Knowledge, attitude and practice among Ophthalmic Health Care Personnel (HCP) towards COVID-19 pandemic in Nepal: A web-based cross-sectional study

Background: Being an added high-risk group, ophthalmic HCP are actively providing emergency eye care services, also enthusiastically participating in prevention and control of the COVID-19 pandemic. Hence, this study aimed to assess the level of knowledge, attitude, and practice (KAP) among ophthalmic HCP towards COVID-19 pandemic. Methods: A web-based cross-sectional study was conducted during the period of lockdown among ophthalmic HCP including consultant ophthalmologist, resident, optometrist, ophthalmic assistant, nursing staff, and other paramedics of eye care centers in Nepal. The KAP questionnaire was designed and distributed online. Data were analyzed using the Chi-square test, Pearson correlation, and binary logistic regression. All tests were performed at 95% Confidence Interval (CI) and p-value <0.05 was considered statistically significant. Results: Of 694 participants, the majority were male (59.1%) from the age group 31-40 years (41.5%) and tertiary eye center (68.9%). Among ophthalmic HCP, there were 29.8% consultants ophthalmologist, 22.6% residents, 23.3% optometrist, 15% ophthalmic assistant, and 9.2% other ophthalmic paramedics, 11.7% working as front-liners in COVID-19 centers. Findings showed, 98.1% had good knowledge, 59.4% had a positive attitude and only 13.3% had good practice regarding COVID-19. Binary logistic regression analysis demonstrated the age of HCP to be a significant determinant of good knowledge (Crude Odds Ratio (COR)=0.72, 95%CI=0.62-0.82), positive attitude (COR=0.92, 95%CI=0.90-0.94) and good practice (COR=1.16, 95%CI=1.10-1.21). Lower odds of poor practice was seen among junior resident (COR=0.26, 95% CI=0.14-0.47) and higher odds of poor practice was seen among HCP with job experience of 5-10 years (COR=2.38, 95% CI=1.23-4.60) towards COVID-19 pandemic. Conclusion: The majority of ophthalmic HCP have good knowledge, insufficient positive attitude, and inadequate evidence-based practice towards the COVID-19 pandemic in Nepal. Hence, this study conclusively recommends to modify existing guidelines and formulate new policies to improve KAP among ophthalmic HCP to effectively control the spread of COVID-19.