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Knowledge and Attitude about Covid-19 Pandemic Containment Measures among Students in Technical Institutions in Kakamega County, Kenya

Erick Wanyama Mukoche*, Maximilla Wanzala, Edwin Kadima Wamukoya

Department of Public Health, Masinde Muliro University of Science and Technology

Abstract: Objectives: The goal of this research was to determine how well students understand and their attitudes towards strategies to prevent the spread of the COVID-19 pandemic. Study Design: Cross-sectional research was conducted using a questionnaire. Technical Vocational Education and Training (TVET) students in three institutions filled out the survey after it was made available to them physically and online. Methods: It was determined whether or not there was a statistically significant correlation between KAP (knowledge and attitude) and other socio-demographic factors by using chi-square testing. Using binary logistic regression, we were able to isolate and adjust for any confounding variables. SPSS was used for the statistical analysis (version 26). Results: According to the respondents' demographic information, the vast majority of participants were male. Participants' average age was under 24. 42% (165/392) of the sample exhibited above-average expertise (good knowledge level [GKL]). As a whole, 42% of those polled had heard of COVID-19 and understood that it is a respiratory virus. Male students had less COVID-19 knowledge than female students (OR = 0.54, p = 0.01), suggesting that gender plays a role in students' exposure to and understanding of the virus. The aggregated attitude items showed that 63.5% of people had a favorable outlook. Sixty-six percent of those polled were concerned about a member of their immediate family contracting COVID-19. It was revealed that students with GKL had a considerably lower rate of anxiety (28.2%, p = 0.015). Knowledge was shown to have a positive association with attitudes (r =.48, p .001), while attitudes were found to have a positive correlation with behaviors (r =.23, p .001). Conclusions: Overall, the survey found that more than half of respondents had enough understanding, and that those with higher levels of expertise were more inclined to go to the appropriate authorities for help. To further understand cultural similarities and variations, the study suggests that future research poll a larger sample of students and those from other nations.

Keywords: TVET, students, knowledge, attitude, sociodemographic characteristics, prevalence, COVID 19

Received January 19, 2023; Revised February 25, 2023; Accepted March 06, 2023

Citation: Erick Wanyama Mukoche, Maximilla Wanzala, Edwin Kadima Wamukoya, Knowledge and Attitude about Covid-19 Pandemic Containment Measures among Students in Technical Institutions in Kakamega County, Kenya. American Journal of Public Health Research, 11 (2). 62-68. January 2023. doi:10.12691/ajphr-11-2-4

1. Introduction

As reported by the World Health Organization (WHO) in Geneva, Switzerland, the new coronavirus (pandemic) has been dubbed "Corona Virus Disease 2019" (2019-nCoV) [1]. On January 30, 2020, the World Health Organization proclaimed a worldwide public health emergency (pandemic) due to the new corona virus [2]. More than 150million individuals have been infected with COVID-19 globally, and more than 3million have died from the virus in various parts of the globe. As of 2020-08-02, all of Africa has reported a total of 802,792 confirmed cases of COVID-19, with 13,779 fatalities, according to a report by WHO Africa [1]. On 13th March 2020, the first case of COVID 19 was confirmed in Kenya (MoH, 2020). Since then, the SARS-CoV-2 has spread to 44 counties with 160,000 confirmed cases and 2,500 deaths as at July 2021 [3,4].

COVID-19 forced millions of students worldwide to shift their learning from school to a home environment. According to Daniel [5], remote learning was associated with many challenges since it required preparations to ensure that students get all the required resources. According to Imran et al. [6], staying away from school significantly impacted to the social, physical, and emotional development of students. As a result, the quality of education and guidance that all students received changed, negatively impacting their developmental process.

A study on knowledge by Olaimat et al., [7] found that 348 out of 350 participants (88.1%) knew a lot about COVID-19, with the majority of healthcare professionals learning about the virus from social media (73.6%) and television (82.6%). 75.5% and 82.6% of participants said, that COVID-19 has no specific treatment and vaccine, respectively (71.5 percent). But 424 (80.3%) of people say they learned about COVID-19 via TV/radio, with 372 (70.5%) saying the same thing about social media [7]. According to a survey conducted by, 67.6 percent of pupils believe that COVID-19 may be spread via the air. This amounts to 276 students. Similarly, 375 (91.9%), 343 (84.1%), and 324 (79.4%) of the participants said that patients with COVID-19 can present with fever, dry cough, and shortness of breath, respectively; 293 (71.8%) of the students have gotten information about COVID-19 from mass media (TV, magazines, newspaper, radio); and nearly fifty percent (54.2%) of the participants have gotten information from social media (Facebook, Instagram, Whatsapp, and telug). Results from studies across Europe that seem to contradict each other. The findings are not entirely clear, thus more research is needed.

With regards to attitudes, Adnan, [8] performed research on students' perceptions of online education in the midst of the COVID-19 epidemic in Pakistan, echoing the approach used by Zhou & Li [9]. They see that, like many other elements of life, education has been severely impacted by the COVID-19 pandemic. Using it, students may easily make the switch from the more conventional methods of learning to the novel approach of virtual learning. In addition, since this is the first-time online education has been widely used, it poses unique issues for both students and educational institutions. It was impossible to know how long the epidemic would last, so that was out [8]. In particular, students in rural and underserved parts of Pakistan faced difficulties due to a lack of inexpensive and dependable internet connections. Some students were unable to participate in the learning process because they were unable to access online resources because of difficulties accessing them through cellphones [8]. In nations with a robust digital infrastructure, online education has the potential to be very successful. However, due to a lack of cutting-edge digital infrastructure, online education in Kenya is inefficient.

There’s a lack of previous studies determining the impacts of strategies on students affected their reliance on positively impacting learners’ perception of academic performance and social-emotional development [10]. Students' responses to the spread of the COVID-19 epidemic in different parts of the world are mostly unknown [11]. There is evidence in the research to suggest that the COVID-19 epidemic had a detrimental impact on students' perspectives and attitudes about learning, but some students had adjusted to the new realities. Because of this context, the study sought to evaluate students' levels of understanding, and attitudes towards pandemic containment measures against covid-19 in Kakamega County, Kenya.

2. Methods

This study focused on gathering quantitative information through the implementation of a cross-sectional study design. Participants were excluded because of an incomplete questionnaire and others due to lack of a consent form. The purpose of the study and the procedures of the questionnaire were explained to the participants. Those who agreed to participate completed an informed consent form and the questionnaire. The participants completed the questionnaires in person enabling them to ask questions or withdraw from the study at any time during the data collection. No incentive was provided to participants. All study protocols and the survey instrument were approved by the University Human Research Ethics committees and conducted in accordance with the ethical principles of the Declaration of Helsinki. To conduct the study among Kakamega students, a research authorization from the National Council of Science and Technology (NACOSTI) was sought. NACOSTI License Number was NACOSTI/P/22/17110

2.1. Study Area

The research was conducted in Kakamega County, which is in the western part of Kenya among three Technical and vocational training institutions. A breakdown of enrolment at three Kakamega County technical schools is shown in Table 1.

Table 1. Summary of number of students as per the registry office

2.2. Participants

The population of current study was technical students. Then the targets, sets of measures, research procedures, sampling days, and details of the study which were conducted according to the study process, was explained to the subjects, and they were asked to hand in the consent form, and study and sign the written pledge. The inclusion criteria for the volunteers were that they were students. Researchers excluded potential participants who did not meet these criteria from the study. Random sampling was used to obtain a sample for inclusion in this research in the first phase of the study. The study population was 422. The total response rate was 93 percent, meaning that more students responded to the survey than were anticipated during the sample size calculation process. A response rate of 50% is considered sufficient, 60% is considered excellent, and 70% is considered very good by [12].

2.3. Protocol

The information was gathered over the course of two weeks via the use of a self-administered questionnaire that had been pre-coded based on previous research [9,12,13]. Students were given the questionnaires and consent letters either by a research assistant or via an internet connection. Similar studies conducted in other countries have shown the reliability of using self-report as a behavior measurement tool [13]. The sequencing and subject of questions in the questionnaire was based on the research objectives. The questionnaire contained 3 different domains: 1) demographics; 2) knowledge items; 3) and Attitude items on covid- 19 containment measures. Data were presented descriptively, and an 18-item scale was constructed to measure participants' familiarity with the virus, its manifestations, and preventative measures. The scale's internal consistency was calculated to be 0.77 using the Cronbach's alpha value. Each right answer counted for one point. We recoded a scale such that a score of 27.16 or below indicates an acceptable knowledge level (AKL), while a score of 27.17 or above indicates an excellent knowledge level (GKL). Attitudes construct was assessed using 14 items scored on a Likert scale. At the Shagungu Vocational Training Centre, the questionnaire instrument was pre-tested. Deficits were identified by comparing data from the preliminary test. Discrepancies with the instrument were corrected using necessary adjustments before using it to ensure validity.

2.4. Statistical Analysis

The expectation-maximization (EM) technique was used to randomly impute missing data in order to remove any potential statistical biases that might arise from utilizing more conventional missing data processes, such as list-wise deletion or pair-wise deletion [14]. Descriptive statistics such as mean and standard deviation were used to describe data. Both univariate and multivariate statistical methods were utilized to examine the correlation and dissimilarity between the dependent and independent variables. Chi square test of independence and logistic regression were used to check association between categorical variables. Findings were considered significant at p <0.05. Researchers used IBM SPSS version 26 for statistical analysis.

3. Results

The background results of the respondents revealed that majority of the respondents were male (n = 197, 50.3%). The average age of the respondents was less than 24 years (n=197, 50.3%). Majority of the respondents were single (n = 306, 78.1%) and were studying for diploma qualification (n = 238, 60.7%). In addition, most of them were in their second year of study (n = 192, 49.0%). Summary of findings in frequencies and percentages are presented in Table 2. Chi-square test of independence was performed to examine the relation between social demographics and respondents’ institution. The relation between institution and the variable education (χ2(df=1, n=392) =48.28, p<0.01) and year of study (χ2(df=2, n=392) =63.46, p<0.01) were statistically significant and the rest were all not statistically significant.

Table 2. Sociodemographic characteristics of respondents

3.1. Knowledge about COVID-19

Of the total sample of 392 participants, 55% had acceptable knowledge levels (AKL; n=219) and 42% had excellent knowledge levels (n=168) (GKL). The total sample size was n=167, and 42% of those people knew that COVID-19 is a virus that mostly affects the lungs. Bats are thought to be COVID-19's natural host, although only 45% of the general public knows this (n=177). It was reported that 94.5 percent, 93.1 percent, 39.8 percent, and 26.5 percent of respondents were aware that COVID-19 could be spread through sneezing, coughing, touching one's face, eyes, nose, or mouth with contaminated hands, coming into direct contact with patients, or touching contaminated surfaces (Table 3).

Table 3. Students’ knowledge about COVID-19

Logistic regression findings are shown in Table 4, which confirm that the amount to which students know about COVID-19 varies considerably by gender; men had lower knowledge levels compared to males (OR = 0.54, p = 0.01). In compared to those aged 24 or younger, individuals aged 25-29 (OR = 1.841, p = 0.004) and older than 30 (OR = 3.462, p 0.001) showed a greater degree of COVID-19 understanding. Students in their second (OR = 2.717, p 0.001) and third (OR = 2.249, p = 0.003) years of college were also statistically significantly more likely to have GKL than those in their first year of college. Compared to students at Sigalagala University, those at Shamberere University were shown to be the least likely to have GKL (OR = 0.235, p = 0.016).

Table 4. Effect of different significant variables on the level of respondents’ knowledge; obtained by binary logistic regression (odds ratios and 95% confidence intervals

3.2. Attitude toward COVID-19

Table 5 shows that the majority of respondents (66.6%) were concerned that a member of their immediate family might get COVID-19, and that an astonishing 7.1% of respondents believed that all people, regardless of socioeconomic class, should take precautions against contracting COVID-19. When asked what they would do if they or a family member showed signs of COVID19, 58.9 percent said they would contact the proper authorities for help. The overall results of the attitude survey showed that 63.5% (n= 249) had an optimistic outlook whereas 36.5% (n= 143) had a negative outlook.

Table 5. Students’ attitudes toward COVID-19

According to Table 6, whereas over 66.4% of respondents were concerned that a family member would get COVID19, students with GKL were found to be substantially less likely to be concerned (28.2%, p = 0.015). Students with AKL were more likely to agree that precautions shouldn't be limited to high-risk populations and the elderly (34.6 percent, p = 0.018). (49.9 percent respectively). Participants with GKL were also more likely than those with AKL to reach out to the proper authorities for guidance (30.5 percent vs. 12.5 percent, p 0.001). (28.7 percent). There was a statistically significant difference (p = 0.004) in the percentage of students with GKL and AKL who believed that local government efforts to stop the spread of COVID 19 would fail (23.3 percent respectively). In addition, 35.1% more pupils with GKL than AKL held the view that the Kenyan government's preventative efforts were neither timely nor enough (43.7 percent respectively).

Table 6. Distribution of different students’ attitudes and measures with their knowledge level about COVID-19

4. Discussion

The objective of this study was to assess knowledge and attitudes of TVET students towards COVID 19 containment measures. Although fewer than half of the participants in this research had an in-depth understanding of COVID-19, the findings reveal that none in the sample group was fully unaware of its existence. Both the date of the research and the widespread media coverage of the COVID-19 pandemic in Kenya at the time might be to blame. A survey of health care professionals revealed disparities in COVID-19 knowledge and opinion within specialties; the very small proportion of research participants with excellent knowledge is in line with those findings [15]. However, the percentage of participants with a good knowledge level is lower than in studies conducted among different segments of society against MERS [16,17] and against COVID-19 [1,9,18,19], where participants demonstrated good knowledge with regard to transmission, symptoms, and treatment of COVID-19.

The level of skill expected varied depending on the kind of question being asked. Only around half of those polled knew that COVID-19 is a respiratory virus, but almost all understood how it spreads and agreed that maintaining high standards of personal hygiene is the best approach to protect against infection. Diploma program students learned more than their non-diploma counterparts. This may be due to the fact that these students are enrolled in health-related courses, which has raised their knowledge of pandemic threats like COVID-19. These findings are consistent with previous research showing that college students know more than those outside of college [20,21], but they contradict the results of a study conducted in Jordan that found no significant difference between the mean of medical and non-medical students in terms of knowledge, attitude, and practice level [20]. Olum et al. [22] conducted research in Uganda and discovered that, generally speaking, women had lower levels of knowledge than males. We discovered no significant relationship between gender and specialization in either knowledge or attitude, in contrast to earlier studies [9,19,23] that revealed females had a substantially higher score than men [24].

Unexpectedly little knowledge of COVID 19 exists among Kenyan students, despite Facebook's dominance as the country's preferred social networking tool. The media in Kenya has been notably silent on the topic of the COVID-19 outbreak, in contrast to other countries where the official government spokesman and the Minister of Health held two press conferences per day on national TV channels regarding the latest updates about COVID-19 and relatable information regarding this disease, including modes of transmission and preventive instructions. Our findings challenge the notion that the media plays a significant role in disseminating information about the COVID-19 and SARS epidemics, which has been the conclusion of previous studies [25,26]. Our finding is generally in line with those of previous studies [15,27,28,29,30] which revealed that most participants used social media to learn about COVID-19.

4.1. Attitudes towards COVID 19 Containment Measures

Most were worried that someone close to them would get COVID-19, and they all agreed that everyone should take the necessary safety measures. Similar findings have been found in a large body of prior research conducted in Egypt [28] and Pakistan [31]. Our findings show that only about a third of those who identify as young do not believe they can be infected with COVID-19, despite the fact that many studies have found that young people make up a disproportionate share of those infected with COVID-19 [2,32,33]. The study's findings provide strong evidence that exposing participants to additional information about COVID-19 improved their impressions of the virus. While AKL students were more worried about catching COVID-19, GKL students were more inclined to say that everyone, not only the elderly and those at high risk, should take precautions. Results also showed that those with GKL were less confident in their immunity to COVID-19 than those with AKL. On top of that, just 26% of people said they were confident in the ability of local authorities to effectively deal with confirmed and suspected cases of COVID-19. A lack of financial and medical resources, as well as gaps in the health care system, may account for discrepancies between our findings and those of research including other communities [9,13,34].

5. Conclusions

In conclusion, over half of the respondents had adequate knowledge, and just under half had excellent knowledge, based on all the questions used to measure knowledge in this study. Significant findings were also seen with increasing years of study; students in their second year or beyond were more likely to have strong knowledge compared to first-year students. The second inquiry aimed to uncover how students felt about efforts to rein in COVID-19. Participants with superior expertise were also more inclined to approach the appropriate authorities for guidance and support.

6. Recommendations

Based on the findings of this research, the following are the recommended corrective measure which can contribute to effective COVID 19 containment measures. Future studies could attempt to survey a greater number of students, as well as those from other countries, in order to observe cultural similarities and differences. This in turn could help us identify how Kenyan students compare to those of other locations; maybe there are philosophical and or concrete training differences.

Disclaimer

The findings and conclusions presented in this manuscript are those of the authors and do not necessarily reflect the official position of Masinde Muliro University.

Funding

There was no external funding for this study.

Abbreviations and Acronyms

COVID-19: Corona virus disease-19

MERS: Middle East Respiratory Syndrome

NACOSTI: National Council of Science and Technology

SPSS: Statistical Package for Social Sciences version

TVET: Technical Vocational Education and Training

WHO: World Health Organization

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