practice scores (P=0.03) (Table 5).

4 Microbes Infect Chemother, 2022, v.2, 1-8, e1457

 KAP among HCWs regarding COVID-19

Table 5
Multivariate linear regression of demographic characteristics with KAP
Variables Knowledge Attitude Practice
Unstandardized Unstandardized Unstandardized
coefficient P* coefficient P* coefficient P*
# # #
(95% CI) (95% CI) (95% CI)
-0.016 -0.03 0.039
Age (Year) 0.67 0.56 0.48
(-.090 to .059) (-.130 to .071) (-.072 to .150)
Gender -0.017 -0.021 0.055
0.32 0.37 0.03
(Male/Female) (-.052 to .017) (-.068 to .025) (.004 to .106)
-0.389 0.207 0.178
Professions <0.001 0.04 0.11
(-.538 to -.239) (.005 to .409) (-.044 to .400)
Marital Status 0.012 0.014 -0.01
0.5 0.54 0.7
(Married/Unmarried) (-.023 to .046) (-.032 to .061) (-.061 to .042)
-0.273 0.154 0.111
Level of Education <0.001 0.01 0.1
(-.364 to -.182) (.031 to .276) (-.024 to .247)
*P<0.05 was considered to indicate significance. Bold values show significant differences.
#CI: Confidence Interval.

Figure 1 Discussion
Correlation scatters among knowledge, attitude, and practice
of HCWs. A: Knowledge vs. Attitude, B: Knowledge vs. HCWs are the frontline warriors in the battle against
Practice, C: Attitude vs. Practice COVID-19. They are exposed to occupational hazards,
including exposure to SARS-CoV-2, stigma and discrimination
in society, heavy workload, and prolonged use of personal
protective equipment (PPE) (World Health Organisation
2020c). A poor understanding of the disease among HCWs
results in delayed identification and treatment and may lead
to a greater risk of spreading the disease. As an essential part
of the health care system, HCWs' KAP plays a vital role in
preventing and spreading COVID-19.

In our study, the mean score for KAP regarding

COVID-19 was more than 95%, suggesting HCWs had
moderate knowledge, an optimistic attitude, and practice
scores. Similarly, Ahmed F. et al. (25) reported that among
HCWs, 83.7% had good knowledge, 78.9% had a positive
attitude, and 77.6% had good practice scores. Furthermore,
these results are consistent with previous studies, which
reported that around 90%-95% of HCWs had good knowledge,
positive attitudes, and adequate practice scores toward the
COVID-19 infection (23, 26, 27).

In this study, knowledge score was associated with a

higher level of education and profession (P<0.001) and was
found to be statistically highly significant. The mean
knowledge score was maximum for resident doctors (44.09)
compared to others. These results agree with the results of
Mushi A. et al. (28), who reported that good knowledge
scores were significantly associated with higher educational
level, physician occupation, and age >49 years old. A study by
Almohammed A. et al. (29) reported that poor knowledge
was associated with low education. However, a study by
Tamang N.et al. (30) found that the factors affecting
knowledge are age, gender, level of education, marital status,
profession, work experience, source of information, infection
prevention and control (IPC) training, and online
course(p<0.05). The factors significantly associated with

Microbes Infect Chemother, 2022, v.2, 1-8, e1457 5

Kumar-Munjal S, Singh-Dhakad M, Kumar M, Gogoi S

adequate knowledge were male gender, nurse, doctor, and score was significantly associated with both attitude and
IPC training. practice scores.

In this study, the attitude score was statistically Attitude score was significantly associated with
significantly associated with profession (P=0.01) and practice score. In another study, Pham A. et al. (34) in Vietnam
education level (P=0.02). This study's attitude score agrees found that those with sufficient knowledge and a positive
with the results from earlier studies. A study by Almohammed attitude towards COVID-19 were more likely to have good
A. et al. (29) found that the participants from the nursing preventive practices. Asdaq S. et al. (36) found that the
profession demonstrated a less favorable attitude. Among attitude score increased significantly with an improvement in
nurses, a master's degree is related to more positive attitudes. knowledge. Besides, there was a greater association between
Ahmed F. et al. (25) found among HCWs that a positive attitudes and practices. A significant enhancement in the
attitude was predicted by sound knowledge and female practice score of the professionals was noted with an increase
gender. In another study, Hussain I. et al. (23) found that in knowledge score, an indicator of a positive correlation
attitudes toward COVID-19 significantly differed with age, between practice and knowledge scores.
marital status, profession, hospital, and residential place.
In this study, the primary source of knowledge and
Similarly, Haghighi F. et al. (29), found male gender information among HCWs was Television (n=48; 28.1%),
was correlated with more correct attitudes. Tamang N.et al. followed by Newspaper & television (n=42; 24.6%), MoHFW
(30) found that positive attitudes were significantly (n=21; 12.3%), WHO website & social media (n=11; 6.4%). Similar
associated with online courses related to COVID-19. results are shown by Kaihan Y. et al. (37), who found Mass
Conversely, Basnet S. et al. (32) found that the HCWs with a media as the primary source of knowledge and information on
clinical experience level of one to five years or more were COVID-19. This corroborates with a study by Abhisek S. et al.
significantly associated with a negative attitude. (38), which showed that more than three fourth (82.1%) of the
participants reported their primary source of knowledge was
In this study, practice score was not associated with news media, while only less than half of the participants
profession and level of education. Nurses and MTS had (44.9%) reported government official websites. In another
significantly better practice scores than resident doctors. study , Albahri A.et al. (39) found that official health
Practice score among female HCWs was significantly organizations were the primary source of information for
correlated with their knowledge. Similar results were shown 91.5% (161/176) of participants, and only 38.1% (67/176)
by Maheshwari S. et al. (33), that gender had a significant reported using scientific journals as one of their sources.
impact on practice scores (P <0.05). Pham A. et al. (34) found
that the female participants, and the receiving of information Few other studies found social media as the primary
from the official websites, reported a significantly higher level source of information. Khasawneh A. et al. (40) found medical
of good practice. Haghighi F. et al. (31) found that 2 - 5 years of students used primarily social media (83.4%) and online search
work experience was associated with better practice among engines (84.8%) as their preferred source of information on
nurses. Conversely, in another study Almohammed A. et al. COVID-19 and relied less on medical search engines (64.1%).
(29), found males were more likely to practice most of the Huynh G. et al. (41) found that HCWs predominantly used
time appropriately. social media to inform themselves about COVID-19 (91.1%).
Alrubaiee G. et al. (42) found that 57.1% of the respondents
In a study, Tamang N. et al. (30) reported that obtained their information via social networks and news
profession, education of master's degree or above, and online media, and a further 60.0% had never attended lectures/
courses are statistically significantly associated with practice discussions about COVID-19.
scores (p < 0.05). In another study, Hussain I. et al. (23) found
a significant difference in practice scores across the Limitations of the study. HCWs may have good
participants' age, educational level, hospital, and residence. In practice scores in our specialty hospital institute. This may lead
a study by Ronald Olum et al. (21), they found factors to excellent to good practice scores. Stratified random
associated with good practices were an age of 40 years or sampling was applied among the different cadre of HCWs to
more and holding a diploma. Ahmed F. et al. (25) found among have equitable distribution as maximum as possible to reduce
HCWs that practice was associated with good knowledge of selection bias. In this study, the data presented were partly
COVID-19. dependent on the participants' honesty, recall ability, and
self-reported, which could have resulted in recall bias. In most
In this study, we found a positive correlation cross-sectional questionnaire-based studies, inherent recall
between knowledge and attitude and a significantly positive bias is expected. The actual practice section of the HCWs is
correlation between knowledge and practice (r=0.188, different from the practice score of the study, as the
p=0.01). These results are consistent with the results of a participants report them. Thus, to provide further depth in this
previous study by Wahed et al. (35), which found a positive section, the observing and auditing approach of the
correlation between knowledge and attitude scores (r=0.215, participants is needed. No previously validated tools
p<0.001). Other researchers found a significant association assessing KAP about COVID-19 among HCWs in hospitals have
between knowledge, attitude, and practice, corroborating determined a cut-off point for adequate or excellent
with the studies (25, 30), which found that the knowledge knowledge, positive attitude, and an appropriate level of

6 Microbes Infect Chemother, 2022, v.2, 1-8, e1457

 KAP among HCWs regarding COVID-19

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significantly positive correlation between knowledge and coronavirus-2019
practice. 7. Eurosurveillance editorial team. Note from the editors:
World Health Organization declares novel coronavirus
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This study revealed that most of the HCWs in our https://doi.org/10.2807/1560-7917.ES.2020.25.5.200131e
institute had good knowledge, positive attitudes, and 8. World Health Organization (WHO). Coronavirus disease
appropriate practices regarding COVID-19 during the second (COVID-19) Weekly Epidemiological Update and Weekly
and third waves of COVID-19 in India. We found that among Operational Update. Available at
HCWs, the primary source of knowledge on COVID-19 was https://www.who.int/emergencies/diseases/novel-
news media such as television and newspapers. Knowledge coronavirus-2019/situation-reports
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Conict of interest 11. Backer JA, Klinkenberg D, Wallinga J. Incubation period of
2019 novel coronavirus (2019-nCoV) infections among
There are no conflicts of interest. travellers from Wuhan, China, 20-28 January 2020. Euro
Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull.
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12. Singhal T. A Review of Coronavirus Disease-2019 (COVID-
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study conception and design: MK, SKM; data collection: MK; Rights as Key to the COVID-19 Response:Parenting in the
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