Diabetics, smokers and asthmatics are at a higher risk of falling severely ill from COVID-19 but only half of the rural and urban population is aware of this, suggests a new study by the Aga Khan University.

Researchers surveyed 738 men and women across Pakistan to assess their knowledge about COVID-19 symptoms, its mode of transmission and ways to protect oneself from the disease.

Participants included 403 people across Pakistan who completed an online survey, 198 respondents in urban Karachi who were interviewed by telephone and 137 individuals who took part in door-to-door surveys in rural Thatta.

While over 90% of those surveyed knew that the elderly were at a relatively higher risk of complications from the disease, nearly half of the respondents were unaware of other risk factors such as diabetes, smoking and asthma.

“Accurate information represents the first step in effectively protecting oneself and one’s loved ones from the disease,” Professor Zafar Fatmi of AKU’s community health sciences department said. “This is especially critical for those living with at-risk groups as it will enable them to take the necessary precautions.”

Less than one in 10 rural residents correctly identified being in crowded areas as a risk factor. Most rural residents (74%) also incorrectly believed mosquito bites to be a cause of COVID-19.

There was inadequate knowledge about the symptoms of the disease. While the majority of respondents correctly recognised fever, coughing and shortness of breath as signs of coronavirus, less than one in three respondents were aware of joint or muscle pain being a symptom.

Similarly, fewer than one in four of those surveyed knew that a person could be carrying the virus without showing any signs or symptoms.

Respondents who could accurately identify more than five of the ten symptoms of the disease listed by the World Health Organisation were considered to have adequate knowledge; just 8% of those surveyed through the study were able to meet or exceed this benchmark.

Researchers also found a widespread belief in the myth that the novel coronavirus could be treated with existing medications. Even though there is no cure for the virus and only its symptoms can be treated, up to 60% of urban Pakistanis believed that pneumonia vaccines could protect them. Eighty-three percent of rural respondents thought that existing medicines can effectively treat the disease.

Data from the study also highlights the need for more awareness of isolation practices. While nearly all respondents were aware that symptoms of COVID-19 last up to two weeks, only between 37% and 64% of those surveyed knew that being in contact with someone with COVID-19 should lead to a quarantine of up to 14 days.

On a more positive note, there was widespread awareness of the importance of hand washing, coughing into one’s elbow and of maintaining distance from those who are coughing or sneezing.

The study also collected data on the most used sources of information. Most urban respondents received their data from newspapers, television, radio and social media. In contrast, most rural residents relied on colleagues for information.

“We are working with partners to develop informative health awareness material on the virus that will be communicated through the sources that people trust,” Dr Fatmi said.

The study was funded by grants from AKU’s Medical College and the University’s Research Council.

Dr Shafaq Mahmood, Dr Ibtisam Qazi, Dr Muneebullah Siddiqui, Dr Anny Dhanwani, Dr Babar Shahid, Dr Hasan Nawaz, Mr Waqas Hameed and Dr Sameen Siddiqi from the university’s community health sciences department also contributed to the study.