Crisis within a crisis, COVID-19 knowledge and awareness among the Syrian population: a cross-sectional study

OBJECTIVES: To gauge specific knowledge around clinical features, transmission pathways and prevention methods, and to identify factors associated with poor knowledge to help facilitate outbreak management in Syria during this rapid global rise of the COVID-19 pandemic. DESIGN: Web-based cross-sectional survey. SETTING: This study was conducted in March 2020, nearly 10 years into the Syrian war crisis. The Arabic-language survey was posted on various social media platforms including WhatsApp, Telegram, Instagram and Facebook targeting various social groups. PARTICIPANTS: A total of 4495 participants completed the survey. Participants with a history of COVID-19 infection, residing outside Syria or who did not fully complete the survey were excluded from the study. The final sample of 3586 participants (completion rate=79.8%) consisted of 2444 (68.2%) females and 1142 (31.8%) males. PRIMARY AND SECONDARY OUTCOME MEASURES: First, knowledge of COVID-19 in four areas (general knowledge; transmission pathways; signs and symptoms; prevention methods). Second, factors associated with poor knowledge. RESULTS: Of the 3586 participants, 2444 (68.2%) were female, 1822 (50.8%) were unemployed and 2839 (79.2%) were college educated. The study revealed good awareness regarding COVID-19 (mean 75.6%, SD ±9.4%). Multiple linear regression analysis correlated poor mean knowledge scores with male gender (β=−0.933, p=0.005), secondary school or lower education level (β=−3.782, p<0.001), non-healthcare occupation (β=−3.592, p<0.001), low economic status (β=−0.669, p<0.040) and >5 household members (β=−1.737, p<0.001). CONCLUSION: This study revealed some potentially troubling knowledge gaps which underscore the need for a vigorous public education campaign in Syria. This campaign must reinforce the public’s awareness, knowledge and vigilance towards precautionary measures against COVID-19, and most importantly aid in controlling the worldwide spread of the disease.