ABSTRACT

Background and aim

The new outbreak "Coronavirus disease 2019 (COVID-19)" happened in china is caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Consequently, it spreads across the globe and is affecting wellbeing frameworks and the global economy. This pandemic disease places a heavy burden on governments in general, so individuals must adhere to WHO's instructions to limit its spread. The current study was applied to find out the extent of commitment among the Iraqi people to the standards of prevention measures against the coronavirus.

Materials and Methods

A cross sectional study was conducted with 1153 respondents widely in all governorates of Iraq to identify the commitment of the Iraqis to the preventive measures against COVID-19 in Iraq. This study covered the Iraqis in three main regions (Southern, middle, and Northern) for data collection. It was conducted between the 17th and 25th of March 2020, and Iraqis were administered with a structured questionnaire comprising of three domains.

Results

The results showed that the majority of the respondents (52%) were female, and most of them (42.3%) were observed between the age group of 31-40 years. About 82% of the respondents were residents of urban areas.

Conclusion

This study reveals the excellent implementation of preventive measures by the population. It is observed that the application of prevention standards in the countryside is less than in the city.

Key Words:
Covid-19; coronavirus; preventive measures; sterilization; implementation (source: MeSH, NLM)

RESUMEN

Antecedentes y objetivo

El nuevo brote "Enfermedad del coronavirus 2019 (COVID-19)" que sufrió en China es el problema del coronavirus 2 del síndrome de dificultad respiratoria aguda grave (SARS-CoV-2). En consecuencia, se extiende por todo el mundo y está afectando los marcos de bienestar y la economía global. Esta enfermedad pandémica supone una gran carga para los gobiernos en general, por lo que las personas deben cumplir con las instrucciones de la OMS para limitar su propagación. El estudio actual se aplicó para determinar el grado de compromiso entre el pueblo iraquí con los parámetros de medidas de prevención contra el coronavirus.

Materiales y Métodos

Se realizó un estudio transversal con 1153 encuestados en todas las provincias de Iraq para identificar el compromiso de los iraquíes con las medidas preventivas contra COVID-19 en Iraq. Este estudio cubrió a los iraquíes en tres regiones principales (sur, medio y norte) para la recopilación de datos. Se realizó entre el 17 y el 25 de marzo de 2020, y los iraquíes fueron administrados con un cuestionario estructurado que consta de tres dominios.

Resultados

los resultados mostraron que la mayoría de los encuestados (52%) eran mujeres, y la mayoría de ellos (42,3%) se observaron entre el grupo de edad de 31-40 años. Alrededor del 82% de los encuestados eran residentes de áreas urbanas.

Conclusión

Este estudio revela la excelente implementación de medidas preventivas por parte de la población. Se observa que la aplicación de normas de prevención en el campo es menor que en la ciudad.

Key Words:
COVID-19; coronavirus; medidas preventivas; esterilización; implementación (fuente: DeCS, BIREME)

Coronaviruses are a group of wrapped non-fragmented with positive-sense RNA belonging to the family "Coronaviridae order Nidovirales" and comprehensively infect human and other different mammais ¹1. Richman DD, Whitley RJ, Hayden FG. Clinical virology [Internet]. 4th ed. Washington: American Society for Microbiology; 2017 [Cited 2020 April 18]. Available from: Available from: https://bit.ly/2Zp2DBS .
https://bit.ly/2Zp2DBS... . Even though the majority of infections of human coronavirus are mild, the epidemics that happened by the two beta coronaviruses such as severe acute respiratory syndrome coronavirus (SARS-COV), and Middle East respiratory syndrome coronavirus (MERS-COV). These conditions give rise to the excessive 10, 000 accumulative cases in the previous two decades, with mortality rates of 10% for SARS-COV and 37% for MERS-COV respectively ²2. De-Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group. J Virol. 2013 Jul 15 [Cited 2020 April 21];87(14):7790-92. Available from: Available from: https://bit.ly/2ylEm4q . DOI:10.1128/JVI.01244-13.
https://bit.ly/2ylEm4q... ^,33. Zaki AM, Van-Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012 Nov 8 [Cited 2020 April 21]; 367(19):1814-20. Available from: Available from: https://bit.ly/2Zva0rp . DOI:10.1056/NEJMoa1211721.
https://bit.ly/2Zva0rp... ⁴4. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15 [Cited 2020 April 21]; 395(10223):497-506. Available from: Available from: https://bit.ly/2TsKq2l . DOI:10.1016/S0140-6736(20)30183-5.
https://bit.ly/2TsKq2l... . At the beginning of December 2019, various pneumonia cases of obscure starting points have been developed in Wuhan, Hubei territory, China.1,2 Most of these patients were reported with exposure to the Hua-nan seafood wholesale market, selling numerous types of live animals. The sickness has quickly spread locally to different parts of China, and then worldwide to numerous nations across six continents⁵5. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological Characteristics of 2143 Pediatric Patients with 2019 Coronavirus Disease in China. Pediatr. 2020 Mar [Cited 2020 April 21]. Forthcoming 2021. Available from: Available from: https://bit.ly/2WTMOBB .
https://bit.ly/2WTMOBB... . The rise of a novel human coronavirus (SARS-COV-2) has become a worldwide health problem causing acute respiratory tract diseases in humans. The transmissions from human-to-human have been portrayed with the incubation period between 2-10 days, encouraging its spread through droplets, debased hands, or surfaces that were well characterized on 3rd of January 2020 ⁶6. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020 Mar [Cited 2020 April 21]; 104(3):246-51. Available from: Available from: https://bit.ly/36pJBgi . DOI:10.1016/jjhin.2020.01.022.
https://bit.ly/36pJBgi... . According to WHO (COVID-19) situation report-62, it is globally observed that there were 292 142 confirmed cases and 12 784 deaths. Notably, 23 669 confirmed (1 314) and 1 596 deaths (130) were reported in the Eastern Mediterranean Region. In Iraq, the total confirmed cases were (214). While the total confirmed new cases (21), total deaths (17), and total new deaths ³3. Zaki AM, Van-Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012 Nov 8 [Cited 2020 April 21]; 367(19):1814-20. Available from: Available from: https://bit.ly/2Zva0rp . DOI:10.1056/NEJMoa1211721.
https://bit.ly/2Zva0rp... , all of them were transmitted locally ⁷7. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report - 67 [Internet]. [place unknown]: World Health Organization; 2020 Mar [Cited 2020 April 21]. Available from: Available from: https://bit.ly/2ARzhSs .
https://bit.ly/2ARzhSs... . Hygiene of hands and materials is one of the most significant measures to prevent healthcare- and outbreak-related viral infection since it plays a vital role in diminishing the spread of diseases ⁸8. Siddharta A, Pfaender S, Vielle N, Dijkman R, Friesland M, Becker B, et al. Virucidal Activity of World Health Organization - Recommended Formulations Against Enveloped Viruses, Including Zika, Ebola, and Emerging Coronaviruses. J Infect Dis. 2017 Mar 15 [Cited 2020 April 21]; 215(6):902-6. Available from: Available from: https://bit.ly/3gcuOdm . DOI:doi.org/10.1093/infdis/jix046.
https://bit.ly/3gcuOdm... . The arrangement of safe water, sanitation, and clean conditions are fundamental to ensuring human health during all irresistible infection episodes, including the COVID-19 flare-up. ensure proper and reliably applied wash and waste administration rehearses in communities, homes, schools, commercial centers, and medicinal services offices will additionally assist with forestalling human-to-human transmission of the COVID-19 infection⁹9. World Health Organization (WHO). Water, sanitation, hygiene and waste management for the COVID-19 virus [Internet]. [Place unknown]: World Health Organization; 2020 Apr 23 [Cited 2020 April 24]. Available from: Available from: https://bit.ly/2zXledx .
https://bit.ly/2zXledx... . The current study was applied to find out the extent of commitment among the Iraqi people to the standards of prevention measures against the coronavirus.

MATERIALS AND METHODS

Before commencing this study, informed consent was taken from all participants. A cross sectional study design was adopted to assess the extent of commitment among the Iraqi people to the standards of prevention measures against the coronavirus. The people in three main regions (Southern, Middle, and Northern) of Iraq were considered as the population of this study and for data collection. The southern region consists of (Basra, Thiqar, Maysan, Al-Qadisiyyah, and Muthanna) while the middle region was (Baghdad, Wasit, Najaf, Al- An-bar, Babil, Karbala, and Diyala) and finally the northern area (Duhok, Erbil, Kirkuk, Saladin, Sulaymaniyah, and Ninevah). Before the start of the study, a pilot study was conducted on a sample of 30 respondents. Then, the data were analyzed to find out the reliability and validity of the questionnaire and the internal consistency by using the Cronbach alpha test. The value of the alpha test was 82.

This study was conducted during the period from 17th to 25th of March 2020. A structured questionnaire was administered to the participants. This questionnaire was designed by the researcher in such way to explore the implementation of preventive measures among them. A total of 1 153 persons from both sex who responded to the questionnaire were included. This study excluded those who did not complete the questionnaire sheet. The questionnaire used in this study consists of three parts; the first one contains demographic characteristics covered age, gender, residence, governorate, and educational level. Second, concerns with implementation of personal preventive measures (finally declined kissing and shaking hands, Staying at home as much as possible, etc.) The third part was about sterilization and disinfection of tools and surfaces such as (use antiseptics and disinfectants to clean hand-touch surfaces, wear gloves before starting the cleaning, wash reusable tools such as brooms and mops with hot water at a temperature of 60-90D after cleaning, etc.). The preventive measures used in the questionnaire were based on the World Health Organization (WHO) and Coronavirus disease (COVID-19): Awareness resources from the Canadian government.

The data analysis was carried out using the statistical package of social science (SPSS) IBM version 20 software. The descriptive statistics frequency and percentile are used to identify the characteristics of our study population. A Chi-square test is used to analyze the association between demographic features and preventive measures with a level of significance of 5% (p<0.05, two-tailed).

RESULTS

Most of the respondents (52%) were female, and most of them (42.3%) were observed between the age group of 31-40 years. About 82% of the respondents were residents of urban areas. Concerning the educational level, the distribution of the respondents was observed at 88% at the university level, 9.1% at the secondary level, and 2.8% at the primary level. According to Iraq regions, the distribution of the respondents at middle, northern and southern regions was observed 49.5, 10.2, and 40.3% respectively. Finally, in respect to preventive measures, most of the respondents have adhered to these protective measures to protect themselves (Table 1).

Further, this study revealed that most respondents always applied personal preventive measures. The implementation of personal preventive measures showed a significant association with the demographic characteristic of respondents (p=0.000) and gender (p=0.013). However, no significant association was found between educational level and personal preventive measure (Table 2).

The association between the sterilization and disinfection of tools, surfaces, and demographic characteristics was represented in Table 3. This study showed that most of the respondents followed sterilization methods for tools and surfaces. A significant association was observed among sterilization measures and age, residence, and educational level, whereas no significant association was found in relation to gender and governorate.

DISCUSSION

Currently, COVID-19 is treated as a significant global health problem affecting all ages and both genders. It is also placing a significant economic encumbrance on public health systems. WHO and European Centre for Disease Prevention and Control has recommended guidelines in hand hygiene, personal protective equipment, and health care as it plays an essential role in preventing the spread of the COVID-19. This study observed that most Iraqis adopted personal protective measures as hand hygiene, social distancing, implementation of quarantine. Such measures are considered as the main route to decrease the virus transmission ¹⁰10. Rahman MD. Coronavirus infection prevention and control practices in the care home setting in 2020. Research Gate. 2020 Mar [Cited 2020 April 21]. Available from: Available from: https://bit.ly/2TsTnIZ .
https://bit.ly/2TsTnIZ... . For this reason, only a few cases in Iraq was observed according to the WHO report as of 21st March 2020. It is noteworthy that the deaths that occurred mostly were due to heart diseases and other chronic diseases ⁷7. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report - 67 [Internet]. [place unknown]: World Health Organization; 2020 Mar [Cited 2020 April 21]. Available from: Available from: https://bit.ly/2ARzhSs .
https://bit.ly/2ARzhSs... .

This study illustrated that most of the respondents applied sterilization method by antiseptics and disinfectants to clean hand-touch surfaces like cans, tables, power presses, televisions to reduce the infection because the virus can remain infectious on inanimate for nine days at room temperature, these disinfectants reduce virus infectivity ⁶6. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020 Mar [Cited 2020 April 21]; 104(3):246-51. Available from: Available from: https://bit.ly/36pJBgi . DOI:10.1016/jjhin.2020.01.022.
https://bit.ly/36pJBgi... .

This study reveals that there is a proper implementation of preventive measures by the Iraq government against COVID-19. It is observed that the application of prevention standards in the countryside is less than in the city. This finding requires the attention of the Ministry of Health by developing health teams consisting of workers in the field of public health and epidemiology to educate the population in rural areas. Therefore, this study identified adequate adherence among Iraqis to preventive measures against COVID-19. There is a need for the effective implementation of preventive measures against COVID-19 in rural areas to control the spread of coronavirus infection ♦

Acknowledgments:

Acknowledgements to all the respondents in this critical circumstance that the world is going through and my friends who help me in sample collection.

REFERENCES

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