Sociodemographic characteristics of the respondents
The sociodemographic characteristics of the respondents are presented in Table 1. A total of 1106 West African adults (≥ 18 years) residing within 975 (87.9%) and outside 131 (12.1%) of the region, respectively, completed the online survey, with 50.4% females and 49.5% males. The average household size was 5.33 ± 3.853, with 52.5% of respondents having between four and six children. Describing their area of residence, most (75.9%) indicated that they lived in an urban setting. Age group composition includes ≤ 20 years (3.9%), 21–30 years (41.8%), 31–40 years (39.1%) and ≥ 41 years (12.2%), with a mean age of 32.14 ± 8.359 years, and missing age for 3% of the participants. More than half (51.7%) of the respondents were married, and 51.4% identified as Christians. Majority (90.6%) had tertiary education and 64.6% worked in the public or private sector, apart from health care professionals (11.4%). Table 1 shows the distribution of participants by country of origin with the highest number (49.6%) of respondents from Nigeria.
Table 1
Sociodemographic factors of the respondents
Variables
|
|
Number of respondents (%)
|
Mean ± SE
|
Country of residence
|
Nigeria
|
470 (42.5)
|
|
Ghana
|
184 (16.6)
|
|
The Gambia
|
179 (16.2)
|
|
Senegal
|
75 (6.8)
|
|
Liberia
|
28 (2.5)
|
|
Other WAC
|
39 (3.5)
|
|
Outside WA
|
131 (11.8)
|
|
Gender
|
Male
|
547 (49.5)
|
|
Female
|
557 (50.5)
|
|
Age group
|
≤ 20
|
43 (3.9)
|
|
21–30
|
462 (41.8)
|
|
31–40
|
432 (39.1)
|
|
≥ 41
|
135 (12.2)
|
|
Mean Age
|
|
1071
|
32.14 ± 8.359
|
Educational status
|
Senior Secondary
|
92 (8.3)
|
|
Tertiary
|
1002 (90.6)
|
|
Vocational
|
9 (0.8)
|
|
Total years of formal education
|
|
1070
|
17.28 ± 4.374
|
Household size
|
1–3
|
282(26.3)
|
|
4–6
|
563(52.5)
|
|
> 6
|
228(21.2)
|
|
Mean household size
|
|
1073
|
5.33 ± 3.853
|
Area description
|
Urban
|
693 (75.9)
|
|
|
Rural
|
25 (2.6)
|
|
|
Suburban
|
196 (21.4)
|
|
Occupation
|
Student
|
186 (16.8)
|
|
Public/Private servant
|
714 (64.6)
|
|
Unemployed
|
74 (6.7)
|
|
Health Professionals
|
126 (11.4)
|
|
Marital Status
|
Single
|
499 (46.5)
|
|
Married
|
554 (51.7)
|
|
Others
|
19 (1.8)
|
|
Religious affiliation
|
Christian
|
568 (80.3)
|
|
|
Islam
|
125 (17.7)
|
|
|
Others
|
12 (2.0)
|
|
WA: West African; WAC: West African Countries; Religious affiliation (Others): Traditional religion and no response; Marital status (Others): Divorced, widowed and separated. |
Knowledge of respondents about COVID-19: Causative agent, means of transmission, main symptoms, high-risk group and places, and who should be tested.
The respondents’ knowledge score on COVID-19 is presented in Table 2, with an average knowledge score of 67.82 ± 8.31. The knowledge score was significantly associated with the country of residence (P = 0.000) and marginally with settlement type (P = 0.05), but not with gender, age, occupation, religion, marital and educational status.
Table 2
Knowledge score of the respondents and multiple linear regression on factors associated with COVID-19 knowledge.
Variables
|
|
Knowledge score (%)
|
Coefficients ± SE
|
P-value
|
Country of residence
|
Nigeria
|
68.50 ± 8.23
|
-0.649 ± 0.137
|
0.000
|
|
Ghana
|
68.33 ± 7.57
|
|
|
|
The Gambia
|
69.06 ± 8.68
|
|
|
|
Senegal
|
66.86 ± 8.39
|
|
|
|
Liberia
|
69.47 ± 8.86
|
|
|
|
Other WAC
|
62.03 ± 8.70
|
|
|
|
Outside WA
|
70.49 ± 7.75
|
|
|
Gender
|
Male
|
67.88 ± 8.72
|
0.388 ± 0.635
|
0.32
|
|
Female
|
68.44 ± 8.20
|
|
|
Age group
|
≤ 20
|
68.37 ± 7.94
|
0.395 ± 0.319
|
0.86
|
|
21–30
|
68.27 ± 8.89
|
|
|
|
31–40
|
67.90 ± 8.31
|
|
|
|
41 and above
|
68.63 ± 7.61
|
|
|
Area description
|
Urban
|
69.58 ± 8.33
|
0.444 ± 0.373
|
0.05
|
|
Rural
|
69.36 ± 8.11
|
|
|
|
Suburban
|
68.01 ± 8.11
|
|
|
Religious affiliation
|
Christian
|
67.83 ± 9.61
|
1.010 ± 0.645
|
0.75
|
|
Islam
|
69.77 ± 9.46
|
|
|
|
Others
|
29.29 ± 3.57
|
|
|
Educational status
|
Senior Secondary
|
29.30 ± 3.63
|
2.104 ± 1.475
|
0.07
|
|
Tertiary
|
33.50 ± 3.32
|
|
|
|
Vocational
|
29.67 ± 3.64
|
|
|
Occupation
|
Student
|
29.19 ± 3.58
|
2.104 ± 1.475
|
0.06
|
|
Public/Private servant
|
28.00 ± 4.63
|
|
|
|
Unemployed
|
29.70 ± 3.51
|
|
|
|
Health Professionals
|
68.31 ± 8.61
|
|
|
Marital Status
|
Single
|
67.98 ± 8.31
|
-0.187 ± 0.660
|
0.63
|
|
Married
|
69.65 ± 7.65
|
|
|
WA: West African; WAC: West African Countries; Religion (Others): Traditional religion and no response; Marital status (Others): Divorced, widowed and separated. |
Notably, on the question on “How is SARS-CoV-2 is transmitted?”, 80.80% of the respondents correctly agreed that the disease can be transmitted by respiratory droplets when an infected person coughs, sneezes or speaks. Additionally, 73.40% correctly agreed that SARS-CoV-2 can be contracted by touching contaminated surfaces and then touching one’s face (Fig. 2). Regarding clinical symptoms, most of the respondents (93.40%) agreed that chest pain, fever, dry cough, shortness of breath are the main symptoms of COVID-19. However, only 31.30% know that, unlike the common cold, stuffy nose, runny nose, and sneezing are less common in persons with COVID-19. The proportion of respondents who correctly identified the people most at risk of contracting COVID-19 is 75.1%: people who work in high-risk settings such as hospitals, prisons and other closed settings, 83.7%: overseas travellers, 71.6%: researchers whose research involves close contact with the causative virus or people with COVID-19 and 72.8%: people with compromised immune system. In addition, 62.8% correctly identified old age, underlying chronic diseases and obesity as predisposing factors for severe COVID-19 conditions. Most of the respondents (80.10%) acquired information about COVID-19 from the mainstream media while 66.70%, 64.70% and 45.5% acquired the information from the internet, social media and their friends and family members, respectively (Fig. 3).
Attitude toward COVID-19: Vaccine acceptance, worried about getting infected and what to do if infected with SARS-CoV-2
The willingness of the respondents to receive COVID-19 vaccine is presented in Table 3. Overall, 75.4% are willing to accept COVID-19 vaccine with the highest level of acceptance from those residing in Ghana (92.4%) and the lowest from The Gambian (38.1%) residents, who were mostly (41.5%) undecided regarding COVID-19 vaccine acceptance. The willingness to accept COVID-19 vaccine was significantly associated (P = 0.000) with country of residence, age category, religious affiliation, occupation, educational status (P = 0.013) and marital status (P = 0.026), but not gender (P = 0.89) and type of settlement (P = 0.95).
Table 3
Willingness to accept COVID 19 vaccine.
Variables
|
Yes
(75.1%)
|
No
(9.9%)
|
Undecided
14.6 (%)
|
P-value
|
Country of residence
|
Nigeria
|
398 (84.7)
|
30 (6.4)
|
42 (8.9)
|
0.000
|
Ghana
|
170 (92.4)
|
6 (3.3)
|
8 (4.3)
|
Senegal
|
40 (54.1)
|
18 (24.3)
|
16 (21.6)
|
Other WAC
|
29 (74.4)
|
5 (12.8)
|
5 (12.8)
|
Gambia
|
67 (38.1)
|
36 (20.5)
|
73 (41.5)
|
Liberia
|
16 (57.1)
|
8 (28.6)
|
4 (14.3)
|
Outside WA
|
110 (84.6)
|
6 (4.6)
|
14 (10.8)
|
Gender
|
Male
|
414 (75.8)
|
55 (10.0)
|
77 (14.1)
|
0.89
|
Female
|
414 (74.6)
|
59 (10.6)
|
82 (14.8)
|
Age group
|
≤ 20
|
28 (66.7)
|
8 (19)
|
6 (14.3)
|
0.000
|
21–30
|
318 (69)
|
61 (13.2)
|
82 (17.8)
|
31–40
|
352 (81.5)
|
37 (8.6)
|
43 (10)
|
41 and above
|
115 (85.2)
|
5 (3.7)
|
15 (11.1)
|
Area description
|
Urban
|
574 (83.1)
|
57 (8.2)
|
60 (8.7)
|
0.95
|
Rural
|
20 (80)
|
2 (8)
|
3 (12)
|
Suburban
|
163 (83.2)
|
18 (9.2)
|
15 (7.7)
|
Religious affiliation
|
Christian
|
528 (93)
|
17 (3)
|
23 (4)
|
0.000*
|
Islam
|
92 (74.8)
|
17 (13.8)
|
11.4 (11.4)
|
Others
|
11 (91.7)
|
-
|
1 (8.3)
|
Educational status
|
Senior Secondary
|
57(62.6)
|
17(18.7)
|
17(18.7)
|
0.013
|
Tertiary
|
764 (76.4)
|
95 (9.5)
|
141 (14.1)
|
Vocational
|
7 (77.8)
|
2 (22.2)
|
0
|
Occupation
|
Student
|
133 (71.9)
|
31 (16.8)
|
21 (11.4)
|
0.000*
|
Public/Private servant
|
553 (77.7)
|
60 (8.4)
|
99 (13.9)
|
Unemployed
|
31 (41.9)
|
16 (21.6)
|
27 (36.5)
|
Health Professionals
|
110 (87.3)
|
6 (4.8)
|
10 (7.9)
|
Marital Status
|
Single
|
370 (74.4)
|
63 (12.7)
|
64 (12.9)
|
0.026
|
Married
|
424 (76.5)
|
48 (8.7)
|
82 (14.8)
|
Others
|
19 (100)
|
-
|
-
|
Total
|
828 (75.2)
|
114 (10.4)
|
159 (14.4)
|
|
WA: West African; WAC: West African Countries; Religion (Others): Traditional religion or no response; Marital status (Others): Divorced, widowed or separated. |
In addition, most of the respondents (65.30%) were worried that they or someone they know may contract COVID-19 (Fig. 4A). Similarly, most of the respondents (73.20%) reported willingness to consult health care professionals while 14.50%, 6.40% and 5.60% will go on self-isolation, self-medication/herbal treatment, or other means of treatment, respectively, if they contract the disease (Fig. 4B).
Perceptions on COVID-19: How to prevent getting infected and/or spreading the virus and perception of government intervention
Most of the respondents (96.7%) perceived that avoiding touching your eyes, nose, and mouth with unwashed hands helps prevent SARS-CoV-2 spread. Similarly, 94.6%, 93.6% and 92.6% respectively perceived that ‘the use of alcohol-based hand sanitisers, covering one’s mouth when coughing or sneezing and avoiding close contact with sick people’ could prevent contracting or spreading SARS-CoV-2 (Fig. 5A). On the other hand, perceptions of what constitute COVID-19 preventive measures were highly variable, including getting a vaccination against flu (62.5%), taking food supplements e.g., Vitamin C (53.2%), eating garlic (41.6%), ginger or drinking lemon or neem tea (26.4%), steaming or taking a hot bath/sauna (25.1%), taking antibiotics (19.4%), gargling mouthwash and/or saline water and staying under the sun (14.6%) (Fig. 5A). On treatment and management of COVID-19 patients, 86.1% agreed that isolation and treatment of COVID-19 patients are best for managing the disease (Fig. 5B). Additionally, 8% perceived that their governments' response to the pandemic was “Excellent” while 20% and 34% stated the response was “Very good” and “Good”, respectively (Fig. 5C) and more than half of the respondents felt that prompt measures were taken by their government to curb the SARS-CoV-2 spread.