scholarly journals Tickborne disease awareness and protective practices among U.S. Forest Service employees from the upper Midwest, USA

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi
Keyword(s):  
The United States ◽  
Forest Service ◽  
High Risk Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Service Employees ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
High Concern

Abstract Background People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States. Methods We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals, 1.97–20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41–24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00–10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.

scholarly journals Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA

2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi
Keyword(s):  
The United States ◽  
Forest Service ◽  
High Risk Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Service Employees ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
High Concern

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.

scholarly journals Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA

2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi
Keyword(s):  
The United States ◽  
Forest Service ◽  
High Risk Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Service Employees ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
High Concern

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.

scholarly journals Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA

2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi
Keyword(s):  
Forest Service ◽  
High Risk Group ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Service Employees ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
High Concern

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, and the proportion of correctly answered knowledge questions, their ranked concern for TBDs, practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern (OR = 3.4 [1.33- 8.91]) and a history of TBD (OR = 4.66 [1.21 – 17.89]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.

scholarly journals Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA

2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi
Keyword(s):  
Prevention Programs ◽  
Forest Service ◽  
High Risk Group ◽  
Targeted Prevention ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Service Employees ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
High Concern

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees.Methods: We conducted a cross-sectional survey to evaluate the exposure to ticks and tick-borne disease infections among U.S. Forest Service employees in a high TBD incidence region of northwestern Wisconsin, and to examine their knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, and the proportion of correctly answered knowledge questions, their ranked concern for TBDs, practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure and their knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern (OR = 3.4 [1.33- 8.91]) and a history of TBD (OR = 4.66 [1.21 – 17.89]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, targeted prevention programs are still needed to reduce their risks for tick bites.

scholarly journals Risks of Major Mental Disorders and Irritable Bowel Syndrome among the Offspring of Parents with Irritable Bowel Syndrome: A Nationwide Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4679
Author(s):  
Ta-Chuan Yeh ◽  
Ya-Mei Bai ◽  
Shih-Jen Tsai ◽  
Tzeng-Ji Chen ◽  
Chih-Sung Liang ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Mental Disorders ◽  
Autism Spectrum ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Early Implementation ◽  
Increased Risk ◽  
Nationally Representative ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.

scholarly journals Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

2018 ◽  
Vol 28 (3) ◽  
pp. 201
Author(s):  
Fatma W. Nazer ◽  
Wael Sabbah
Keyword(s):  
Ethnic Differences ◽  
Tooth Loss ◽  
Family Income ◽  
The United States ◽  
Outcome Variable ◽  
Behavioral Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Ethnic Inequalities

<p class="Pa7"><strong>Objective: </strong>To assess whether there are ethnic differences in tooth loss among adult Americans aged &lt;40 years and whether socioeconomic position attenuates these differences if they exist.</p><p class="Pa7"><strong>Methods: </strong>Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indica­tors (income and education), health insur­ance, dental visits, smoking and diabetes.</p><p class="Pa7"><strong>Results: </strong>A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ra­tios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the rela­tionship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).</p><p class="Default"><strong>Conclusions: </strong>Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged &lt;40 years.</p><p class="Default"><em>Ethn Dis. </em>2018;28(3):201-206; doi:10.18865/ ed.28.3.201</p>

scholarly journals Home Infusions for Inflammatory Bowel Disease are Safe: United States Experience and Patient Perspectives

2021 ◽  
Author(s):  
Bharati Kochar ◽  
Yue Jiang ◽  
Wenli Chen ◽  
Yuting Bu ◽  
Edward L Barnes ◽  
...  
Keyword(s):  
United States ◽  
Inflammatory Bowel Disease ◽  
Patient Experience ◽  
Bowel Disease ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
States Experience

Abstract Background Home-infusions (HI) for biologic medications are an option for inflammatory bowel disease (IBD) patients in the United States (US). We aimed to describe the population receiving HI and report patient experience with HI. Methods We conducted a retrospective cohort study in the Quintiles-IMSLegacy PharMetrics Adjudicated Claims Database from 2010-2016 to describe the population receiving infliximab and vedolizumab HI and determine predictors for an urgent/emergent visit post-HI. We then administered a cross-sectional survey to IBD-Partners Internet-based cohort participants to assess knowledge and experience with infusions. Results We identified claims for 11,892 conventional infliximab patients, 1,573 home infliximab patients, 438 conventional vedolizumab patients and 138 home vedolizumab patients. There were no differences in demographics or median charges with infliximab home and conventional infusions. Home vedolizumab infusions had a greater median charge than conventional vedolizumab infusion. Less than 4% of patients had an urgent/emergent visit post-HI. Charlson comorbidity index &gt;0 (OR:1.95, 95% CI:1.01-3.77) and Medicaid (OR:3.01, 95%CI:1.53-5.94) conferred significantly higher odds of urgent/emergent visit post-HI. In IBD-Partners, 644 IBD patients responded; 56 received HI. The majority chose HI to save time and preferred HI to conventional infusions. Only 2 patients reported an urgent/emergent visit for HI-related problems. Conclusions HI appears to be safe in IBD patients receiving infliximab and vedolizumab. However, patients with fewer resources and more co-morbidities are at increased risk for an urgent/emergent visit post-HI. The overall patient experience with HI is positive. Expansion of HI may result in decreased therapy-related logistic burden for carefully selected patients.

scholarly journals Relationship between parental overweight and obesity and childhood metabolic syndrome in their offspring: result from a cross-sectional analysis of parent–offspring trios in China

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e036332
Author(s):  
Zhaogeng Yang ◽  
Yanhui Li ◽  
Bin Dong ◽  
Di Gao ◽  
Bo Wen ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Child Outcomes ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Metabolic Dysfunction ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Maternal Overweight

ObjectiveMetabolic syndrome (MS) and its components are observed to emerge in childhood and may continue into adulthood. The study aimed to investigate the association between parental overweight and risk of childhood MS and its components in their offspring.MethodsData were obtained from a cross-sectional survey conducted in Chinese children and adolescents; a total of 11 784 children aged 7–18 years were included in this study; child outcomes were obtained from objective measurements and parental data were obtained from questionnaires; MS was defined according to the modified criteria of Adult Treatment Panel Ⅲ; correlation between parental overweight and offspring MS was assessed via multivariate logistic regression models adjusted for potential covariates.Results3476 (29.5%) children were found to have overweight fathers, 1041 (8.8%) had overweight mothers and 852 (7.2%) had both overweight parents. The prevalence of MS was 7.1% in total, 8.2% in boys and 5.9% in girls; children with overweight parents had a higher prevalence of MS and its components (except for elevated glucose) compared with children with normal-weight parents. Children with overweight fathers, mothers and both parents had 2.17 times (95% CI: 1.65–2.85), 2.89 times (95% CI: 2.03–4.11) and 2.81 times (95% CI: 1.91–4.15) higher risk of MS, respectively. Children with overweight mothers were likely to have a higher risk of MS compared with children with overweight fathers. Parental overweight was positively correlated with higher risk of MS, abdominal obesity and low HDL-C both in boys and girls.ConclusionParental overweight was strongly associated with increased risk of MS in their offspring, the risk was highest in children with both parents to be overweight. Maternal overweight seems to have a stronger correlation with offspring MS than paternal overweight. Parental overweight is one of the factors for identifying metabolic dysfunction risk in their offspring and other factors need to be considered as well.

scholarly journals Risk and Protective Factors Associated with Custodial Grandparents’ Psychological Distress in COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 956-956
Author(s):  
Yanfeng Xu ◽  
Merav Jedwab ◽  
Qi Wu ◽  
Sue Levkoff ◽  
Ling Xu
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Parenting Stress ◽  
Financial Services ◽  
The United States ◽  
Material Hardship ◽  
Cross Sectional Survey ◽  
Custodial Grandparents ◽  
Cross Sectional ◽  
Logistic Regression Models

Abstract The fear and anxiety of COVID-19 and its related policy measures have increased individuals’ psychological distress. The objective of this study was to examine relationships between material hardship, parenting stress, social support, and resilience and custodial grandparents’ psychological distress during the COVID-19 pandemic and further investigate the moderating role of kinship license status. A cross-sectional survey was administered to collect data from custodial grandparents (N = 362) in the United States. T-tests, chi-square tests, and logistic regression models were conducted using STATA 15.0. Results indicated that material hardship (OR = 1.77, p &lt; 0.001) was associated with higher odds of psychological distress, whereas custodial grandparents’ resilience (OR = 0.08, p &lt; 0.001) and social support (OR = 0.39, p &lt; 0.001) were associated with lower odds of experiencing psychological distress. Increased parenting stress in COVID-19 was not significantly associated with psychological distress. Kinship license status moderated the relationships between social support (OR = 0.23, p &lt; 0.05), resilience (OR = 5.06, p &lt; 0.05) and psychological distress. To address custodial grandparents’ psychological distress, more allocated emergency funds and tailored financial services should be provided to meet material needs, and interventions with a focus on resilience and social support are particularly needed. Although licensed custodial grandparents were more likely to experience psychological distress due to their pre-existing vulnerability than unlicensed counterparts, parallel services should be provided to all kinship caregivers.

scholarly journals Community knowledge, perceptions and practices around COVID-19 in Sierra Leone: a nationwide, cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040328
Author(s):  
Paul Sengeh ◽  
Mohammad B Jalloh ◽  
Nance Webber ◽  
Ibrahim Ngobeh ◽  
Thomas Samba ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Regression Models ◽  
Strong Association ◽  
Communication Strategy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
High Knowledge ◽  
Knowledge Attitudes And Practices

ObjectivesTo assess the public’s knowledge, attitudes and practices about the novel coronavirus in Sierra Leone to inform an evidence-based communication strategy around COVID-19.DesignNationwide, cross-sectional Knowledge, Attitudes and Practices survey.Setting56 randomly selected communities in all 14 districts in Sierra Leone.Participants1253 adults aged 18 years and older of which 52% were men.Main outcome measuresWe calculated proportions of core indicators (awareness, knowledge, risk perception, practices). A composite variable for knowledge (based on seven variables) was created, and categorised into low (0–2 correct), medium (3–4) and high (5–7). Predictors of knowledge were analysed with multilevel ordinal regression models. Associations between information sources, knowledge and two practices (washing hands with soap and avoiding crowds) were analysed using multilevel logistic regression models.ResultsWe found that 75% of the respondents felt at moderate or great risk of contracting coronavirus. A majority (70%) of women did not know you can survive COVID-19, compared with 61% of men. 60% of men and 54% of women had already taken action to avoid infection with the coronavirus, mostly washing hands with soap and water (87%). Radio (73%) was the most used source for COVID-19 information, followed by social media (39%). Having a medium or high level of knowledge was associated with higher odds of washing hands with soap (medium knowledge: adjusted OR (AOR) 2.1, 95% CI 1.0 to 4.4; high knowledge: AOR 4.6, 95% CI 2.1 to 10.2) and avoiding crowds (medium knowledge: AOR 2.0, 95% CI 1.1 to 3.6; high knowledge: AOR 2.3, 95% CI 1.2 to 4.3).ConclusionsThis study shows that in the context of COVID-19 in Sierra Leone, there is a strong association between knowledge and practices. Because the knowledge gap differs between genders, regions, educational levels and age, it is important that messages are specifically targeted to these core audiences.

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