Exploring Patients’ Understanding, Perceptions, and Actions Regarding COVID-19 at Hoima Regional Referral Hospital

Gumisiriza Godfrey

Faculty of Medicine and Surgery Kampala International University Western Campus Uganda.


This research delved into the perceptions and behaviors surrounding COVID-19 among 150 patients admitted to Hoima Regional Referral Hospital. Employing a quantitative cross-sectional approach and random sampling, data was collected via interviews. Results revealed high awareness (98%) of COVID-19’s viral origin, with most participants (81%) recognizing the significance of avoiding crowded places. However, misconceptions persisted, notably around asymptomatic transmission (83% lacked accurate knowledge). Surprisingly, a considerable number (63%) frequented crowded areas, while mask usage was inconsistent despite 69% using them when leaving home. Additionally, around 55% didn’t maintain recommended distancing during conversations. The study underscored deficiencies in information, negative attitudes, and inadequate practices in combating COVID-19, urging swift corrective measures. Notably, despite shortcomings, social media and the internet facilitated knowledge acquisition. The findings linked poor practices to inadequate knowledge, lower education levels, and contact with confirmed COVID-19 cases. Addressing these gaps is critical, especially given the associations between poor knowledge, education, travel history, and inadequate practices.

Keywords: COVID-19 epidemic, Patients, Deaths, Poor knowledge, Educational level.


Coronavirus disease (COVID-19) is a disease caused by a newly emerging novel coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) that appeared in late 2019 disseminating to cause a global pandemic in 2020 [1]. It is related to the SARS-CoV and Middle Eastern Respiratory Coronavirus (MERS-CoV) that emerged in the early 2000s in East Asia and the Middle East respectively [2]. These viruses are of zoonotic origin with SARS-CoV2 thought to have originated in bats and they were not previously identified in humans [3]. Initially, most cases at the epicenter of the outbreak in Wuhan, Hubei province, China had contact with live animals and seafood suggesting animal to human transmission [4]. Later on, person to person spread was reported outside the epicenter and on 31st December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province of China [5]. Globally, the new Coronavirus has infected close to 132 million people with more than 2.8 million deaths as of April 7, 2021 and in the United States alone, the number of COVID-19 cases surpassed 30.5 million with more than 552,000 deaths [6]. The infections and associated morbidity and mortality continue to increase worldwide with intermittent flareups even in countries that were assumed to have brought it under control [6]. Currently, the WHO reports that COVID-19 deaths in Africa have surged by 40% ever since the virus was re- ported on the continent on 14 February 2020; this surge comes as Africa is battling new and more contagious variants for which it has geared up its largest-ever vaccination drive [7]. Uganda launched its mass COVID-19 vaccination program on 10th/03/2021 thereby joining a host of countries in Africa to initiate jab inoculations. According to the Ministry of Health, Uganda aims at vaccinating at least 49.6% of its population (21,936,011) with Oxford University–AstraZeneca COVID-19 vaccine at different phases [7]. Approximately 2.3% of the world’s population has now been infected by the severe acute respiratory coronavirus-2 (SARS CoV-2), the novel coronavirus and etiologic agent of COVID-19, and more than 3.3 million people have died [8]. As of 1 May 2021, 150,110,310 confirmed cases of COVID-19, including 3,158,792 deaths, had been reported to the WHO globally. Of these, over 4.5 million confirmed cases including more than 121,000 deaths were in sub-Saharan Africa. Although initially slow to spread in Africa, confirmed cases of COVID-19 on the continent are rising steadily [9]. The uptake of COVID-19 vaccines is critical to personal health, protecting vulnerable populations, reopening socio-economic life, and achieving population health and safety through immunity [10]. Moreover, it has been suggested that because the COVID-19 pandemic is so serious, the patient character could be more influential regarding uptake than the level of medical advice received, because during the pandemic any eligible patients will have been advised by their general practitioner (GP) to have the vaccination [11]. While the governments of high-income countries pre-ordered these vaccines, low- and middle-income countries had difficulties in purchasing enough doses for their population and to bridge this gap, the COVAX initiative was created to rapidly procure and deliver doses of a safe, effective, and approved vaccine for equitable distribution around the world [12]. The big question is whether these vaccines can easily be accepted by their end-users [7] because much as vaccines are essential in battling against COVID-19, it is paramount to establish vaccine acceptance campaigns before they reach the community because the fear of vaccines has grown radically in the past years [3]. In some African communities, this fear has led to a significant increase in rates of vaccine refusal which has led to an increase in vaccine-preventable diseases [13]. In Uganda, COVID-19 vaccination with the AstraZeneca vaccine was launched on 10 March 2021, with priority being given to healthcare workers and individuals at risk of severe COVID-19 and death; however, little is known about acceptance of receiving the vaccine among Ugandans, especially in the priority groups and reports from the government of Uganda also indicate there is a slow uptake of the COVID-19 vaccine in the country, with only about 400,000 people vaccinated by 10 May 2021 [8]. Adherence to the recommended COVID-19 prevention measures is mostly influenced by knowledge, attitudes, and practices; thus, communities and healthcare workers must be equipped with adequate knowledge of COVID-19 prevention policies for them to have positive attitudes and appropriate practices that contribute to decreasing the risk of infection [3].

Earlier studies on viral disease outbreaks, like SARS in 2003 and Ebola in 2018, have shown that the management and control of an outbreak requires a good understanding of the population about the disease to avoid its spread in the community [14]. It is therefore necessary that a survey is undertaken to establish the level of awareness, knowledge and attitudes of the population about the COVID-19 pandemic and the measures put in place to mitigate it [3]. The continent of Africa has poorly equipped health settings to manage thousands of COVID-19-infected people in comparison to developed countries [15]. It is also clear from the current reports that even the healthcare systems in high-income countries have been overwhelmed by patients even though they are better equipped [16]. Hence, the best strategy for a low-resourced setting like Africa and Uganda in particular would be to mitigate the spread by quickly improving the awareness, knowledge and attitude and the adherence of the population to the preventive measures in place [13]. However, there is a paucity of data on public knowledge and attitudes toward the prevention of COVID-19 [16]. It is, therefore important that a survey like this be carried out so that evidence-based plans are put in place to address inadequacies identified.


The study population’s knowledge, attitude, and preventative activities such as appropriate hand washing, avoidance of handshaking, and physical distance were poor to protect oneself from this extremely infectious pandemic virus. Notably, there is startlingly little information, a negative attitude, and insufficient practice in tackling the COVID-19 epidemic, all of which must be corrected immediately. Despite their shortcomings, social media and the internet aided in the acquisition of necessary knowledge. Poor practice is associated with poor knowledge, a low educational level, and contact with verified COVID-19 cases, whereas poor knowledge, a low educational level, and travel history are all associated with poor practice.


Therefore, there is an urgent need for health education activities aimed at enhancing COVID-19-related knowledge, attitude, and practice, especially among illiterates, those with a history of travel and contact, and generally among poor populations. The population’s attitudes and practices toward COVID-19 should be assessed in further research, which could make use of open-ended questions, in-depth interviews, or focus group discussions. This will help shed more light on COVID-19’s biopsychological effects in a nation with a weak health system and economy.


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CITE AS: Gumisiriza Godfrey (2023). Exploring Patients’ Understanding, Perceptions, and Actions Regarding COVID-19 at Hoima Regional Referral Hospital. INOSR APPLIED SCIENCES 11(1):50-63.