Abstract

Introduction: The COVID-19 pandemic is a real global health crisis. Despite preventive measures, the infection with SARS-CoV-2 continues to rage and has become a community epidemic. The objective of this work was to study SARS-CoV-2 infection among motorcycle taxi drivers in Parakou city in 2021. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection, carried out from February 1 to March 31, 2021. It concerned the motorcycle taxi drivers of Parakou city, selected by random sampling. The variables studied were knowledge, attitude, practice towards COVID-19 and infection with SARS-CoV-2. The data processing was done with the software Epi Data analysis and Stata. Results: Of the 426 subjects surveyed, 83.57% had a good knowledge of COVID-19; however 48.59% had a good attitude and 49.30% an adequate practice toward COVID-19. Factors associated with good knowledge of SARS-CoV-2 infection were school subjects (OR = 1.92; p = 0.025) and monthly income greater than or equal to 40000F CFA (OR = 1.87; p <0.001). The factor associated with good attitude towards SARS-CoV-2 was walking more than 25 neighborhoods (OR = 0.65; p = 0.021) and the factor associated with adequate practice was age over 45 years. (OR = 0.58; p = 0.044). Among these motorcycle taxi drivers, 2 were infected with SARS-CoV-2. The prevalence of SARS-CoV-2 was 0.47%. Conclusion: Motorcycle taxi drivers have a good level of knowledge but an attitude and a practice to be improved. The prevalence of SARS-CoV-2 infection is low in this risk group.

1. Introduction

National and international news is marked by a pandemic called Coronavirus Disease 2019 (COVID-19). It is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first case was identified on December 8, 2019 in Wuhan, Hubei province in China. The virus has been called an “enemy of humanity” by the director of the World Health Organization (WHO) and has spread around the world ¹. On March 11, 2020, the WHO declared COVID-19 a global pandemic ². This disease has led to a global health crisis with heavy economic burdens. It appeared for the first time in Africa on February 14, 2020, precisely in Egypt ³. Benin, like other countries in the world, has not been spared from this pandemic. The first COVID-19 case was detected on March 16, 2020 at Porto-Novo from Burkinabe who had 49-year-old, he entered Beninese territory by air on March 12, 2020 after a stay in Belgium and Burkina-Faso ⁴. COVID-19 is a challenge of health and safety in the workplace. The risk of worker contagion is high in many professions ⁵. Despite preventive measures, SARS-CoV-2 infection continues to rage and has become a community epidemic. This imperatively implies adapting the response to this disease to the current context. Thus, the WHO has recommended a mass screening strategy to all countries affected by the pandemic ⁶. In Benin, the motorcycle taxi is a means of transport widely used by the population. Motorcycle taxi drivers represent a considerable social stratum. In this period of the COVID-19 pandemic, they are vulnerable because they are exposed to all kinds of passengers. They are thus exposed to a risk of contamination and can be a means of spreading COVID-19 because the profession exposes them to non-respect of physical distance, careless handling of coins and banknotes. It is therefore important to study the knowledge, attitudes, practices and prevalence of SARS-CoV-2 infection among motorcycle taxi drivers with the aim of adapting response measures; to isolate and treat positive cases to break the chain of contamination.

2. Methods

The study was conducted over the period from December 2020 to October 2021 with data collection carried out from February 1 to March 31, 2021 in the municipality of Parakou (Borgou, Benin). The study population were 426 taxi-motorcycle drivers in the municipality of Parakou. Sampling was done by simple random draw. The motorcycle taxi drivers who were included in this study are those who were at least 18 years old and who consented to participate in the study. The dependent variables were represented by the levels of knowledge (good, average, insufficient and bad), attitudes (fair, approximate, and harmful) and practices (adequate, inadequate and harmful) whose rating grid used to assess the levels is a questionnaire inspired by that of Essi et al. ⁷ and whether or not SARS-CoV-2 infection is present. Diagnosis of SARS-CoV-2 infection was made by reverse transcription polymerase chain reaction (RT-PCR). Epi Data analysis v2.2.3.187 (EpiData Association 2009) and Stata SE v12.0 (StataCorp LP 2011) software were used for bivariate and multivariate analysis respectively. From an ethical point of view, the study had obtained the prior approval of the Local Ethics Committee for Biomedical Research of the University of Parakou (opinion No. 0383/CLERB-UP/P/SP/R/SA) and the consent free and enlightened of the subjects investigated.

3. Results

A total of 426 drivers participated in this study. The average age of the subjects was 36.52 years ± 9.56 years with the extremes of 19 years and 69 years. They were all male. Sars-Cov2 chemoprophylaxis was practiced by 22.54% of subjects and used quinine and azithromycin respectively in 51.16% and 13.54% of cases. The sources of information on SARS-CoV-2 infection among taxi-motorcycle drivers were radio and television channels (92.72%) and family and friends (80.05%). Among the 426 motorcycle taxi drivers, 2 were infected with SARS-CoV-2; the prevalence were 0.47% (95% CI: 0.13-1.70) (Table 1).

Knowledge was good in 83.57% of respondents, average in 14.79%, insufficient in 1.17% and bad in 0.47%. The attitudes were correct in 48.59% of respondents, approximate in 33.57%, wrong in 17.14% and harmful in 0.7%. The practices were adequate in 49.30% of respondents, inadequate in 20.89% and harmful in 29.81%. (Table 2)

Factors associated with good knowledge of SARS-CoV-2 infection in multivariate analysis were school subjects (OR=1.92: 95% CI OR adjusted 1.08-3.39; p=0.025) and income monthly greater than or equal to CFAF 40,000 (OR=1.87: 95% CI OR adjusted 1.42-2.52; p<0.001). The factor associated with the right attitude towards SARS-CoV-2 in multivariate analysis was walking more than 25 neighborhoods per day (OR=0.65: 95% CI OR adjusted 0.45-0.94; p=0.021). The factor associated with good practice in the face of SARS-CoV-2 in multivariate analysis was age over 45 years (OR= 0.58: 95% CI OR adjusted 0.35-0.98; p=0.044). (Table 3)

4. Discussion

The rating grid used to assess the levels of knowledge, attitude and practice is a questionnaire inspired by the literature ⁷ validated and indicated for this study. Screening for COVID-19 was done by qualitative RT-PCR, the reference method for identifying SARS-CoV-2, recommended by the World Health Organization. Some subjects could be in the incubation phase of SARS-CoV-2 infection. This could be a cause of false negative results for some RT-PCR COVID-19 results and the oropharyngeal swab could be a limitation because the nasopharyngeal swab gives better results ⁸. In the present study, 83.57% of the subjects surveyed had good knowledge. This high rate testifies to the effectiveness of the strategies put in place to raise awareness as part of the response to COVID-19. This result can be superimposed on that found in the general population in Libya which was 81.0% ⁹. In Bangladesh ¹⁰ and Ethiopia ¹¹ in general population studies reported lower proportions of good knowledge, respectively 61.2% and 69.3%. The low proportion in Bangladesh ¹⁰ could be explained by the fact that the data collection was carried out online with the possibility of errors in filling out the questionnaire. A higher proportion (91.6%) of good knowledge was reported among health students, who would have received lessons about the disease in the Democratic Republic of Congo ¹². Schooling and monthly income greater than or equal to 40,000 CFA francs were associated with good knowledge of SARS-CoV-2 infection. In Ethiopia also being educated is a factor associated with good knowledge (OR = 2.78; p = 0.021) ¹¹ and monthly income greater than 93.55 US dollars (about 51.500 CFA francs) was associated with good knowledge (OR = 8; 95% CI: 1.94-33.1) ¹³. The monthly income would make it possible to be connected to the communication media (television, internet, etc.) to follow the news on COVID-19.

The attitude was good in 48.59% in this study. A similar proportion (46%) for the right attitude was reported among international migrants in China ¹⁴. A lower proportion (24.4%) of good attitude was found ¹⁵ in India in people staying in overnight shelters during confinement. This difference could be explained by the fact that the study population was migrants who were not aware of COVID-19. On the other hand, in Bangladesh ¹⁶ and Ethiopia ¹⁷ proportions of good attitude higher than ours, respectively 62.3% and 72.39%. This high proportion of the level of good attitude would be related to the fact that students have the Internet at their fingertips for information. Subjects walking more than 25 neighborhoods (OR=0.65; p=0.021) were at risk of not having a good attitude towards COVID-19. In China ¹⁸ studies proved that epidemic situations in other provincial regions were significantly correlated with migration from Wuhan (p<0.0001). This observation has led most countries, including Benin, as part of the strategy to combat COVID-19, to carry out containment and limit travel. It is urgent to sensitize taxi-motorcycle drivers to limit the number of neighborhoods covered.

The practice was adequate in 49.30% of the subjects surveyed in this study. A similar proportion (44%) of adequate practice was reported in Sudan ¹⁰ among subjects working in public transport. A study In the Democratic Republic of Congo ¹² reported a lower proportion (36.9%) of adequate practice among students. This low proportion would be linked to the non-compliance by students with the barrier measures recommended for the response to COVID-19. Subjects over 45 years old (OR= 0.58; p=0.044) presented a risk of not having an adequate practice in the face of COVID-19. This finding could be harmful because the elderly are subject to severe forms of COVID-19. One stydy ¹⁶ in Bangladesh reported that age >30 years was associated with adequate practice (p<0.001).

The prevalence of SARS-CoV-2 infection in the present study was 0.47% (95% CI: 0.13-1.70). This observation constitutes a real public health problem. Because the taxi-motorcycle driver being in permanent contact with the subjects transported and his colleagues, could spread the disease to several people. Hence the need for the driver and passenger to adopt preventive measures. In Togo a low prevalence (0.7%) of SARS-CoV-2 contamination in populations at high risk of infection including motorcycle taxi drivers was reported ¹⁹. A study ²⁰ in Ethiopia found a prevalence of 3.3%. This difference could be explained by the fact that the study population was visitors to a hospital center likely to be sick subjects or contact subjects. The prevalence of SARS-CoV-2 infection is higher in countries very affected by the pandemic, in this case Egypt ²¹ and France ²² where authors reported 14.3% and 38% respectively. The high prevalence in the study in France ²² could be explained by the fact that screening is carried out among symptomatic healthcare personnel suspected of COVID-19.

5. Conclusion

The study of SARS-CoV-2 infection among taxi-motorcycle drivers in the municipality of Parakou in 2021 reveals that most respondents have a good knowledge of COVID-19. On the other hand, less than half of the drivers have a good attitude and adequate practice in the face of COVID-19. The prevalence of COVID-19 is low but remains worrying because these sick subjects could maintain the chain of contamination. Educational level and monthly income are the factors associated with good knowledge of SARS-CoV-2 infection. The daily number of neighborhoods covered and age are respectively the factors associated with good attitude and good practice in the face of SARS-CoV-2 infection. It is mandatory to take appropriate measures to improve the attitude, practice and break the chain of contamination of COVID-19 among motorcycle taxi drivers. Studies in other at-risk groups to assess the prevalence and factors associated with SARS-CoV-2 infection are to be encouraged.

References