Factors associated with awareness and knowledge of COVID-19 prevention in rural Tanzania: A community-based cross-sectional study

Abstract

Introduction: By 2022, reported COVID-19 cases had declined worldwide. However, the disease remained a concern in low- and middle-income countries such as Tanzania, where underreporting and limited surveillance may have obscured the true burden. Since there was no definitive cure, continued prevention, including vaccination, mask use, hygiene practices, and social distancing, remained important. Adherence to these measures depends partly on community awareness and knowledge, yet little was known about whether accurate prevention information had reached remote and nomadic communities. This study assessed factors associated with awareness and knowledge of COVID-19 prevention in rural Tanzania. Methods: A community-based cross-sectional study was conducted in September 2022 in Kibaha and Monduli Districts. Multistage sampling was used to recruit 689 adults aged 18 years and above. Trained interviewers administered structured questionnaires to assess awareness and knowledge of COVID-19 prevention. Knowledge was measured using a 10-item dichotomous scale. Logistic regression was used to identify predictors of awareness that COVID-19 is preventable and adequate knowledge of prevention measures. Analyses were conducted using SPSS version 23. Results: Among 689 participants, 63.4% were female, 50.2% had primary education, and 78.5% were self-employed. Overall, 97.4% had heard of COVID-19, but only 66.9% recognized that it is preventable. Awareness that COVID-19 is preventable was significantly associated with residence and education. Compared with residents of Mlandizi, participants from Esilalei (AOR = 0.3, 95% CI: 0.14–0.50) and Engutoto (AOR = 0.4, 95% CI: 0.22–0.78) were less likely to report this awareness. Participants with no formal education (AOR = 0.0, 95% CI: 0.01–0.18) and primary education (AOR = 0.1, 95% CI: 0.02–0.45) were also less aware than those with college or university education. Among participants who recognized that COVID-19 is preventable (n = 449), knowledge of prevention strategies was consistently high, with a median score of 10 (IQR: 9–10). Mask use (96.0%) and social distancing (95.3%) were the most frequently recognized measures, while staying home when sick (81.7%) and COVID-19 vaccination (84.6%) were less commonly recognized. Conclusion: Although general awareness of COVID-19 was high, recognition that the disease is preventable varied by education and residence. Targeted, context-specific communication is needed to ensure that accurate and actionable prevention information reaches underserved, remote, and nomadic communities.