Knowledge, attitudes, and practices toward Covid-19 among the Mongolian general population during the period of the Covid-19 pandemic: a nationwide, population-based, randomised, cross-sectional study

Improving knowledge, attitudes, and practices toward COVID-19 is critical to control the infection rate of the pandemic successfully. Mongolia declared a state of emergency in January 2020 but no study was performed on public adherence to centralised measures and awareness of the pandemic in Mongolia. This study aimed to determine knowledge, attitudes, and practices (KAP) toward COVID-19 in the general population, especially regarding the extent to which KAP has contributed to the control measures before local COVID-19 outbreaks. The study was conducted between July and October 2020, when the pandemic was limited to internationally imported cases. We adapted a structured KAP questionnaire that was used to survey residents of Wuhan, China, during the initial outbreak of the pandemic. Participants aged between 13 and 65 years (n=1324, mean age=39.79±14.8), 73.2% were women, and 27.2% held a bachelor's degree or above. The results suggested that 81.9% of the participants had sufficient knowledge about the transmission, symptoms, treatment, and prevention of the disease. In the multiple linear regression, an increase in age and education contributed positively to a high knowledge score (p<0.05, p<0.001, respectively). The majority of the participants (96.2% - 96.5%) had compliance with the measures to control COVID-19 spread with good practices (82.4% - 93.1%) toward COVID-19 prevention. In the binary logistic regression analyses, the COVID-19 knowledge score was associated with a higher likelihood of optimistic attitudes and preventive practices (OR: 0.617 - 0.845). In conclusion, despite the sufficient knowledge toward the COVID-19 pandemic among the general population of Mongolia, a relatively low level of optimistic attitudes and appropriate practices compared to other populations may negatively impact preventing the outbreak in the society. Health education programs aimed at improving COVID-19 knowledge will be helpful to minimise local epidemic growth and the current government measures such as lockdowns, quarantines, and travel restrictions.