KNOWLEDGE, ATTITUDE AND PRACTICE OF HEALTHCARE WORKERS TOWARDS NOVEL CORONA VIRUS (COVID-19) IN JUGAL HOSPITAL, HARARI REGIONAL STATE, ETHIOPIA

Introduction: Coronavirus (CoVs) belong to the subfamily Corona virinae in the family of Corona viridae of the order Nido virales, and this sub family includes four genera: Alpha corona virus, Beta corona virus, Gamma corona virus and Delta corona virus. The genome of CoVs is a single‐stranded positive‐sense RNA (+ssRNA) (~30 kb) with 5′‐cap structure and 3′‐poly‐A


INTRODUCTION
Corona virus disease 2019 (abbreviated "COVID-19") is an emerging respiratory disease that is caused by a novel corona virus and was first detected in December 2019 in Wuhan, China. The disease is highly infectious and its main clinical symptoms include fever, dry cough, fatigue, myalgia, and dyspnea (Nishiura et al., 2020).
CoVs belong to the subfamily Corona virinae in the family of Corona viridae of the order Nido virales, and this sub family includes four genera: Alpha corona virus, Beta corona virus, Gamma corona virus and Delta corona virus. The genome of CoVs is a single-stranded positive-sense RNA (+ssRNA) (~30 kb) with 5′-cap structure and 3′poly-A tail (Snijder et al., 2006). Originally, the disease is classified under zoonotic diseases; the pathogen can be transmitted from animal to human and human to human (Bai et al., 2020). It is transmission from human to human is through droplet, feco-oral, and direct contact and has an incubation period of 2-14 days (World Health Organization, 2020b). It causes illness ranging from simplest of common cold to severe acute respiratory syndrome (SARS) (Yin & Wunderink, 2018).
The World Health Organization (WHO) declared COVID-19 a public health emergency of international concern On 30 January 2020, (PHEIC) (Eurosurveillance Editorial Team, 2020 There is a concern about possible increased numbers of human infections and deaths. By the end of January, the WHO and Centers for Disease Control and Prevention (CDC) had published recommendations for the prevention and control of COVID-19 for HCWs (Centers for Disease Control and Prevention, 2020; World Health Organization, 2020a).
Health care providers in hospitals are at risk of infection through occupational exposure to suspected cases. They are also expected to participate in health education activities on the infection, particularly if they have relevant information which can be given to patients, and through them, to their families and members of the community. It is important therefore that they have adequate and correct knowledge, attitudes and practices (KAP) towards CoV.
The aim of this study therefore was to evaluate KAP towards CoV among health care providers in Jugal hospitals in Harari region.

Study Setting and Participants
The institutional cross-sectional quantitative study was conducted from February to March 2020 at Jugal hospital, Harar, Ethiopia, which is found 525 km to East of Addis Ababa. The hospital has a total of 220 health professionals.

Instruments
Data were collected using a self-administered questionnaire. Construction, the questionnaire included: 16 questions on knowledge, 14 questions on attitudes and 9 questions on practices.

Data Analysis
For data processing and analysis, SPSS version 20 was used. Data was checked for completeness and consistency; coded data was entered into computer programs after the required cleaning was done descriptive analyses was performed.

Ethical Consideration
The study was conducted among all health professionals in Jugal Hospital. Ethical clearance was obtained from Harar Health Science College Institutional Review Board (IRB) (Ref.no.HHSC-09/2020). Before the staring of the field work, consent was obtained from both administrative body and respondent.

Socio-Demographic Characteristics of the Participants
Among a total of 220 health care workers, 207 of whom completed the study questionnaire and participated in the study which makes response rate of 94%, 120 (57.97%) of the participants were female, around half of the participants 101(48.79%) were age group of 25-34 years, regarding occupation more than half 118(57%) were nurses and regarding Attending training/seminar about Novel Corona virus only 5(2.42%) participated (See Table 1).  Table 2).  Table 3).

COVID 19 Prevention Practices
In regards to COVID 19 prevention practice, all of the participants 207(100%) reported that they wash their hands using soap and water continuously, cover their nose and mouth with a tissue while sneezing or coughing and avoid touching their eyes, nose or mouth. But an interesting issue is only 7(3.38%) of the participants answered that there is enough soap and water to wash hand, hand sanitizers and personal protective equipment materials like mask, glove apron, etc. (See Table 4). 192 (92.75%) 6 (2.90%) 9 (4.35%) People who have contact with someone infected with the COVID-19 virus should be immediately isolated in a proper place. In general, the observation period is 14 days.

DISCUSSION
This study revealed that all respondents heard about COVID-19. This finding is more than study done in UAE which was (97.8%) (Bhagavathula, Aldhaleei, Rahmani, Mahabadi, & Bandari, 2020). In addition, all respondents responds that maintaining hand hygiene and covering the nose and mouth while coughing could help to prevent COVID-19 transmission which is higher than study done in UAE which was (85.6%) (Bhagavathula et al., 2020).
In this study, all of the participants agreed that that COVID-19 could lead to pneumonia, respiratory failure, and death which is high compared to the study done in UAE which was (84%) (Bhagavathula et al., 2020). Also, all participants agreed that sick patients should share their recent travel history which is high compared to the study done in UAE which was (92.7%) (Bhagavathula et al., 2020).
All of the participants felt that washing hands with soap and water could help to prevent COVID-19 which is high compared to the study done in UAE which was (87%). (Bhagavathula et al., 2020). 95.17% of the respondents respond that that flu vaccination is not sufficient to prevent COVID-19, which is high compared to the study done in UAE which was (90.7%) (Bhagavathula et al., 2020).
This study revealed that 92.75% of the respondents respond that supportive care is the only treatment option that is currently available which is high compared to the study done in UAE which was (83.2%) (Bhagavathula et al., 2020). Additionally, 92.75% of the respondents knew that symptoms appear in 2-14 days which is high compared to the study done in UAE which was (84.3%) (Bhagavathula et al., 2020). This disparity could partly be attributed to the difference in the study time, the UAE study was done in beginning month of corona virus epidemic whereas this study done in late months after getting a lot of information regarding the diseases.
In this study, only (2.42%) attend training/seminar about Novel Corona virus which is very low compared to study done in UAE which shows 44.1% of them had the opportunity to attend lectures/discussions about COVID-19 (Bhagavathula et al., 2020).This disparity could partly be attributed to the difference in socio economic status of the country to give lecture using video conferences and like.

Limitations
This study was conducted using a crosssectional study design, the study was subjected to recall bias because it was self-reported and it was dependent on the honest answer and recall ability of the participants. Since the disease is new, there are no many researches done in the topic. For discussion, only one research was obtained. Despite these limitations, the findings provide valuable information about the knowledge, attitude and practice of the staffs.

CONCLUSION
The finding of this study showed that majority of respondents have adequate knowledge, attitude and practice about COVID-19. Nevertheless, greater than 95% of respondents said that they are not ready to give care for a patient who is positive for COVID-19. The reason behind this is that there is no enough soap and water to wash hand, hand sanitizers and personal protective equipment materials like mask, glove and due to this they are afraid that one of their family members can get infection. The hospital must fulfill necessary personal protective equipment, hand washing materials and prepare seminar/lecture for all of the staffs and the Regional Health Bureau must prepare temporary residence to staffs specially who assigned in corona center not to contaminate their family members.

Declaration of Conflict of Interests
The author would like to declare that no conflict of interests in this study.