{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:31:42Z","timestamp":1771234302969,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic has affected populations globally, including Ghana. Knowledge of the COVID-19 disease, and the application of preventive public health interventions are pivotal to its control. Besides a lockdown, measures taken against the spread of the virus include the wearing of face masks, social distancing, regular hand washing with soap and, more recently, vaccination against the virus. In order to establish a possible link between the knowledge of the disease and compliance with preventive measures, including vaccination, a cross-sectional study employing an interview-structured questionnaire was conducted in six regions of Ghana (n = 1560). An adequate level of knowledge of COVID-19 (69.9%) was reported. The linear multiple regression analysis further explicated the differences in the knowledge of COVID-19 among the respondents by their knowledge of cholera and influenza (adjusted R-Square = 0.643). Despite this profound knowledge of the illness, two thirds of the respondents were unwilling to follow basic preventive measures and only 35.3% were willing to be vaccinated. Amazingly, neither knowledge of COVID-19 nor the socio-demographic characteristics had any meaningful influence on the practice of preventive measures. Personal attitude leading to efficient public compliance with preventive measures, therefore, is a critical issue demanding special attention and effective interventions by the government and locals with authority to curb the spread of the pandemic which surpasses the traditional channels of public health communication. This includes a roll-out of persuasion, possibly including public figures and influencers, and in any case, a balanced and open discussion addressing the acceptance of the COVID-19 vaccine in order to avoid new variants and comparable problems currently facing many countries of Western Europe. Indeed, a profound hesitancy against vaccination may turn African countries such as Ghana for many years into hotspots of new viral variants.<\/jats:p>","DOI":"10.3390\/ijerph182412902","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T09:52:29Z","timestamp":1638870749000},"page":"12902","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Knowledge into the Practice against COVID-19: A Cross-Sectional Study from Ghana"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6235-6331","authenticated-orcid":false,"given":"Prince","family":"Yeboah","sequence":"first","affiliation":[{"name":"Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6754-0069","authenticated-orcid":false,"given":"Dennis Bomansang","family":"Daliri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Komfo Anokye Teaching Hospital, Kumasi, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1965-4253","authenticated-orcid":false,"given":"Ahmad Yaman","family":"Abdin","sequence":"additional","affiliation":[{"name":"Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-4409","authenticated-orcid":false,"given":"Emmanuel","family":"Appiah-Brempong","sequence":"additional","affiliation":[{"name":"Department of Health Promotion & Education, School of Public Health, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-6873","authenticated-orcid":false,"given":"Werner","family":"Pitsch","sequence":"additional","affiliation":[{"name":"Department for Economics and Sociology of Sports, Faculty of Economics and Empirical Human Sciences, Institute of Sport Sciences, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anto Berko","family":"Panyin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3303-148X","authenticated-orcid":false,"given":"Emmanuel Bentil Asare","family":"Adusei","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Chemistry, Faculty of Pharmacy & Pharmaceutical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afraa","family":"Razouk","sequence":"additional","affiliation":[{"name":"Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2911-2607","authenticated-orcid":false,"given":"Muhammad Jawad","family":"Nasim","sequence":"additional","affiliation":[{"name":"Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6288-7220","authenticated-orcid":false,"given":"Claus","family":"Jacob","sequence":"additional","affiliation":[{"name":"Division of Bioorganic Chemistry, School of Pharmacy, Saarland University, 66123 Saarbruecken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1126\/science.abd3902","article-title":"COVID-19 in Africa: Dampening the storm?","volume":"369","author":"Mbow","year":"2020","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/S0140-6736(20)30411-6","article-title":"Preparedness and vulnerability of African countries against importations of COVID-19: A modelling study","volume":"395","author":"Gilbert","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.ijid.2020.02.049","article-title":"Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future","volume":"93","author":"Kapata","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.9745\/GHSP-D-21-00172","article-title":"The conundrum of Low COVID-19 mortality burden in sub-Saharan Africa: Myth or reality?","volume":"9","author":"Adams","year":"2021","journal-title":"Glob. Health Sci. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e143380","DOI":"10.1172\/JCI143380","article-title":"Recent endemic coronavirus infection is associated with less-severe COVID-19","volume":"131","author":"Sagar","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4956","DOI":"10.1038\/s41598-021-84487-0","article-title":"COVID-19 in South Africa: Outbreak despite interventions","volume":"11","author":"Bossert","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e884","DOI":"10.1016\/S2214-109X(20)30234-5","article-title":"Leveraging Africa\u2019s preparedness towards the next phase of the COVID-19 pandemic","volume":"8","author":"Senghore","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bonful, H.A., Addo-Lartey, A., Aheto, J.M.K., Ganle, J.K., Sarfo, B., and Aryeetey, R. (2020). Limiting spread of COVID-19 in Ghana: Compliance audit of selected transportation stations in the Greater Accra region of Ghana. PLoS ONE, 15.","DOI":"10.1101\/2020.06.03.20120196"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1038\/s41591-020-0960-y","article-title":"Socio-demographic and epidemiological consideration of Africa\u2019s COVID-19 response: What is the possible pandemic course?","volume":"26","author":"Gaye","year":"2020","journal-title":"Nat. Med."},{"key":"ref_10","unstructured":"(2021, September 24). Press Releases|COVID-19|Ghana. Available online: https:\/\/www.ghanahealthservice.org\/covid19\/press-releases.php."},{"key":"ref_11","unstructured":"(2021, November 23). Why Is Europe Returning to the Dark Days of COVID?. The ASEAN Post, Available online: https:\/\/theaseanpost.com\/article\/why-europe-returning-dark-days-covid."},{"key":"ref_12","unstructured":"Lund-Thomsen, P., and Ramirez, J. (2020). Beyond Compliance and Cooperation?, CBS."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102372","DOI":"10.1016\/j.scs.2020.102372","article-title":"Data-driven dynamic clustering framework for mitigating the adverse economic impact of Covid-19 lockdown practices","volume":"62","author":"Rahman","year":"2020","journal-title":"Sustain. Cities Soc."},{"key":"ref_14","unstructured":"Barrett, G. (2021). The Future of Legal Europe: Will We Trust in It?, Springer Nature."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1136\/jech-2020-214290","article-title":"Harnessing behavioural science in public health campaigns to maintain \u2018social distancing\u2019 in response to the COVID-19 pandemic: Key principles","volume":"74","author":"Bonell","year":"2020","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Fox, J., and Weisberg, S. (2018). An R Companion to Applied Regression, Sage Publications.","DOI":"10.32614\/CRAN.package.carData"},{"key":"ref_17","unstructured":"Canty, A., and Ripley, B.D. (2021, December 06). boot: Bootstrap R (S-Plus) Functions. R Package Version 1.3-28. Available online: https:\/\/cran.r-project.org\/web\/packages\/boot\/citation.html."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yapi, R., Houngbedji, C., N\u2019Guessan, D., Dind\u00e9, A., Sanhoun, A., Amin, A., Gboko, K., Heitz-Tokpa, K., Fokou, G., and Bonfoh, B. (2021). Knowledge, attitudes, and practices (KAP) regarding the COVID-19 outbreak in C\u00f4te d\u2019Ivoire: Understanding the Non-compliance of populations with Non-pharmaceutical interventions. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094757"},{"key":"ref_19","first-page":"134","article-title":"Knowledge, Attitude and Practice of Gambians towards the Novel Coronavirus (COVID-19) Pandemic in The Gambia: A cross-sectional study","volume":"34","author":"Mendy","year":"2021","journal-title":"Afr. J. Health Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"618731","DOI":"10.3389\/fpubh.2020.618731","article-title":"Knowledge, attitude, and Self-Reported practice toward measures for prevention of the spread of COVID-19 among ugandans: A nationwide online Cross-Sectional survey","volume":"8","author":"Ssebuufu","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ali, M., Nelson, A., Lopez, A.L., and Sack, D.A. (2015). Updated Global Burden of Cholera in Endemic Countries. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003832"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Besser, A., Flett, G.L., Nepon, T., and Zeigler-Hill, V. (2020). Personality, cognition, and adaptability to the COVID-19 pandemic: Associations with loneliness, distress, and positive and negative mood states. Int. J. Ment. Health Addict., 1\u201325.","DOI":"10.1007\/s11469-020-00421-x"},{"key":"ref_23","unstructured":"Nettleton, S. (2020). The Sociology of Health and Illness, John Wiley & Sons."},{"key":"ref_24","first-page":"1","article-title":"A cross-sectional survey of knowledge, attitude and practice (KAP) towards COVID-19 pandemic among the Syrian residents","volume":"21","year":"2021","journal-title":"BMC Public Health"},{"key":"ref_25","first-page":"66","article-title":"COVID-19 Perception, knowledge, and preventive practice: Comparison between South Korea, Ethiopia, and democratic republic of Congo","volume":"24","author":"Lee","year":"2020","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s10900-020-00827-7","article-title":"Knowledge, Perceptions, and Attitude of Egyptians Towards the Novel Coronavirus Disease (COVID-19)","volume":"45","author":"Abdelhafiz","year":"2020","journal-title":"J Community Health"},{"key":"ref_27","unstructured":"(2021, November 21). Ghana Living Wage Individual|2021 Data|2022 Forecast|2015\u20132020 Historical. Available online: https:\/\/tradingeconomics.com\/ghana\/living-wage-individual."},{"key":"ref_28","first-page":"100191","article-title":"Adherence to social distancing and wearing of masks within public transportation during the COVID 19 pandemic","volume":"7","author":"Dzisi","year":"2020","journal-title":"Transp. Res. Interdiscip. Perspect."},{"key":"ref_29","unstructured":"Zhang, J., Nonvignon, J., and Mao, W. (2021, December 06). How Well is Ghana\u2014With One of the Best Testing Capacities in Africa\u2014Responding to COVID-19? Brook Institution. Available online: https:\/\/www.brookings.edu\/blog\/future-development\/2020\/07\/28\/how-well-is-ghana-with-one-of-the-best-testing-capacities-in-africa-responding-to-covid-19\/."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Saba, C.K.S. (2021, November 21). COVID-19: Implications for Food, Water, Hygiene, Sanitation, and Environmental Safety in Africa: A Case Study in Ghana. Available online: https:\/\/www.preprints.org\/manuscript\/202005.0369\/v1.","DOI":"10.20944\/preprints202005.0369.v1"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"22407","DOI":"10.1038\/s41598-020-79898-4","article-title":"Physical distancing and risk of COVID-19 in small-scale fisheries: A remote sensing assessment in coastal Ghana","volume":"10","author":"Okyere","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1046\/j.1365-2648.1999.01077.x","article-title":"The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus","volume":"30","year":"1999","journal-title":"J. Adv. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-019-2904-x","article-title":"Role of individual perceptions in the consistent use of malaria preventive measures: Mixed methods evidence from rural Rwanda","volume":"18","author":"Asingizwe","year":"2019","journal-title":"Malar. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s10865-007-9118-3","article-title":"The Role of Self-Efficacy in HIV treatment adherence: Validation of the HIV treatment adherence Self-Efficacy Scale (HIV-ASES)","volume":"30","author":"Johnson","year":"2007","journal-title":"J. Behav. Med."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Mondal, P., Sinharoy, A., Sankoorikal, B.-J., Siddaiah, R., Mazur, L., and Graff, G. (2021). The influence of sociodemographic heterogeneity on the perceptions of COVID-19: A countrywide survey study in the USA. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18178922"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Chen, D., and Wang, Y.-J. (2021). Inequality-Related Health and Social Factors and Their Impact on Well-Being during the COVID-19 Pandemic: Findings from a National Survey in the UK. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18031014"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Gamba, R.J., Wood, L.M., Ampil, A., Engelman, A., Lam, J., Schmeltz, M.T., Pritchard, M.M., Santillan, J.K.A., Rivera, E.S., and Ortiz, N. (2021). Investigating the Feasibility of a Restaurant Delivery Service to Improve Food Security among College Students Experiencing Marginal Food Security, a Head-to-Head Trial with Grocery Store Gift Cards. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18189680"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Kim, B.H., Ranzenhofer, L., Stadterman, J., Karvay, Y.G., and Burke, N.L. (2021). Food insecurity and eating pathology in adolescents. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18179155"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Cohen, A., Ozer, E., Rehkopf, D., and Abrams, B. (2021). High school composition and health outcomes in adulthood: A cohort study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073799"},{"key":"ref_40","unstructured":"Seydou, A. (2021, December 06). Who Wants COVID-19 Vaccination? In 5 West African Countries, Hesitancy is High, Trust Low. Available online: https:\/\/afrobarometer.org\/publications\/ad432-who-wants-covid-19-vaccination-5-west-african-countries-hesitancy-high-trust-low."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1038\/s41591-020-1124-9","article-title":"A global survey of potential acceptance of a COVID-19 vaccine","volume":"27","author":"Lazarus","year":"2021","journal-title":"Nat. Med."},{"key":"ref_42","first-page":"1","article-title":"Willingness to accept a potential COVID-19 vaccine in Nigeria","volume":"9","author":"Chiedozie","year":"2021","journal-title":"Am. J. Med. Sci. Med."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Acheampong, T., Akorsikumah, E., Osae-Kwapong, J., Khalid, M., Appiah, A., and Amuasi, J. (2021). Examining vaccine hesitancy in Sub-Saharan Africa: A survey of the knowledge and attitudes among adults to receive COVID-19 vaccines in Ghana. Vaccines, 9.","DOI":"10.3390\/vaccines9080814"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2962","DOI":"10.1080\/21645515.2021.1912551","article-title":"The COVID-19 vaccine social media infodemic: Healthcare providers\u2019 missed dose in addressing misinformation and vaccine hesitancy","volume":"17","author":"Hernandez","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Yeboah, P., Forkuo, A.D., Amponsah, O.K.O., Adomako, N.O., Abdin, A.Y., Nasim, M.J., Werner, P., Panyin, A.B., Emrich, E., and Jacob, C. (2020). Antimalarial drugs in Ghana: A case study on personal preferences. Science, 2.","DOI":"10.3390\/sci2020028"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ditekemena, J., Nkamba, D., Mavoko, A., Fodjo, J.S., Luhata, C., Obimpeh, M., Van Hees, S., Nachega, J., and Colebunders, R. (2021). COVID-19 Vaccine acceptance in the democratic republic of congo: A cross-sectional survey. Vaccines, 9.","DOI":"10.3390\/vaccines9020153"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1353\/hpu.0.0323","article-title":"More than Tuskegee: Understanding Mistrust about Research Participation","volume":"21","author":"Scharff","year":"2010","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"E141","DOI":"10.1503\/cmaj.1095915","article-title":"What\u2019s important to know about the new COVID-19 variants?","volume":"193","author":"Duong","year":"2021","journal-title":"Can. Med. Assoc. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.cmi.2021.05.022","article-title":"Novel SARS-CoV-2 variants: The pandemics within the pandemic","volume":"27","author":"Boehm","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Carcelen, A.C., Prosperi, C., Mutembo, S., Chongwe, G., Mwansa, F.D., Ndubani, P., Simulundu, E., Chilumba, I., Musukwa, G., and Thuma, P. (2021). COVID-19 vaccine hesitancy in Zambia: A glimpse at the possible challenges ahead for COVID-19 vaccination rollout in sub-Saharan Africa. Hum. Vaccines Immunother., 1\u20136.","DOI":"10.1080\/21645515.2021.1948784"},{"key":"ref_51","unstructured":"(2021, November 23). Corona: Germany Measures of the Federal Government. Available online: https:\/\/www.deutschland.de\/en\/news\/german-federal-government-informs-about-the-corona-crisis."},{"key":"ref_52","unstructured":"Saner, E. (2021, November 23). The Psychology of Masks: Why Have so Many People Stopped Covering Their Faces?, The Guardian, Available online: https:\/\/www.theguardian.com\/world\/2021\/oct\/26\/the-great-cover-up-why-the-uk-stopped-wearing-face-masks."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/12902\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:42:40Z","timestamp":1760168560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/12902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":52,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182412902"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182412902","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]}}}