Title: Risk Perception related to COVID-19 among Sub-Sahara Africans: A Web-based Comparative Survey of local and diaspora residents

Abstract Background Perceived risk towards the coronavirus pandemic is a key to improved compliance with public health measures to reduce the infection. This study investigated how Sub-Saharan Africans (SSA) living in their respective countries and those in the diaspora perceive their risk of COVID-19 outbreak and the factors associated. Methods A web-based cross-sectional survey on 1969 participants aged 18 years and above (55.1% male) was conducted between April 27th and May 17th 2020. The dependent variable was perception of risk for contracting COVID-19 scores. Independent variables included demographic characteristics; COVID-19 related knowledge and attitude scores. Univariate and multiple linear regression analyses identified the factors associated with risk perception towards COVID-19. Results Among SSA respondents, majority were living in SSA (n = 1855, 92.8%) and 143 (7.2%) in the diaspora. There was no significant difference in the mean risk perception scores between the two groups (p = 0.117), however, those aged 18–28 years had lower risk perception scores (p = 0.003) than the older respondents, while those who were employed (p = 0.040) and had higher level of education (p < 0.001) had significantly higher risk perception scores than other respondents. After adjusting for covariates, multivariable analyses revealed that SSA residents aged 39–48 years (adjusted coefficient, β = 0.06, 95% CI [0.01, 1.19]) and health care sector workers (β = 0.61, 95% CI [0.09, 1.14]) reported a higher perceived risk of COVID-19. Knowledge and attitude scores increased as perceived risk for COVID-19 increases for both SSAs in Africa (β = 1.19, 95% CI [1.05, 1.34] for knowledge; β = 0.63, 95% CI [0.58, 0.69] for attitude) and in Diaspora (β = 1.97, 95% CI [1.16, 2.41] for knowledge; β = 0.30, 95% CI [0.02, 0.58] for attitude). Conclusions There is a need to promote preventive measures with focus on increasing people’s knowledge about COVID-19 and encouraging positive attitude towards the mitigation measures. Such interventions should target older participants and non-healthcare workers.