Discussion
Our results reveal that mean knowledge score was similar amongst adults
and adolescents. However, adult males on average scored better than the
adult females. Overall, 98 % of the study participants knew about COVID
19 and 92% participants acknowledged COVID- 19 as a preventable
infection. Formal school education and belonging to district NWTD and
SWTD (vs. the reference district Khyber) were significantly associated
with higher knowledge score amongst both adults and adolescents. In
addition, formal school education and adults belonging to district
Kurram, Orakzai and SWTD (vs. the reference district Khyber) had greater
odds of believing that COVID 19 is preventable.
The higher mean score amongst adult males that adult females in our
study can be explained by the fact that these districts are culturally
rigid with little opportunity for females to come out. They also have
little opportunities for education and remain confined to homes.
Overall, however, a high proportion of participants was aware of COVID19
and related information. Finding of similar online surveys conducted on
same topic in same time zone are supportive of these findings, although
those research studies reached to settled KP and not NMDs due to
connectivity issues and security reasons.
Ipsos tracker and snap poll conducted in April through Random Digit
Dialer (RDD) with 1000 plus interviews and 73% males, found 93%
respondents aware of COVID19 (18). 12% respondents of this survey were
from Khyber Pakhthunkhwa. Similarly, a web-based survey conducted by AKU
(n= 403) with 30% respondents from Khyber Pakhthunkhwa and 41% males,
found 99.5 % awareness (19).
Online survey conducted in Hubei, China with 6910 respondents, found
90% respondents with correct knowledge of which 66% were women and
64% had Bachler degree (20). A cross sectional survey conducted in
Malaysia with 4850 respondents found 80.5% respondents with correct
knowledge (21). Similarly, a population-based survey of 8591
participants conducted in Iran found 90% respondents knowledgeable
(22).
Our findings further revealed that formal school education and belonging
to particular districts may have a positive association with knowledge
and attitude related to COVID 19. These findings are in line with
literacy rates and the educational opportunities available in these
districts [13]. Another important factor, that may explain the lower
knowledge amongst some districts, is the protracted emergency that
affected these districts intensely and for longer period. Most
population remained displaced (TDPs) due to conflict situation.
Two third of the respondents knew about symptoms of fever and cough, and
handshake as major reason for spread of disease. Three fourth
respondents agreed to consult doctors for sickness. Nearly all
respondents termed it preventable out of which two third identified hand
wash and home stay as means for prevention. Four out of five respondents
knew about test to diagnose the disease.
These findings support the theory of concurrent multisource information
dissemination for a global pandemic. Though Government of Pakistan and
Government of Khyber Pakhthunkhwa launched Risk Communication and
Community Engagement (RCCE) very early but global media played much role
in spreading the knowledge as radio and television were identified major
source of information. This was followed by relatives and health worker.
Displayed material was the least identified source.