Knowledge and Preventive Practices towards COVID-19 among staff and students in the Walter Sisulu University, South Africa; a mixed method study

1) Project background, context and needs addressed As the new decade began in 2020, there was also a global increase in infection and death from a deadly invisible virus called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) originating in Wuhan, Hubei Province, China. (1-5) [1-5]. Today, more than 200 countries worldwide are affected by this disease (COVID-19), a fatality rate of 6.87% [6]. Africa accounted for approximately 20.313 (0.84%). Africa had the most reported cases in the Africa continent, 3,158 (15.56%), followed by Egypt 3,144 (15.48%) on 20 April 2020[6, 7]. Africa was a major concern throughout the area. Evidences suggest that human to human transmission is caused as the main symptoms within one week of viral infection by droplets from coughing or snoring or direct contact with contaminated surfaces that may cause tough or / fever or/ or sore throat [4]. Countries worldwide have taken a broad array of steps to avoid the transmission chain of this viruses, and to reduce its harmful impact [8] in response to this deadly global COVID-19 pandemic. One such initiative is the promotion of a high standard of hygiene (e.g., daily soap hand washing), temporary closing of educational facilities, libraries, theatres, shopping mores, dining places, and avoiding religious activities and public meetings, which involves non- pharmaceutical interventions (NPIs). As vaccines and effective therapies are currently not in place for the disease, these steps have been introduced with a view to planning essential services such as high demand medical care [10]. The global trend and magnitude of this pandemic have unmistakably led many African countries, including South Africa, to enforce the postponement and closure of the academic activities of the educational institution in an effort to prevent transmission of the virus [11]. For this reason, the African education sector is now faced with a reduction in funding for advanced innovative research, along with fewer face-to-face conferences and collaborations [12]. Another effect of this pandemic is online education, currently seen as an alternative means of continuing education and its economic impact [13]. As the global fight against COVID-19 continues and plans for alternative forms of learning are being developed, the adherence of students and university faculties to current preventive measures, such as hand washing and social distancing, is crucial. This is because knowledge, attitudes and preventive practices (KAP) towards COVID-19 also play a critical role in this fight [14]. As a result, this study is designed to provide evidence from the assessment of COVID-19 Knowledge, Attitudes and Preventive Practices by staff and students at Walter Sisulu University (WSU), Eastern Cape, South Africa. 2) Aims or research questions being addressed Specific Aim 1: To understand if the staff and students have adequately accurate knowledge about COVID-19 and preventive measures Specific Aim 2: To describe the attitude toward COVID-19 by students and faculties in the Walter Sisulu University, South Africa. Specific Aim 3: To assess the preventive practices toward COVID-19 by students and faculties in the Walter Sisulu University, South Africa. 3) Study design Study design This study would apply a concurrent mixed-method study design involving both quantitative (short online survey for staff and students) and qualitative (KITIs for selected respondents in the institution). Study setting and sampling This study will be conducted in the Eastern Cape (EC) province of South Africa, with an estimated population of 6 712 276 (11.4% of the total population of South Africa in 2019) [17]. There are more than eight (8) higher public institutions in the Eastern Cape, including Walter Sisulu [18]. Walter Sisulu University was established on 1 July 2005 as a result of a merger between Border Technikon, Eastern Cape Technikon and the University of Transkei. The university is named after Walter Sisulu, a prominent figure in the struggle against apartheid and has four campuses, namely Mthatha, East London (Buffalo City), Butterworth and Komani (Queenstown). At present, the university has more than 31,500 students enrolled in various faculties for various academic degrees such as diplomas, bachelor's degrees, honors, master's degrees and doctoral degrees across campuses [19]. 4) Approach used to maximise the impact of research outputs, to improve health and the research community Quantitative approach A short online survey will be used to assess awareness and preventive practices towards COVID-19 among staff and students at Walter Sisulu University. Study Population and sample size: All consenting staff and students in the WSU will be eligible to study. Using Stata statistical software, the minimum sample size of students to be included in this study will be approximately 800 using Stata: since no previous study was available in South Africa, we assumed a 50% knowledge on COVID-19 by students of WSU, effect size of 5% difference, power of 80%, level of significance set at 0.05. Conversely, assuming a 50% knowledge on COVID-19 by staff of WSU, effect size of 20% difference, power of 80%, and level of significance set at 0.05, approximately 320 staff would be enrolled in the study. Data collection: After a preliminary review of the questionnaires that will be adopted, the data will be retrieved using secured online self-administered short questionnaires. Data collection will be done by the study participants who will be sent a link to complete the online survey questionnaire. Measures: Variables to be collected will include sociodemographic variables of study participants (age, sex or gender, occupation, educational status, faculty, department), awareness variables and preventive practices for COVID-19 by staff and students. View the demo online short questionnaire here - https://forms.gle/HVoSYDdvLfevzqsV7. Data management and analysis: Data will be entered into Epidata software and Stata 14.1 will be used for the analysis. Descriptive and inferential analysis will be carried out, where appropriate, with a statistical significance level of 0.05. Qualitative approach A qualitative research method will be conducted to explore knowledge, attitudes and preventive practices towards COVID-19 among purposively selected staff and students. Data collection, management and analysis: Approximately twenty-five key informant telephonic interviews (KITIs) will be conducted among selected students and WSU staff, respectively. Interview questions for the KITIs will be finalized. Interviews will be recorded, and notes will be taken as well. In addition, the recordings would be transcribed and encoded into themes using both content analysis and grounded theory techniques [20, 21]. View the demo interview questions here - https://forms.gle/KBsKqMJ1f5yv46PEA. Ethical considerations This proposal will be submitted to the Faculty of Health Sciences Research and Ethics Committee for ethical approval, along with the completed Ethics Application Form. Data would be anonymized in accordance with the ethical principles for protecting the information of study participants. All completed data will only be made available to appropriate study personnel and stored in locked cabinets at Walter Sisulu University. 5) Expected outcomes I expect the study to produce manuscript publications and abstract for conference presentation. I am also optimistic that the findings will also provide additional pilot data to develop another grant application that will focus on developing interventions that would facilitate high-level preparedness for future emerging diseases. In addition, the process of conducting this study would enhance my expertise and skills in formulating, designing health interventions and conducting multi-disciplinary and international research projects. 6) Your role in the project - I would be an investigator.