Knowledge, Attitude, Perceptions and Practice towards COVID-19: A systematic review and Meta-analysis

Background: Several studies among various population groups have been conducted to investigate the level of knowledge, attitudes, perceptions, and risk reduction practices (KAP) related to COVID-19. A comprehensive review on this topic is important to highlight the areas for improvement and interventions to prevent COVID-19. Thus, the purpose of this study was to summarize the level of KAP about COVID-19 via a systematic review Methods: A systematic literature search was performed using a combination of selected keywords in four scientific databases to identify relevant literature published from January 1 to May 31, 2020. Nineteen articles were included in the systematic review, and sixteen studies in the meta-analysis. The data was analyzed using a random-effects model due to the heterogeneity between the studies. Results: Lack of COVID-19-related knowledge, positive perceptions, and preventive practices were detected and seems widespread. In particular, 56.6% (95%CI: 45.9-67%) of the health care workers (HCWs) and medical students had poor knowledge about COVID-19 and only 46% (95%CI: 15-77) of the total study sample had positive perceptions towards COVID-19. Besides, 81.7% of the sample prioritized practicing hand hygiene to prevent COVID-19, but wearing a face mask to prevent COVID-19 transmission was suboptimal (73.4%). Finally, around eighty percent of the subjects had good knowledge about COVID-19 symptoms (79%) and its transmission (82%) and reported that they avoided crowded places to prevent getting COVID-19 (89%). Conclusion: Evidence-based practices on risk communication and raising awareness should be planned by local governments in collaboration with healthcare organizations. Specifically, educational initiatives for HCWs to prioritize wearing a face mask and practicing hand hygiene should be considered a priority.