Determinants of Knowledge, Attitudes, and Practices of Frontline Health Care Givers During the First Wave of Covid-19 in Africa: a Multi-centers Online Cross-sectional

Abstract Background: During its first wave in sub-Saharan Africa, there was insufficient understanding of the new pandemic of coronavirus disease 2019 (COVID-19) among frontline health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risks of contacting and spreading the disease. This study was carried out to determine the knowledge, attitude, and practices (KAP) of frontline health care givers (HCGs) towards COVID-19 in Africa and their related factors.Methods: This was a multi-centers online cross-sectional study conducted over a 3-months study-period using a google survey link among front lines African HCGs in the COVID-19 response units within 28 African countries. Bivariate and Multivariate logistic regression were used to assess the associations between co-variates. Statistical significance was set at p≤ 0.05 and 95% confidence interval. Results: There a total of 518 out of 588 approached HCGs participated in the study from 28 African countries. Overall, 496 (96%) had bad practice score, and 405 (78%) had positive attitude regarding COVID-19. The related factors of KAP towards COVID-19 identified were the lack of self- esteem and self-confidence in the management of COVID-19 (aOR: - 0.17, 95% CI=-0.766 to -4.33, p >0.05), Ignorance (aOR: 1.55, 95% CI=1.003 to 2.402, p <0.048), lack of knowledge updates on COVID-19 (aOR: 1.81, 95% CI=1.105 to 2.951, p <0.018).Conclusions: Majority of the frontline HCG has an overall good knowledge and attitude towards the disease across the African continents regardless of their level of study. However, the KAP is influenced negatively by the lack of self-esteem, self- confidence, ignorance, and insufficiency of frequent update of COVID-19 information. Promoting psychological support in addition to regular trainings could help to enhance the KAP of frontline HCG in African region.