The gaps and strengths towards effective infection prevention and control on a background of knowledge attitude and perception on COVID-19 among undergraduate students in Southeastern Nigeria: a multicentre online cross-sectional survey

The advent of the Coronavirus Disease (COVID-19) pandemic posed a serious health burden locally and globally as it altered people’s daily activities due to restrictive preventive measures instituted by countries and health authorities to curb its spread like wildfire. The undergraduate population remains at the epicentre for the spread and curbing of COVID-19. This study assessed the knowledge, attitude, and perception of COVID-19 among undergraduate students in Southeastern Nigeria. The gaps and strengths achieved towards effective infection prevention and control in the eastern states were assessed. This was a cross-sectional online population-based survey conducted among undergraduate students attending Universities in 5 states (Abia, Anambra, Ebonyi, Enugu, and Imo), located in Southeastern Nigeria from June 29 to July 20, 2020. A structured pre-tested questionnaire was designed for the Google survey tool (Google Forms), and the generated link was shared with students online. From a total of 1,012 respondents from Universities in Southeastern Nigeria, 560 (55%) were females and 452 (45%) were males. The overall mean age of the respondents was 21.63±0.65years. The age distribution did not vary considerably across states (t=-0.007, p=0.995>0.05). The majority (93.8%) of the respondents were Igbos, Yorubas, and Hausas accounting for 2.6% and 0.4% respectively while 3.3% did not identify their ethnic group. Christians (96.0%) were dominant compared to Islam (2.7%) while traditionalists and other non-captured worshippers accounted for 0.5% and 0.8% respectively. Most of the respondents were in second and fourth years in the university. The variation across the states is statistically significant ( =112.01, p=0.000<0.05). The respondents identified that their main source of information concerning COVID-19 was social media (26.9%). The level of knowledge was highest among people in Anambra state (78.0%); followed by those in Enugu state (74.3%), those in Abia state (72.2%), those in Imo state (70.8%), and lastly, by those in Ebonyi state (65.4%). The participants’ attitudes about COVID-19 safety practices were on average moderately positive (49.2%) with the best result in Imo state (60.5%), followed by Abia state (55.3%), Ebonyi state (52.4%), Enugu state (42.9%) and lastly Anambra state (35.1%). In summary, the respondents’ general perception of the realness, infectiveness, and source is positive (>50.0%) in all the Southeastern states. The knowledge, attitude, and perception of COVID-19 among undergraduate students in Eastern states, of Nigeria were appreciable but a lot has to be done in terms of enhanced public health education, positive behavioural changes as well as proactive preventive measures to curb the progress of the COVID-19 pandemic.