Journal of Antivirals & Antiretrovirals
Open Access

Seroprevalence of Antivirals and Risks of Acquiring among Quarantined Individuals in North West Ethiopia: A Survey Study

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Introduction

The new corona virus (COVID-19) has been identified as the cause of acute respiratory disease since the end of December 2019. Later, the World Health organization labeled it as SARS-CoV2 single strain of RNA virus that belongs to the family corona virus of SARS-COV and MERS-COV, for the recent origin of COVD-19 diseases [1,2]. The difference between them is the genetic make- up, clinical presentations, case fatality, and the rate of spread across the world [3,4]. The route of transmission for COVID-19 is respiratory droplets produced from an infected person while sneezing and coughing. It is also transmitted by infected surfaces and objects since the virus can survive everywhere [4]. The main symptom of COVID-19 range from mild (asymptomatic) to severe illness characterized by fever, dry cough, dyspnea, headache, sore throat, and rhinorrhea rarely associated with hemoptysis and respiratory collapse [4,5]. The aforementioned research reported that the COVID-19 pandemic has no effective treatment, but early recognition of higher-risk conditions, risky practice progresses, and early looking for supportive care will radically suppress the spread of these viruses [6].

In Ethiopia, access to COVID-19 testing had a great barrier to understanding the true prevalence of COVID-19 cases in the community [7]. Despite multiple preventive measurements that have been done previously to avoid this abominable disease from the higher-level organization (WHO) to national levels, the success or failure of these efforts largely rely on behavioral changes of the clients. Community acceptance and readiness for the prevention of COVID-19 are still hindered by the false assurance of perception myths and miss understanding on were living far away from areas where COVID-19 was rampant and still no locally reported cases has reflected [8]. So this study aims to assess the sero-prevalence, knowledge and practice of COVID-19 prevention among quarantined individuals in northwest Ethiopia.

Several articles have been researched to provide information useful for the pathology of SARS-CoV-2, with the ultimate goal of devising an effective treatment for the virus, which will provide the least toxicity possible [1-5].

Methodology

Study setting

This study was conducted in Benishangul, Gumuz regions in the North-Western part of Ethiopia which is located with 34°10' N and 37°40' E and in the latitude 09°17' N and 12°06' N [9]. The capital city of the region is Assosa, located at a distance of 659 km in the west, and Pawe also located 565 km North West direction of Addis Ababa [10]. This region covered 0.381 (4.6%) square kilometers of national landmass coverage of Ethiopia. According to the 2019 national population projection has an estimated 1.21 million population been survived [11]. According to the Ethiopian Demographic Health Survey (EDHS) of 2016, 77% of those populations live in rural areas, and 23% live in the urban with five indigenous ethnic groups [11]. Presently, this region has two general, and three primary hospitals, with one regional laboratory, which have to withstand daily healthcare services. Nationally, starting from the COVID-19 outbreak, the regional health bureau has established two COVID-19 diagnosed and treatment centers [4]. Bilaterally, the regional health bureau ordered and prepared interview plate-form for all quarantined individuals during care observation. The projection focused on awareness about the mode of transmission, clinical features, and prevention measures for multilateral community intervention during a pandemic [12]. Entirely, in the quarantine centers, 4233 COVID-19 symptom suspected individuals diagnosed to identify individuals who has COVID-19 on his/her blood serum.

Study design and periods

Institution-based survey was conducted from 21, April 2020-30 December 2020.

Study populations

All quarantined individuals from two quarantine center in Benishangul Gumuz Region.

Sample size determination

Since it was the survey study all quarantined individuals in both quarantine centers included.

Operational definition

Positive sero-prevalence: Quarantined individuals the SARS-CoV-2 IgG antibody test declared having COVID-19 positive results after testing.

Knowledge: The assessment part of knowledge includes about COVID-19 pandemics, using five different dimensions COVID-19 background knowledge using (three items), on sign and symptom (two-item), mode of transmission (six items), and on prevention methods (5) items, and by employing Bloom's cut off point classification range for knowledge, attitude, and practice question classification guideline. Which considered “good” was scored ranges 80%-100%, and “poor” was considered ≤ 79% ranges [13,14].

The practice of prevention: The expression for the practice of prevention items for COVID-19 respondents considered as "good" was scored ranges 80%-100%, and "poor "was scored ranges considered ≤ 79% ranges [13,14]. The prepared survey questionnaire was adopted from WHO (2020) survey tools for COVID-19 prevention practice [15,16], with the consolidation of different national survey findings [17-19].The prepared structured questionnaires’ contained the category of “yes” labeled as “1” and “No” labeled as “0” with each item weighted one point.

Data collection procedure and quality control

Data regarding the socio-demographic, source of information for exposure risk, and prevention practicing for COVID-19 were collected through face-to-face interviews using a structured questionnaire adapted from different literature [17-19], and WHO (2020) Survey tools for COVID-19 prevention measures [15,16]. The tools were developed and validated by a multidisciplinary working group of infectious disease physicians, lecturers, and public health professionals, and environmental team members. Three BSc nurses and two laboratory technicians were collected the data were by supervising strictly by two public health officers.

Data processing and analysis

The data entry was performed using Epi-Data version 3.1 and then exported into STATA/R version 14 (SE) for analysis. The descriptive statics was presented by narration and tabulations. The internal consistency and reliability of the knowledge and practice questions were tested by the reliability test of Cronbach's alpha coefficients, and it is credible ranges i.e., 0.76.

Results

Socio demographic characteristics

Of the overall sample required (N=4233), 4230 individuals were included in this study and giving an overall response rate of 99.8%. The mean (± SD) age of the respondent was 37.5 (± 18.5) years of age, and ranging from 18 years to 98 years. Likewise, more than half, 2,280 (53.90%) of the study participants were male, and two- thirds of them 2,833 (66.97%) were urban dwellers. The majority, 1,536 (36.31%) of the study participant had no formal educations. 1,106(26.15%) having diplomas and above certificates (Table 1).

Table 1: Socio-demographic characteristics of COVID-19 quarantined population in North West regions of Ethiopia 2020.

The overall seroprevalence of COVID-19 for symptom suspected quarantined individuals was found 5.11: 95% CI (4.47-5.87). Of the total 4233, COVID-19 suspected and received SARS-CoV-2 IgG antibody tested, 216 individuals were positive for COVID-19 infections. The largest number of 137 cases out of 2522 (5.43%) COVID-19 diagnosed individuals were from the Assosa quarantine center, whereas the remaining 79 (4.62%) cases out of 1711 suspected individuals were from Pawe quarantine centers, respectively.

Knowledge of respondents towards COVID-19 preventions

Of all participants, 3,889(91.94%) agreed frequent hand washing by soap and water prevents the risk of COVID-19. Whereas, 3,987 (94.26%) quarantined individuals were wearing facemask during let out home prevent the risk of COVID-19. Generally, eighty-six percent of the study participant had good knowledge of COVID-19 mode of transmission, clinical presentations, and knowledge on prevention measures (Table 2).

Table 2: Knowledge towardsCOVID-19 infections among the quarantined population in North West Ethiopia, 2020.

Practice of prevention respondents towards COVID-19

Among the top practiced preventive behaviors implemented by quarantined individuals before quarantining, frequent hand washing, avoiding handshaking, and stopping going in crowded places were reported as follows as 3,772 (89.17%), 3,296( 77.92%), and 3,204 (75.74%), respectively. The overall practice of prevention towards COVID-19 infection on symptoms suspected quarantined individuals were found 62.82%; 95%CI: 60.75-63.8) (Table 3).

Table 3: Practice of prevention towards COVID-19 infection among quarantined population in North West Ethiopia, 2020.

Discussion

This is among the first study done to determine COVID-19 seroprevalence, knowledge, and prevention mitigations on symptoms of suspected individuals. The overall seroprevalence was reported 5.11:95% CI (4.47-5.77). This study finding is higher than the finding in Dire Dawa 3.2% [20], Sweden 4.2%, Canada 1.8%, Germany 0.12% [21,22].This might be low utilization for mass media (radio’ TV, mobiles, and internet) to disseminated COVID-19 preventive messages, in addition to high community myth and behavioral non-adherence for prevention message of COVID-19 in Ethiopia [8]. Likewise, the existence of fragile health sectors, favor undoubtedly the distribution of COVID-19 as compared to the sophisticated health system in western countries [7,21].However, the report of this study is lower than the study finding in Peru 70.0%, Mexico 27%, Brazil 12%, and the Philippines 94.0% [21,23,24]. This might be due to all those studies were population- based estimation, whereas our study is a survey among quarantined populations [25]. This report is nearly comparable with the online survey finding of Ethiopia 91.1% and china 89.1% [25,26].

Knowledge of quarantined individuals towards COVID-19

This study found that the respondent's knowledge about transmission, clinical sign, and prevention of COVID-19 infection was as 86.45%: 95%CI (85.2-87.12). The level of knowledge on COVID-19 on clinical sign and symptoms, transmission, and prevention measure was higher than found in Addis Zemen 33.9%, Addis Ababa 48%, Gonder city 51.04, Dessie city 51.4%, Kombolcha district 54.11%, Amararegions 70% report in Malaysia 70.3% [13,14,17,27-30]. This discrepancy might be attributed to the types of research participants, and the study period when the survey was conducted. Nevertheless, this study report is lower than online survey finding in Ethiopia 91.2%, Dessie city 92.7%, and central Nepal population 91.8% [31-33]. The possible difference could be the due difference in socio-demographic characteristics of the level of education, residence types, and the economic status among the quarantined population.

Practice of prevention towards COVID-19

According to the report of this research, sixty-three percent of respondents had the good preventive practice of prevention for COVID-19 infection. This is higher than the finding on reported Gondar City residents 51.04%, 44.6% reported in Dessie city resident, Dessie health center 41.7%, FMOH reported 49%, systemic reviewing and meta-analysis in Ethiopia 52.83%, and Uganda 32% [6,27,28,32-35]. This finding is lower than reported in Guragie zone 76.2% and online survey finding in Ethiopia 76%. This might be due to the existence of high social cohesion and interdependency Ethiopia makes it difficult to implement practicing rules of COVID-19 infection prevention rules easily. The majority of the Ethiopian population has lived below this economic class this makes difficult to implement always for COVID-19 prevention measures by purchasing soaps, sanitizer and face masks.

Conclusion

Finally, the overall sero-prevalence of the quarantined population in North West regions is high as compared with previously reported. However, the majority of the quarantined population knows how to prevent themselves from the COVID-19 pandemic, but changing this prevention knowledge into the practice of tackling is great hiatus. Even though the respondents having good knowledge for COVID-19 exposed risk prevention but implementing mitigation prevention practice for COVID-19 infections lower as compared with their levels of knowledge.

Limitations

The main limitation of this study was the data involved only quarantined individuals while the difficulty of inferred result for the community.

Declarations

Ethics approval and consent to participate

The ethical clearance and data collection permission obtained from Benishengul Regional health bureau (Ethic Ref. No: BHSC/- 984/16/12), and during the data collection period written consent was assured from individuals beyond addressing permission letters for data collection for two quarantine centers. All information collected from patients was kept confidential and names of patients were not included.

Consent for Publications

Consent of publication was taken from study participants and quarantine centers during data collection period.

Availability of Data and Materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Competing Interests

The authors declared that there is no competing interest.

Funding

The Benishangule gumuz health bureau has supported by finance for data collection wage and printing cost.

Authors' Contributions

FK has drafted original research, write, and organized the collected data

BK and TK participating in preparing manuscript and participate in software analysis

AFA also involved in data analysis, result writing, editing and writing the manuscript.

Acknowledgment

We authors would like to thanks Benishangule Gumuze regional health bureau for their unreserved support during the one-year data collection time.

References

1. Dhama K, Khan S, Singh KP, Tiwari R, Chaicumpa W. Coronavirus disease 2019-COVID-19. Clin Microbiol Rev. 2020;12.
2. Fatmi Z, Mahmood S, Hameed W, Siddiqui M, Dhanwani A, Siddiqi S. Knowledge, attitudes and practices towards COVID-19 among Pakistani residents: Information access and low literacy vulnerabilities. Eastern Mediterranean Health J. 2020;26(12):1446-1455.
3. EPHI. Ethiopian national comprehensive COVID-19 management handbook. 2021.
4. Machhi J, Herskovitz J. WRBDD: The natural history, pathobiology, and clinical manifestations of sars-cov-2 infections. J Neuroimmune Pharmacol. 2020.
5. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. Jama. 2020;323(20):2052-2059.
6. Abate BGHK, Mekonnen CK. Knowledge, attitude and practice towards covid-19 in Ethiopia: A systematic review. Dove Medical Press. 2021;197:156.
7. Morlock AM, Downen M, Sonali N. Shah4: COVID-19 prevalence and predictors in United States adults during peak stay-at-homeorders. PLoS One. 2021;16(1):e0245586.
8. Kebede ZB, Fufa D, Yitayih Y, Abafita J, Belay AJ, Ambelu A. Myths, beliefs, and perceptions about COVID-19 in Ethiopia: A need to address information gaps and enable combating efforts. Plos One. 2020.
9. Kebede F. Time to develop pulmonary tuberculosis and predictors among HIV infected children receiving anti-retroviral therapy in assosa and pawe general hospitals, northwest Ethiopia: A retrospective cohort study. J Pulmonary Respiratory Med. 2020;10.
10. Kebede F, Eticha N, Negese B, Giza M, Tolossa T, Wakuma B. Predictors for a cure rate of severe acute malnutrition 6-59 month children in stabilizing center at pawe general hospital, northwest Ethiopia: Retrospective cohort study. Int J Child Health Nutrition. 2021;10:34-43.
11. UNICEF. Situation analysis of children and women: Benishangul-gumuz region. 2019.
12. Disassa KTT, Worku A. A Preliminary study on molecular characterization of mycobacterium tuberculosis in benishangul gumuz region, western Ethiopia. British Microbiol Res J. 2015.
13. Molla MD. Knowledge, attitude and practice towards COVID-19 among chronic disease patients at addis zemen hospital, northwest ethiopia. Infection Drug Resistance. 2020;13: 13.
14. Koo BKP, Talib RA, Poh BK. Assessment of knowledge, attitude and practice towards whole grains among children aged 10 and 11 years in Kuala Lumpur, Malaysia. Int J Food Sci Nutrition Dietetics. 2015; 171-177.
15. World Health Organization. COVID-19-survey-tool-and-guidance for rapid, simple, flexible behavioural insights on COVID-19. 2020.
16. World Health Organization. Critical preparedness, readiness and response actions for COVID-19. WHO Interim Guidance. 2020.
17. Defar A, Molla G, Abdella S, Tessema M, Ahmed M, Tadele A, et al. Knowledge, practice and associated factors towards the prevention of COVID-19 among high-risk groups: A cross-sectional study in Addis Ababa, Ethiopia. PloS One. 2021;16(3):e0248420.
18. Kassa AM, Mekonen AM, Yesuf KA, Tadesse A, Bogale GG. Knowledge level and factors influencing prevention of COVID-19 pandemic among residents of Dessie and Kombolcha city administrations, North-East Ethiopia: A population-based cross-sectional study. BMJ Open. 2020;10(11):e044202.
19. Gutu B, Legese G,  Fikadu N, Kumela B, Shiferaw FSWMZRY, Tesfaye LBY, et.al. Assessment of preventive behaviour and associated factors towards COVID-19 in Qellam Wallaga Zone, Oromia, Ethiopia: A community-based cross-sectional study. Plos One. 2021; e0251062.
20. Abbasi MA, Arshad M, Khan RNM. Spread of covid-19 and its impact on Pakistan: A need for prospective planning. 2020.
21. Wang P, Nair MS, Liu L, Iketani S, Luo Y, Guo Y, et al. Antibody resistance of SARS-CoV-2 variants B. Nat. 2021;10.
22. Hung LLLN. Knowledge, attitudes and practices of COVID-19 among income-poor households in the Philippines: A cross-sectional study. J Global Public Health. 2021;8.
23. Zhang M, Zhoua M, Tang F, Wang Y, Niea H, Zhang L, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. J Hospital Infection. 2020.
24. Azene ZN, Merid MW, Muluneh AG, Geberu DM, Kassa GM, Yenit MK, et al. Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia. Plos One. 2020;15(12):e0244265.
25. Gebretsadik D, Gebremichael S, Belete MA. Knowledge, attitude and practice toward COVID-19 pandemic among population visitingdessie health centre for covid-19 screening, northeast Ethiopia. Dove Medical Press Infection Drug Resistance. 2021;14:905-915.
26. Kassa AK, Yesuf KA, Tadesse AW. Knowledge level and factors influencing prevention of COVID-19 pandemic among residents of dessie and kombolcha city administrations, north-east Ethiopia: A population-based cross-sectional study. BMJ. 2020.
27. Asemahagn MA. Factors determining the knowledge and prevention practice of healthcare workers towards COVID-19 in Amhara region, Ethiopia: A cross-sectional survey. BMC Tropical Med Health. 2020;48:72.
28. Bekele D, Tsegaye R, Teshome W. The knowledge and practice towards COVID-19 pandemic prevention among residents of Ethiopia. An online cross-sectional study. Plos One. 2021;16(1):e0234585. 
29. Alemu T, Amare S, Legesse S, Abera A, Ayalew M, Bezabih B. COVID-19 knowledge, attitude, practices and their associated factors among dessie city residents, northeast Ethiopia: A cross-sectional study. Risk Management Healthcare Policy. 2021;14:439-451.
30. Sah GS, Shrestha G, Dhakal A, Mulmi R, Sapkota A, Poudel S. Knowledge, attitudes, and practices of cancer patients towards covid-19: A cross-sectional study in central nepal. Cancer Manag Res. 2020; 12:10173-10180.
31. Atkure GM, Tessema SAM, Ahmed M, Tadele FG. Knowledge, practice and associated factors towards the prevention of COVID-19 among high-risk groups: A cross-sectional study in Addis Ababa, Ethiopia. 2020.
32. Bob O, Amodan, Bulage L, Katana E, Ario AR, Joseph N. RCaRKW: Level and determinants of adherence to COVID-19 preventive measures in the first stage of the outbreak in Uganda. Int J Environ Res Public Health.  2020;17: 8810.
33. Melis T, Mesele M, Argaw M. COVID-19 preventive measure practices and knowledge of pregnant women in Guraghe zone hospitals COVID-19. Int J Women’s Health. 2020.