Knowledge , Attitude and Practice Toward COVID – 19 in Mosul City

Backgroud: COVID-19 or the disease caused by the SARS – Cov2 – (sever acute respiratory syndrome caused by coronavirus 2 ). Coronavirus has caused a pandemic that has affected patients in more than 188 countries and territories around the world. Prodigious restrictions and safety measures have been adopted by the governments to control the spread of wildfire coronavirus disease 2019 (COVID-19) pandemic. However, the effective implementation of these measures depends upon the knowledge, attitudes, and practices (KAP) of the people. Materials and Methods: A cross-sectional survey was designed for the present study. The study was conducted from May 2020 to Septembet 2020 in Mosul city and include adults who are not working in the medical field and visit family medicine centers or hospitals for any reasons except having a disease Results: this study revealed that about (190) 95% of the participant knows that the disease can be spread by droplet of patient and (136) 68 % of them believe that surfaces touched by patient could be one of the measures to transmit the disease and (156) 78% of them said that the disease may transmited from asymptomatic patient. Regarding the knowledge of the participant about measures used to prevent spread of Covid 19 this research demonstrates that (198) 99% and (190) 95% of them convinced that proper hand wash and maintain appropriate distance between himself and other person specially with symptoms is an effective measure to prevent transmission of the disease . On the other hand , this study check the attitude of the participants toward Covid 19 which found that 76% and 72% of them have a good attitude toward covid 19 which was washing hands regularly and put facemask while only 59% believe that curfew during pandemic state are useful and 58% found that the preventive measures advised by health personnel were useful and 63% still considered that this disease designed as a biological weapon. Conclusions: According to this study about 65% of the participant have good knowledge , 63.4 % of them have good attitude a toward Covid 19 which is very important to limit it's transmission through the population .

Spread of Sever Acute Respiratory Syndrome -Corona Virus type2 can happen through direct, indirect, or close contact with diseased people through infected discharges such as saliva and respiratory secretions and droplets , which are released when a diseased people sneezes,coughs and talks. .Less than 10 respiratory droplets are 5-10 μm in diameter while droplets <5μm in diameter are stated to as aerosols. Respiratory droplet transmission can occur when a person is in close contact (within 1 metre) with a diseased people who has respiratory symptoms (e.g. coughing or sneezing) in these situations , respiratory droplets that contain virus can arrive the mouth, nose or eyes of a contacted people and can develop infection, while indirect contact considering contact of a host with a contaminated things or surfaces may also be occur. 4,5 . Remarkable constraint and safety manouvers have been achieved by the governments to control the transmission of wildfire coronavirus disease 2019 pandemic. Nevertheless, the effective accomplishment of these manouvers depends upon the knowledge, attitudes, and practice s (KAP) of the community . 6

AIM OF THE STUDY
To determine the knowledge of people that visit family medicine center and hospitals about Covid 19 and what is there attitude and practice toward such a patient. .

SUBJECTS AND METHODS
A cross-sectional study design has been adopted for this study. The study was conducted from May 2020 to September 2020 in Mosul city and include adults whose job was far from the medical field and visit family medicine centers or hospitals for any reason except having the disease a special questionnaire form filled in by the individual himself directly after securing the protective measures to prevent the transmission of disease . Those who have the following criteria will be included in this study : The following criteria were excluded : 1.Those who have any illness or other reasons make them unable to fill the questionnaire 2.Those who refused to contribute in research .
The questionnaire was prepared in Arabic, which is the main language in Iraq, and it covered the socio-demographic informations, knowledge about corona virus disease 19, practices about the illness, and attitude against preventive measures toward coronavirus disease 19 7 . The sample size was 200 participants and randomly selected and agreement has been taken from each participant and official permission from health care institutions has been obtained .

RESULTS
This study shows that (84) 42% of participant their ages between 18 to < 30 years while those who are more than or equal to 40 years was (46) 23 % from the participant as shown in table 1.
Regarding gender (108) 54% of the participant were male and (96) 48% of those included in this study finished their university or high education and only (16) 8% of them finish primary school as seen in table 1.
On the other hand (130) 65% of participant was single and (132) 62% of them was employed as it evident in table 1 . Concerning common symptoms of COVID 19 , table 2 reveals that 89%, 88%, 91%, 84%, 90% and 91% of the participants know that cough , body aches, loss of taste and smell , COVID 19 more serious for the old age people and more dangerous for those with chronic illness respectively.  proper hand wash, maintain appropriate distance between themselves and others specially those with symptoms , avoid rubbing eyes, touching nose and mouth , cover the mouth and nose while coughing or sneezing by bending elbow and stay home without going out unless there is necessary things specially at pandemic state respectively an effective measure to prevent transmission of the disease . So according to this study about 65% of the participant have good knowledge toward COVID 19 . On the other hand , this study check the attitude of the participants toward COVID 19 which found that the attitude of those who wash their hands regularly was 76%, those who put facemask was 72% , those who have any symptoms similar to COVID 19 will inform health authorities was 70% and those will take a vaccine once it be available was 75%, while only 59% believe that curfew during pandemic state are useful and 58% found that the preventive measures advised by health personnel useful as shown in table 4 . In addition to that table 5 revealed that 94% of the participant think that COVID19 is a dangerous disease 89% have an idea that he /she or any member of his /her family can infected with this disease while 46.5% consider infection with this disease will left a stigma on patient and 63% still considered that this disease designed as a biological weapon .  8 and nearly mimic other one done in South Korea which revealed that the mean age of participants was 47.44 years . Nearly half of them were females (51.4%), and 59.2% had a diploma, followed by a bachelor's degree (31.9%) and graduate or professional degree (9%) 9 . In this study there was 95% of the participant knows that the disease can be spread by droplet of patient and 68 % of them believe that surfaces touched by patient could be one of the measures to transmit the disease and 78% of them said that the disease may transmited from asymptomatic patient , while 15 % of the sample think that dealing with pets may transmit the disease and 43% of them still consider that the goods imported from China are infectious . Concerning common symptoms of COVID 19 , this research showed that 89%, 88%, 91%, 84%, 90% and 91% of the participants know that cough , body aches, loss of taste and smell , COVID 19 more serious for old age and more dangerous for those which have chronic disease respectively . So according to this study about 65% of the participant have good knowledge toward COVID 19 which is very important to limit it's transmission through the population . This knowledge may be gained from their physicians, TV or Radio channels, social media, health messages distributed by health institutions, from friends or family members, this result was mimic one implemented in Bangladish which clarified that 61.2% had adequate knowledge 10 and similar to other study done in Ethiopia which found that the rate of correct answers of knowledge questions was 67.2% 11 but lower than other study achieved in Saudi Arabia which demonstrated that most of those share in study had a good knowledge level (89.77%) to the Corona virus disease 19 pandemic. Again they reach a good level of knowledge with a score of 89.6% among contributors , specially from the Western area of Saudi Arabia 12 this could be due difference between sample size and level of education and quality of both samples and may be due to difference in resources between KSA and Iraq .
Regarding attitude of the participants this study showed that about 63.4 % of them answer correctly on 15 questions prepared to check their attitude toward Covid 19 and revealed that the attitude of the participants toward COVID 19 which found that 76%, 72% , 70% , 75%, of them have a good attitude toward the followings : wash their hands regularly , put facemask , if they have any symptoms similar to COVID 19 will inform health authorities and they will take vaccine once it be available respectively which is nearly mimic to other study done in Egypt 7 and similar to other study achieved in Bangladesh which clarified that 62.3% of participants had more good attitudes towards Corona virus disease 19 13 and mimic other study also done in Bangladesh which found that The mean of good attitudes rates for all participants was between 55.28 and 68.50% 14 and nearly resemble other study done in Hong Kong which revealed that Most of contributor accept that COVID-19 is a dangerous disease (83.0%) and were anxious that they would diseased with it (61.9%) or be isolated (69.0%). However, fewer than 40% of the contributors thought that they or their families were at risk of SARS-CoV-2 infection 15 and there is other study done in India which clarified that the most of those share in study (>90%) had right knowledge about preventive procedures to prevent the transmission of Covid-19 which is higher than that in this research 8 . Regarding to practice or practice of the participants , this study showed that that 94% of the participant think that COVID19 is a dangerous disease 89% have an idea that he /she or any member of his /her family can infected with this disease while 46.5% consider infection with this disease will left a stigma on patient and 63% still considered that this disease designed as a biological weapon. This study showed that satisfactory knowledge, positive attitude and poor practice were found among the participants which is similar to other study done in Egypt 16 , so that this study revealed that the Iraqi population in Mosul city needs more health educational program about Covid 19 to increase their KAP .