MERS-CoV infection: Mind the public knowledge gap
Identifieur interne : 000E43 ( Pmc/Corpus ); précédent : 000E42; suivant : 000E44MERS-CoV infection: Mind the public knowledge gap
Auteurs : Amen Bawazir ; Eman Al-Mazroo ; Hoda Jradi ; Anwar Ahmed ; Motasim BadriSource :
- Journal of Infection and Public Health [ 1876-0341 ] ; 2017.
Abstract
In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV.
In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information.
The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all <25%). In a multivariate logistic regression analysis age ≤30 years (Odds Ratio (OR) = 1.647, 95%CI 1.048–2.584,
This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted.
Url:
DOI: 10.1016/j.jiph.2017.05.003
PubMed: 28647126
PubMed Central: 7102865
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PMC:7102865Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">MERS-CoV infection: Mind the public knowledge gap</title><author><name sortKey="Bawazir, Amen" sort="Bawazir, Amen" uniqKey="Bawazir A" first="Amen" last="Bawazir">Amen Bawazir</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Mazroo, Eman" sort="Al Mazroo, Eman" uniqKey="Al Mazroo E" first="Eman" last="Al-Mazroo">Eman Al-Mazroo</name><affiliation><nlm:aff id="aff0010">Infection Control Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Jradi, Hoda" sort="Jradi, Hoda" uniqKey="Jradi H" first="Hoda" last="Jradi">Hoda Jradi</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Ahmed, Anwar" sort="Ahmed, Anwar" uniqKey="Ahmed A" first="Anwar" last="Ahmed">Anwar Ahmed</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Badri, Motasim" sort="Badri, Motasim" uniqKey="Badri M" first="Motasim" last="Badri">Motasim Badri</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28647126</idno><idno type="pmc">7102865</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102865</idno><idno type="RBID">PMC:7102865</idno><idno type="doi">10.1016/j.jiph.2017.05.003</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000E43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E43</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">MERS-CoV infection: Mind the public knowledge gap</title><author><name sortKey="Bawazir, Amen" sort="Bawazir, Amen" uniqKey="Bawazir A" first="Amen" last="Bawazir">Amen Bawazir</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Mazroo, Eman" sort="Al Mazroo, Eman" uniqKey="Al Mazroo E" first="Eman" last="Al-Mazroo">Eman Al-Mazroo</name><affiliation><nlm:aff id="aff0010">Infection Control Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Jradi, Hoda" sort="Jradi, Hoda" uniqKey="Jradi H" first="Hoda" last="Jradi">Hoda Jradi</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Ahmed, Anwar" sort="Ahmed, Anwar" uniqKey="Ahmed A" first="Anwar" last="Ahmed">Anwar Ahmed</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Badri, Motasim" sort="Badri, Motasim" uniqKey="Badri M" first="Motasim" last="Badri">Motasim Badri</name><affiliation><nlm:aff id="aff0005">College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Infection and Public Health</title><idno type="ISSN">1876-0341</idno><idno type="eISSN">1876-035X</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV.</p><p>In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information.</p><p>The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all <25%). In a multivariate logistic regression analysis age ≤30 years (Odds Ratio (OR) = 1.647, 95%CI 1.048–2.584, <italic>P</italic> = 0.030), male gender (OR = 1.536, 95%CI 1.105–2.134, <italic>P</italic> = 0.01), and no tertiary education (OR = 1.957, 95%CI 1.264–3.030, <italic>P</italic> = 0.003) were independent significant predictors of poor epidemiological knowledge.</p><p>This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A. Assiri</name></author><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Al Rabeeah, A A" uniqKey="Al Rabeeah A">A.A. Al-Rabeeah</name></author><author><name sortKey="Al Rabiah, F A" uniqKey="Al Rabiah F">F.A. Al-Rabiah</name></author><author><name sortKey="Al Hajjar, S" uniqKey="Al Hajjar S">S. Al-Hajjar</name></author><author><name sortKey="Al Barrak, A" uniqKey="Al Barrak A">A. Al-Barrak</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mailles, A" uniqKey="Mailles A">A. Mailles</name></author><author><name sortKey="Blanckaert, K" uniqKey="Blanckaert K">K. Blanckaert</name></author><author><name sortKey="Chaud, P" uniqKey="Chaud P">P. Chaud</name></author><author><name sortKey="Van Der Werf, S" uniqKey="Van Der Werf S">S. van der Werf</name></author><author><name sortKey="Lina, B" uniqKey="Lina B">B. Lina</name></author><author><name sortKey="Caro, V" uniqKey="Caro V">V. Caro</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Askarian, M" uniqKey="Askarian M">M. Askarian</name></author><author><name sortKey="Danaei, M" uniqKey="Danaei M">M. Danaei</name></author><author><name sortKey="Vakili, V" uniqKey="Vakili V">V. Vakili</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alsolamy, S" uniqKey="Alsolamy S">S. Alsolamy</name></author><author><name sortKey="Arabi, Y M" uniqKey="Arabi Y">Y.M. Arabi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bermingham, A" uniqKey="Bermingham A">A. Bermingham</name></author><author><name sortKey="Chand, M" uniqKey="Chand M">M. Chand</name></author><author><name sortKey="Brown, C" uniqKey="Brown C">C. Brown</name></author><author><name sortKey="Aarons, E" uniqKey="Aarons E">E. Aarons</name></author><author><name sortKey="Tong, C" uniqKey="Tong C">C. Tong</name></author><author><name sortKey="Langrish, C" uniqKey="Langrish C">C. Langrish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ki, M" uniqKey="Ki M">M. Ki</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Reusken, C B" uniqKey="Reusken C">C.B. Reusken</name></author><author><name sortKey="Haagmans, B L" uniqKey="Haagmans B">B.L. Haagmans</name></author><author><name sortKey="Muller, M A" uniqKey="Muller M">M.A. Muller</name></author><author><name sortKey="Gutierrez, C" uniqKey="Gutierrez C">C. Gutierrez</name></author><author><name sortKey="Godeke, G J" uniqKey="Godeke G">G.J. Godeke</name></author><author><name sortKey="Meyer, B" uniqKey="Meyer B">B. Meyer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gautret, P" uniqKey="Gautret P">P. Gautret</name></author><author><name sortKey="Benkouiten, S" uniqKey="Benkouiten S">S. Benkouiten</name></author><author><name sortKey="Salaheddine, I" uniqKey="Salaheddine I">I. Salaheddine</name></author><author><name sortKey="Belhouchat, K" uniqKey="Belhouchat K">K. Belhouchat</name></author><author><name sortKey="Drali, T" uniqKey="Drali T">T. Drali</name></author><author><name sortKey="Parola, P" uniqKey="Parola P">P. Parola</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Memish, Z" uniqKey="Memish Z">Z. Memish</name></author><author><name sortKey="Al Tawfiq, J" uniqKey="Al Tawfiq J">J. Al-Tawfiq</name></author><author><name sortKey="Makhdoom, H" uniqKey="Makhdoom H">H. Makhdoom</name></author><author><name sortKey="Al Rabeeah, A" uniqKey="Al Rabeeah A">A. Al-Rabeeah</name></author><author><name sortKey="Assiri, A" uniqKey="Assiri A">A. Assiri</name></author><author><name sortKey="Alhakeem, R" uniqKey="Alhakeem R">R. Alhakeem</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, M U" uniqKey="Khan M">M.U. Khan</name></author><author><name sortKey="Shah, S" uniqKey="Shah S">S. Shah</name></author><author><name sortKey="Ahmad, A" uniqKey="Ahmad A">A. Ahmad</name></author><author><name sortKey="Fatokun, O" uniqKey="Fatokun O">O. Fatokun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nour, M O" uniqKey="Nour M">M.O. Nour</name></author><author><name sortKey="Babilghith, A O" uniqKey="Babilghith A">A.O. Babilghith</name></author><author><name sortKey="Natto, H A" uniqKey="Natto H">H.A. Natto</name></author><author><name sortKey="Al Amin, F O" uniqKey="Al Amin F">F.O. Al-Amin</name></author><author><name sortKey="Alawneh, S M" uniqKey="Alawneh S">S.M. Alawneh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almutairi, K M" uniqKey="Almutairi K">K.M. Almutairi</name></author><author><name sortKey="Al Helih, E M" uniqKey="Al Helih E">E.M. Al Helih</name></author><author><name sortKey="Moussa, M" uniqKey="Moussa M">M. Moussa</name></author><author><name sortKey="Boshaiqah, A E" uniqKey="Boshaiqah A">A.E. Boshaiqah</name></author><author><name sortKey="Alajilan, A S" uniqKey="Alajilan A">A.S. Alajilan</name></author><author><name sortKey="Vinluan, J M" uniqKey="Vinluan J">J.M. Vinluan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Mohrej, O A" uniqKey="Al Mohrej O">O.A. Al-Mohrej</name></author><author><name sortKey="Al Shirian, S D" uniqKey="Al Shirian S">S.D. Al-Shirian</name></author><author><name sortKey="Al Otaibi, S K" uniqKey="Al Otaibi S">S.K. Al-Otaibi</name></author><author><name sortKey="Tamim, H M" uniqKey="Tamim H">H.M. Tamim</name></author><author><name sortKey="Masuadi, E M" uniqKey="Masuadi E">E.M. Masuadi</name></author><author><name sortKey="Fakhoury, H M" uniqKey="Fakhoury H">H.M. Fakhoury</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Di Giuseppe, G" uniqKey="Di Giuseppe G">G. Di Giuseppe</name></author><author><name sortKey="Abbate, R" uniqKey="Abbate R">R. Abbate</name></author><author><name sortKey="Albano, L" uniqKey="Albano L">L. Albano</name></author><author><name sortKey="Marinelli, P" uniqKey="Marinelli P">P. Marinelli</name></author><author><name sortKey="Angelillo, I F" uniqKey="Angelillo I">I.F. Angelillo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Seale, H" uniqKey="Seale H">H. Seale</name></author><author><name sortKey="Mclaws, M L" uniqKey="Mclaws M">M.-L. McLaws</name></author><author><name sortKey="Heywood, A E" uniqKey="Heywood A">A.E. Heywood</name></author><author><name sortKey="Ward, K F" uniqKey="Ward K">K.F. Ward</name></author><author><name sortKey="Lowbridge, C P" uniqKey="Lowbridge C">C.P. Lowbridge</name></author><author><name sortKey="Macintyre, C" uniqKey="Macintyre C">C. MacIntyre</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Zwart, O" uniqKey="De Zwart O">O. De Zwart</name></author><author><name sortKey="Veldhuijzen, I K" uniqKey="Veldhuijzen I">I.K. Veldhuijzen</name></author><author><name sortKey="Elam, G" uniqKey="Elam G">G. Elam</name></author><author><name sortKey="Aro, A R" uniqKey="Aro A">A.R. Aro</name></author><author><name sortKey="Abraham, T" uniqKey="Abraham T">T. Abraham</name></author><author><name sortKey="Bishop, G D" uniqKey="Bishop G">G.D. Bishop</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hoda, J" uniqKey="Hoda J">J. Hoda</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Public Health</journal-id><journal-id journal-id-type="iso-abbrev">J Infect Public Health</journal-id><journal-title-group><journal-title>Journal of Infection and Public Health</journal-title></journal-title-group><issn pub-type="ppub">1876-0341</issn><issn pub-type="epub">1876-035X</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28647126</article-id><article-id pub-id-type="pmc">7102865</article-id><article-id pub-id-type="publisher-id">S1876-0341(17)30135-1</article-id><article-id pub-id-type="doi">10.1016/j.jiph.2017.05.003</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>MERS-CoV infection: Mind the public knowledge gap</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Bawazir</surname><given-names>Amen</given-names></name><email>bawazir56@hotmail.com</email><email>bawazira@ksau-hs.edu.sa</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Al-Mazroo</surname><given-names>Eman</given-names></name><xref rid="aff0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Jradi</surname><given-names>Hoda</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Ahmed</surname><given-names>Anwar</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Badri</surname><given-names>Motasim</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>College of Public Health and Health Informatics<xref rid="fn0005" ref-type="fn">1</xref>, King Saud Bin Abdulaziz University for Health Sciences<xref rid="fn0010" ref-type="fn">2</xref>, Saudi Arabia</aff><aff id="aff0010"><label>b</label>Infection Control Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: Department of Community and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Mail Code 2350, P.O. Box 3660, Riyadh 11481, Saudi Arabia. <email>bawazir56@hotmail.com</email><email>bawazira@ksau-hs.edu.sa</email></corresp><fn id="fn0005"><label>1</label><p id="npar0005"><ext-link ext-link-type="uri" xlink:href="http://cphhi.ksau-hs.edu.sa" id="intr0005">http://cphhi.ksau-hs.edu.sa</ext-link>.</p></fn><fn id="fn0010"><label>2</label><p id="npar0010"><ext-link ext-link-type="uri" xlink:href="http://www.ksau-hs.edu.sa" id="intr0010">www.ksau-hs.edu.sa</ext-link>.</p></fn></author-notes><pub-date pub-type="pmc-release"><day>21</day><month>6</month><year>2017</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><season>Jan-Feb</season><year>2018</year></pub-date><pub-date pub-type="epub"><day>21</day><month>6</month><year>2017</year></pub-date><volume>11</volume><issue>1</issue><fpage>89</fpage><lpage>93</lpage><history><date date-type="received"><day>31</day><month>1</month><year>2017</year></date><date date-type="rev-recd"><day>5</day><month>4</month><year>2017</year></date><date date-type="accepted"><day>1</day><month>5</month><year>2017</year></date></history><permissions><copyright-statement>© 2017 Production and hosting by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences.</copyright-statement><copyright-year>2017</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="abs0005"><p>In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV.</p><p>In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information.</p><p>The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all <25%). In a multivariate logistic regression analysis age ≤30 years (Odds Ratio (OR) = 1.647, 95%CI 1.048–2.584, <italic>P</italic> = 0.030), male gender (OR = 1.536, 95%CI 1.105–2.134, <italic>P</italic> = 0.01), and no tertiary education (OR = 1.957, 95%CI 1.264–3.030, <italic>P</italic> = 0.003) were independent significant predictors of poor epidemiological knowledge.</p><p>This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted.</p></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>Corona virus</kwd><kwd>Attitude</kwd><kwd>Riyadh</kwd><kwd>Saudi Arabia</kwd><kwd>MERS-CoV</kwd></kwd-group></article-meta></front><body><sec id="sec0005"><title>Introduction</title><p id="par0005">Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus that causes a viral respiratory disease (Middle East respiratory syndrome, MERS) <xref rid="bib0005" ref-type="bibr">[1]</xref>. Globally, the World Health Organization (WHO) has reported 1864 laboratory-confirmed MERS-CoV cases with 659 associated deaths in 27 countries since September 2012 <xref rid="bib0010" ref-type="bibr">[2]</xref>. According to the last WHO report, the Kingdom of Saudi Arabia (KSA) remains the most afflicted country, with remarkable morbidity and mortality rates <xref rid="bib0015" ref-type="bibr">[3]</xref>. The first case of coronavirus infection was identified in the KSA in June 2012 <xref rid="bib0020" ref-type="bibr">[4]</xref>. Subsequently, continuous detection of the virus has been reported in different healthcare facilities in the KSA and other Asian countries, including Korea, the United Arab Emirates and Iran <xref rid="bib0025" ref-type="bibr">[5]</xref>, <xref rid="bib0030" ref-type="bibr">[6]</xref>, <xref rid="bib0035" ref-type="bibr">[7]</xref>, <xref rid="bib0040" ref-type="bibr">[8]</xref>. Most of the reported cases have emerged from the Middle East; other cases reported elsewhere had direct connections with primary cases of infection in the Middle East <xref rid="bib0045" ref-type="bibr">[9]</xref>. Therefore, many countries worldwide have implemented prevention measures, particularly amongst potential travelers to Middle Eastern countries. The KSA is a particular concern since it is the epicenter of the disease and a destination for millions seeking the Haj pilgrimage or Umrah annually.</p><p id="par0010">Strict guidelines have been developed for disease control and prevention, with a particular emphasis on protective measures <xref rid="bib0050" ref-type="bibr">[10]</xref>. These guidelines include frequent and thorough hand washing and avoiding people who are sick and coughing, undercooked meat, unsafe water, close contact with animals and camel-based products, such unpasteurized milk or raw meat <xref rid="bib0020" ref-type="bibr">[4]</xref>. Because no MERS-CoV vaccine is available currently, these protective measures can potentially reduce the risk of viral infection.</p><p id="par0015">Major gaps exist in the knowledge of the epidemiology, prevalence and clinical spectrum of the infection <xref rid="bib0005" ref-type="bibr">[1]</xref>. As highlighted by the WHO, provision of information to the general public about the virus, its transmission modes and adequate protective measures is the cornerstone for prevention and control of the disease <xref rid="bib0050" ref-type="bibr">[10]</xref>, <xref rid="bib0055" ref-type="bibr">[11]</xref>.</p><p id="par0020">Although there is a great need to clarify the nature, genomic features, and epidemiological characteristics of the disease, the number of investigations conducted in this field is far from the expected. This information is urgently needed for the planning and effective implementation of preventive and control measures to combat dissemination of the virus within and outside of the Middle Eastern region. Despite the strong link between the transmission patterns of the disease and both zoonotic transfers and human-to-human transmission <xref rid="bib0060" ref-type="bibr">[12]</xref>, data on the risk and contributing factors to the rapid spread and health effects of the virus are lacking, particularly in hospitalized patients from the KSA <xref rid="bib0040" ref-type="bibr">[8]</xref>. Significant questions remain unanswered on the extent of the Saudi people's awareness of the characteristics and nature of this virus. Finding answers to these questions is instrumental for the implementation of effective preventive measures to reduce and control the frequent occurrence of MERS-CoV outbreaks. Increased public awareness of the disease may decrease the risk of the virus and help combat the disease in the annual mass-gathering events that occur in the KSA, such as the Hajj and Umrah. This study aimed to identify the gap in knowledge of the adult population residing in Riyadh, KSA, toward the nature and transmission modes of MERS-CoV infection.</p></sec><sec id="sec0010"><title>Methods</title><p id="par0025">A cross-sectional study was conducted from June to September of 2015. Five main commercial malls in Riyadh were randomly selected. People in the main cities in the KSA visit malls for different purposes, including shopping and entertainment, all year long. Therefore, malls can be considered representative of the Saudi population for purposes such as scientific research. Approval for the project was obtained from the Research Committee, College of Public Health and Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, and from the Institutional Research Board Committee (IRBC) at King Abdullah International Medical Research Center (KAIMRC) (#IRBC/383/15), Riyadh, National Guard Health Affairs at the Ministry of the National Guard.</p><p id="par0030">The study included Saudi adults living in Riyadh aged 18 years and older. The study excluded non-Saudi adults or visitors from outside of Riyadh. Proportional quota sampling was used to ensure that the respondents were demographically representative of the general population, with quotas based on age, gender, region and social class. A sample size of 768 was calculated based on an expected 50% proportion of poor knowledge in this population toward MERS-CoV transmission and prevention measures at 80% power with a 95% confidence level and a design effect of two <xref rid="bib0050" ref-type="bibr">[10]</xref>. A two-stage sampling method was employed. The first stage consisted of selecting 5 top malls located in different zones of Riyadh city (north, south, middle, east, and west). Then, a simple random sample of adults shopping in these malls who were willing to participate in the study was interviewed using a self-administered questionnaire. To measure the level of knowledge in both males and females, a 1:1 ratio was purposefully chosen. The enrollment strategy was undertaken to cover all three different work shifts of the malls (morning, afternoon, and night). Of 768 possible participants, 676 individuals of both genders were successfully interviewed (response rate = 88.02%).</p><sec id="sec0015"><title>Data collection tool</title><p id="par0035">All respondents were informed of the purpose of the study. Consenting participants were selected randomly from each study site, and a self-administered questionnaire was distributed and filled out by the participants. The questionnaire was initially designed in English after a thorough search for relevant recent literature on public knowledge, attitudes and practices. Further information was retrieved from the WHO and the KSA Ministry of Health websites on both the H1N1 virus <xref rid="bib0050" ref-type="bibr">[10]</xref> and MERS-CoV <xref rid="bib0065" ref-type="bibr">[13]</xref>, <xref rid="bib0070" ref-type="bibr">[14]</xref>, <xref rid="bib0075" ref-type="bibr">[15]</xref> and was adapted with some modifications to the local context of both the nature of coronaviruses and the cultural context of the KSA. Furthermore, the questionnaire was reviewed by experts in infectious diseases for relevance, simplicity and internal consistency. Arabic translation of the questionnaire was conducted by a professional translator.</p><p id="par0040">The questionnaire was designed to contain 5 parts, of which three parts were reported in this study. These parts included socio-demographic information [age (<30 or ≥30 years), gender, marital status (married or unmarried), education level (tertiary or no tertiary) and occupation (employed or unemployed)], seven questions on the participants’ sources of information about the disease and 18 questions measuring the level of knowledge (nature of the disease, transmission, signs and symptoms, and methods of prevention). A Likert scale (yes, no, and do not know) was used in 18 questions to measure knowledge. The 18 knowledge questions were categorized into two knowledge domains (epidemiological and clinical). The former domain included 10 questions, and the latter domain included 8 questions. The epidemiological domain questions were related to knowledge of the nature of the causative agent, modes of transmission (droplets, contact, and animal to man or other transmission), incubation period and availability of vaccines. The clinical domain measured knowledge of the clinical signs and symptoms (cough, fever, shortness of breath, pharyngitis, diarrhea, no symptoms, death and other consequences) and questions inquiring about the availability of a cure for the disease. To evaluate the responses to these questions, a correct answer was allocated a value of one, and a wrong answer was allocated a value of zero. The total possible knowledge score of 18 (range from 0 to 18) was dichotomized to poor knowledge if the total score was <14 (25th percentile of the total score) or good knowledge if the score was ≥14.</p><p id="par0045">A pilot study on 20 subjects was conducted, and the data were analyzed to ensure face validity, comprehension and feasibility. Cronbach's alpha reliability coefficient was 0.71, which was considered satisfactory for the purpose of this study.</p></sec><sec id="sec0020"><title>Data analysis</title><p id="par0050">Data were summarized as frequencies and proportions and were compared using the Chi-square test. Logistic regression models were fitted to identify factors associated with a poor score (a score <14). Variables found significant in the univariate analyses were included in the final multivariate logistic regression analysis. All tests were two-sided, and statistical significance was considered at a <italic>P</italic>-value of <0.05. The data entry and statistical analysis were performed using the Statistical Program for Social Sciences (IBM SPSS Corp, SPSS Statistics ver. 20, USA).</p></sec></sec><sec id="sec0025"><title>Results</title><sec id="sec0030"><title>Sociodemographic characteristics of the participants</title><p id="par0055">The study included 676 participants. Of these, 289 (42.8%) were aged <30 years, 353 (52.2%) were males, 389 (57.5%) were married, 557 (82.4%) had received a tertiary education and 622 (92%) were employed. The sociodemographic characteristics of the participants are shown in <xref rid="tbl0005" ref-type="table">Table 1</xref>.<table-wrap position="float" id="tbl0005"><label>Table 1</label><caption><p>Socio-demographic characteristics of the participants (<italic>N</italic> = 676).</p></caption><alt-text id="at0065">Table 1</alt-text><table frame="hsides" rules="groups"><thead><tr><th colspan="2" align="left">Characteristics</th><th align="left"><italic>n</italic></th><th align="left">%</th></tr></thead><tbody><tr><td align="left">Age</td><td align="left">>30 years</td><td align="left">289</td><td align="left">42.8</td></tr><tr><td align="left"></td><td align="left">≤30 years</td><td align="left">387</td><td align="left">57.2</td></tr><tr><td align="left">Gender</td><td align="left">Female</td><td align="left">323</td><td align="left">47.8</td></tr><tr><td align="left"></td><td align="left">Male</td><td align="left">353</td><td align="left">52.2</td></tr><tr><td align="left">Marital status</td><td align="left">Married</td><td align="left">389</td><td align="left">57.5</td></tr><tr><td align="left"></td><td align="left">Unmarried</td><td align="left">287</td><td align="left">42.5</td></tr><tr><td align="left">Tertiary education</td><td align="left">No</td><td align="left">119</td><td align="left">17.6</td></tr><tr><td align="left"></td><td align="left">Yes</td><td align="left">557</td><td align="left">82.4</td></tr><tr><td align="left">Employment</td><td align="left">No</td><td align="left">54</td><td align="left">8.0</td></tr><tr><td align="left"></td><td align="left">Yes</td><td align="left">622</td><td align="left">92.0</td></tr></tbody></table></table-wrap></p></sec><sec id="sec0035"><title>Source of information regarding the disease</title><p id="par0060">The majority (89.0%) of the respondents reported that information about MERS-CoV was received from the internet, followed by the SMS (23.9%). Few participants reported that they received information from other sources, such as television, healthcare workers, family members, magazines or books (18.7%, 15.5%, 12.6%, 11.0%, and 8.3%, respectively). No significant differences were found in the sources of information between respondents with a good or poor level of knowledge on MERS-CoV in this cohort of participants (<xref rid="tbl0010" ref-type="table">Table 2</xref>).<table-wrap position="float" id="tbl0010"><label>Table 2</label><caption><p>Association between source of information and overall level of knowledge on MERS-CoV.</p></caption><alt-text id="at0070">Table 2</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left"></th><th colspan="2" align="left">Poor<hr></hr></th><th colspan="2" align="left">High<hr></hr></th><th colspan="2" align="left">Total<hr></hr></th><th align="left"></th></tr><tr><th align="left"></th><th align="left">No.</th><th align="left">%</th><th align="left">No.</th><th align="left">%</th><th align="left">No.</th><th align="left">%</th><th align="left"><italic>P</italic>-value</th></tr></thead><tbody><tr><td align="left">Internet</td><td align="left">257</td><td align="left">87.1</td><td align="left">539</td><td align="left">90.0</td><td align="left">796</td><td align="left">89.0</td><td align="left">0.197</td></tr><tr><td align="left">SMS</td><td align="left">80</td><td align="left">27.1</td><td align="left">134</td><td align="left">22.4</td><td align="left">214</td><td align="left">23.9</td><td align="left">0.118</td></tr><tr><td align="left">Television</td><td align="left">52</td><td align="left">17.6</td><td align="left">115</td><td align="left">19.2</td><td align="left">167</td><td align="left">18.7</td><td align="left">0.571</td></tr><tr><td align="left">Health care workers</td><td align="left">40</td><td align="left">13.6</td><td align="left">99</td><td align="left">16.5</td><td align="left">139</td><td align="left">15.5</td><td align="left">0.249</td></tr><tr><td align="left">Family members</td><td align="left">34</td><td align="left">11.5</td><td align="left">79</td><td align="left">13.2</td><td align="left">113</td><td align="left">12.6</td><td align="left">0.482</td></tr><tr><td align="left">Magazines</td><td align="left">29</td><td align="left">9.8</td><td align="left">69</td><td align="left">11.5</td><td align="left">98</td><td align="left">11.0</td><td align="left">0.447</td></tr><tr><td align="left">Books</td><td align="left">19</td><td align="left">6.4</td><td align="left">55</td><td align="left">9.2</td><td align="left">74</td><td align="left">8.3</td><td align="left">0.162</td></tr></tbody></table></table-wrap></p></sec><sec id="sec0040"><title>Knowledge assessment</title><p id="par0065"><xref rid="tbl0015" ref-type="table">Table 3</xref>shows the frequencies of correct responses to each question in the epidemiological and clinical domains. Almost all of the participants had heard of the coronavirus disease and were able to relate its cause to a viral origin (100% and 99%, respectively). The participants also highly recognized the mode of transmission of the disease as via the respiratory tract through coughing (99.0%) and from person to person (94.4%). However, they were less likely to associate the transmission of infection with talking with an infected person or to shaking hands with an infected person (52.4% and 49.3%, respectively). Frequencies of correct answers to questions related to whether the virus could be transmitted from an animal to a person, whether the camel was a reservoir of the causative agent, whether the agent could cause repeated infections and whether they knew of any vaccine against the agent were 86.4%, 84.8%, 66.3%, and 75.1%, respectively. Knowledge about signs and symptoms, such as fever, cough, shortness of breath, pharyngitis and diarrhea, was high (97%). Questions such as “Could MERS-CoV lead to direct death” also showed a high rate of positive answers (89.5%). However, the participants’ knowledge about other questions related to the incubation period of the disease, the recovery of patients and infection without signs and symptoms was poor (59.2%, 25.0%, and 24.1%, respectively).<table-wrap position="float" id="tbl0015"><label>Table 3</label><caption><p>Positive responses on different questions related to epidemiological and clinical knowledge.</p></caption><alt-text id="at0075">Table 3</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left"></th><th align="left">Questions</th><th align="left"><italic>n</italic></th><th align="left">%</th></tr></thead><tbody><tr><td align="left">1</td><td align="left">Have you ever heard about Corona (MERS-CoV)</td><td align="left">676</td><td align="left">100.0</td></tr><tr><td align="left">2</td><td align="left">The corona disease is caused by a virus</td><td align="left">669</td><td align="left">99.0</td></tr><tr><td align="left">3</td><td align="left">MERS-CoV can be transmitted through cough droplets</td><td align="left">672</td><td align="left">99.4</td></tr><tr><td align="left">4</td><td align="left">MERS-CoV can be transmitted from person to person</td><td align="left">638</td><td align="left">94.4</td></tr><tr><td align="left">5</td><td align="left">MERS-CoV can be transmitted through talk with others</td><td align="left">354</td><td align="left">52.4</td></tr><tr><td align="left">6</td><td align="left">MERS-CoV can be transmitted through hand shake with others</td><td align="left">333</td><td align="left">49.3</td></tr><tr><td align="left">7</td><td align="left">MERS-CoV can be transmitted from animal to person</td><td align="left">584</td><td align="left">86.4</td></tr><tr><td align="left">8</td><td align="left">Camels transmit the virus</td><td align="left">573</td><td align="left">84.8</td></tr><tr><td align="left">9</td><td align="left">MERS-CoV can cause multiple infections</td><td align="left">448</td><td align="left">66.3</td></tr><tr><td align="left">10</td><td align="left">Do you know of a vaccine against MERS-CoV</td><td align="left">508</td><td align="left">75.1</td></tr><tr><td align="left">11</td><td align="left">Fever and cough are among the signs and symptoms of MERS-CoV</td><td align="left">670</td><td align="left">99.1</td></tr><tr><td align="left">12</td><td align="left">Shortness of breath is among the signs and symptoms of MERS-CoV</td><td align="left">668</td><td align="left">98.8</td></tr><tr><td align="left">13</td><td align="left">Pharyngitis is among the signs and symptoms of MERS-CoV</td><td align="left">669</td><td align="left">99.0</td></tr><tr><td align="left">14</td><td align="left">Diarrhea is among the signs and symptoms of MERS-CoV</td><td align="left">662</td><td align="left">97.7</td></tr><tr><td align="left">15</td><td align="left">MERS-CoV can lead to direct death</td><td align="left">605</td><td align="left">89.5</td></tr><tr><td align="left">16</td><td align="left">Do you know how long after exposure to MERS-CoV can an individual get sick</td><td align="left">400</td><td align="left">59.2</td></tr><tr><td align="left">17</td><td align="left">A MERS-CoV patient can be cured</td><td align="left">169</td><td align="left">25.0</td></tr><tr><td align="left">18</td><td align="left">MERS-CoV can be found in individuals with no signs or symptoms</td><td align="left">163</td><td align="left">24.1</td></tr></tbody></table></table-wrap></p></sec><sec id="sec0045"><title>Factors related to knowledge about MERS-CoV</title><p id="par0070">Overall, good knowledge was reported in this study (66.4%). However, according to the analysis of the two knowledge domains (epidemiological and clinical), the participants were less knowledgeable (58.3%) regarding the epidemiological features of the disease, whereas they scored high in knowledge (90.7%) regarding the clinical manifestation of MERS-CoV (<xref rid="tbl0020" ref-type="table">Table 4</xref>).<table-wrap position="float" id="tbl0020"><label>Table 4</label><caption><p>Association between participant characteristics and epidemiological, clinical and overall knowledge toward MERS-CoV disease.</p></caption><alt-text id="at0080">Table 4</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left"></th><th align="left"></th><th colspan="5" align="left">Epidemiological<hr></hr></th><th colspan="5" align="left">Clinical<hr></hr></th><th colspan="5" align="left">Overall<hr></hr></th></tr><tr><th colspan="2" align="left">Characteristic</th><th colspan="2" align="left">Good<hr></hr></th><th colspan="2" align="left">Poor<hr></hr></th><th align="left"></th><th colspan="2" align="left">Good<hr></hr></th><th colspan="2" align="left">Poor<hr></hr></th><th align="left"></th><th colspan="2" align="left">Good<hr></hr></th><th colspan="2" align="left">Poor<hr></hr></th><th align="left"></th></tr><tr><th align="left"></th><th align="left"></th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>P</italic><sup>†</sup></th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>P</italic></th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>n</italic></th><th align="left">%</th><th align="left"><italic>P</italic></th></tr></thead><tbody><tr><td align="left">Age</td><td align="left">>30 years</td><td align="left">152</td><td align="left">38.6</td><td align="left">137</td><td align="left">48.6</td><td align="left">0.010</td><td align="left">260</td><td align="left">42.4</td><td align="left">29</td><td align="left">46.0</td><td align="left">0.580</td><td align="left">176</td><td align="left">39.5</td><td align="left">113</td><td align="left">49.1</td><td align="left">0.016</td></tr><tr><td align="left"></td><td align="left">≤30 years</td><td align="left">242</td><td align="left">61.4</td><td align="left">145</td><td align="left">51.4</td><td align="left"></td><td align="left">353</td><td align="left">57.6</td><td align="left">34</td><td align="left">54.0</td><td align="left"></td><td align="left">270</td><td align="left">60.5</td><td align="left">117</td><td align="left">50.9</td><td align="left"></td></tr><tr><td align="left">Gender</td><td align="left">Female</td><td align="left">202</td><td align="left">51.3</td><td align="left">121</td><td align="left">42.9</td><td align="left">0.032</td><td align="left">305</td><td align="left">49.8</td><td align="left">18</td><td align="left">28.6</td><td align="left">0.001</td><td align="left">231</td><td align="left">51.8</td><td align="left">92</td><td align="left">40.0</td><td align="left">0.004</td></tr><tr><td align="left"></td><td align="left">Male</td><td align="left">192</td><td align="left">48.7</td><td align="left">161</td><td align="left">57.1</td><td align="left"></td><td align="left">308</td><td align="left">50.2</td><td align="left">45</td><td align="left">71.4</td><td align="left"></td><td align="left">215</td><td align="left">48.2</td><td align="left">138</td><td align="left">60.0</td><td align="left"></td></tr><tr><td align="left">Marital status</td><td align="left">Married</td><td align="left">240</td><td align="left">60.9</td><td align="left">149</td><td align="left">52.8</td><td align="left">0.036</td><td align="left">355</td><td align="left">57.9</td><td align="left">34</td><td align="left">54.0</td><td align="left">0.546</td><td align="left">270</td><td align="left">60.5</td><td align="left">119</td><td align="left">51.7</td><td align="left">0.028</td></tr><tr><td align="left"></td><td align="left">Unmarried</td><td align="left">154</td><td align="left">39.1</td><td align="left">133</td><td align="left">47.2</td><td align="left"></td><td align="left">258</td><td align="left">42.1</td><td align="left">29</td><td align="left">46.0</td><td align="left"></td><td align="left">176</td><td align="left">39.5</td><td align="left">111</td><td align="left">48.3</td><td align="left"></td></tr><tr><td align="left">University</td><td align="left">No</td><td align="left">49</td><td align="left">12.4</td><td align="left">70</td><td align="left">24.8</td><td align="left">0.000</td><td align="left">93</td><td align="left">15.2</td><td align="left">26</td><td align="left">41.3</td><td align="left">0.000</td><td align="left">55</td><td align="left">12.3</td><td align="left">64</td><td align="left">27.8</td><td align="left">0.000</td></tr><tr><td align="left"></td><td align="left">Yes</td><td align="left">345</td><td align="left">87.6</td><td align="left">212</td><td align="left">75.2</td><td align="left"></td><td align="left">520</td><td align="left">84.8</td><td align="left">37</td><td align="left">58.7</td><td align="left"></td><td align="left">391</td><td align="left">87.7</td><td align="left">166</td><td align="left">72.2</td><td align="left"></td></tr><tr><td align="left">Employment</td><td align="left">No</td><td align="left">24</td><td align="left">6.1</td><td align="left">30</td><td align="left">10.6</td><td align="left">0.032</td><td align="left">47</td><td align="left">7.7</td><td align="left">7</td><td align="left">11.1</td><td align="left">0.337</td><td align="left">27</td><td align="left">6.1</td><td align="left">27</td><td align="left">11.7</td><td align="left">0.010</td></tr><tr><td align="left"></td><td align="left">Yes</td><td align="left">370</td><td align="left">93.9</td><td align="left">252</td><td align="left">89.4</td><td align="left"></td><td align="left">566</td><td align="left">92.3</td><td align="left">56</td><td align="left">88.9</td><td align="left"></td><td align="left">419</td><td align="left">93.9</td><td align="left">203</td><td align="left">88.3</td><td align="left"></td></tr></tbody></table><table-wrap-foot><fn><p><italic>P</italic><sup>†</sup>: <italic>χ</italic> test.</p></fn></table-wrap-foot></table-wrap></p><p id="par0075">The overall level of knowledge varied across several characteristics of the study participants. Individuals who were 30 years of age or older (<italic>P</italic> = 0.016), female (<italic>P</italic> = 0.04), married (<italic>P</italic> = 0.028), had received a tertiary education (<italic>P</italic> < 0.001) and were employed (<italic>P</italic> = 0.10) showed significantly better overall knowledge about MERS-CoV than their counterparts. Knowledge about the clinical manifestations of the disease did not vary significantly by age (<italic>P</italic> = 0.58), marital status (<italic>P</italic> = 0.54), or employment status (<italic>P</italic> = 0.34) (<xref rid="tbl0020" ref-type="table">Table 4</xref>).</p><p id="par0080"><xref rid="tbl0025" ref-type="table">Table 5</xref>shows the final multivariate logistic models for independent predictors of poor epidemiological, clinical, and overall knowledge scores. Some socio-demographic characteristics, such as age, gender, and education level, were significant independent predictors of poor epidemiological knowledge, whereas only the female gender and a tertiary educational level were significant predictors for poor clinical knowledge (<xref rid="tbl0025" ref-type="table">Table 5</xref>).<table-wrap position="float" id="tbl0025"><label>Table 5</label><caption><p>Multivariate factors associated with the poor knowledge toward MERS-CoV disease.</p></caption><alt-text id="at0085">Table 5</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left"></th><th align="left"></th><th colspan="3" align="left">Epidemiological<hr></hr></th><th colspan="3" align="left">Clinical<hr></hr></th><th colspan="3" align="left">Overall<hr></hr></th></tr><tr><th align="left">Factor</th><th align="left"></th><th align="left">OR<sup>†</sup></th><th align="left">95% CI</th><th align="left"><italic>P</italic><sup>‡</sup></th><th align="left">OR</th><th align="left">95% CI</th><th align="left"><italic>P</italic></th><th align="left">OR</th><th align="left">95% CI</th><th align="left"><italic>P</italic></th></tr></thead><tbody><tr><td align="left">Age (years)</td><td align="left">>30 years</td><td align="left">1.647</td><td align="left">1.048–2.584</td><td align="left"><bold>0.030</bold></td><td align="left">1.370</td><td align="left">0.660–2.950</td><td align="left">0.421</td><td align="left">1.618</td><td align="left">1.01–2.591</td><td align="left"><bold>0.045</bold></td></tr><tr><td align="left"></td><td align="left">≤30 years</td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td></tr><tr><td align="left">Gender</td><td align="left">Male</td><td align="left">1.536</td><td align="left">1.105–2.134</td><td align="left"><bold>0.011</bold></td><td align="left">2.556</td><td align="left">1.399–4.670</td><td align="left"><bold>0.002</bold></td><td align="left">1.790</td><td align="left">1.264–2.534</td><td align="left"><bold><0.001</bold></td></tr><tr><td align="left"></td><td align="left">Female</td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td></tr><tr><td align="left">Marital status</td><td align="left">Unmarried</td><td align="left">0.845</td><td align="left">0.538–1.328</td><td align="left">0.466</td><td align="left">0.640</td><td align="left">0.294–1.395</td><td align="left">0.262</td><td align="left">0.846</td><td align="left">0.528–1.356</td><td align="left">0.487</td></tr><tr><td align="left"></td><td align="left">Married</td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td></tr><tr><td align="left">University</td><td align="left">No University</td><td align="left">1.957</td><td align="left">1.264–3.030</td><td align="left"><bold>0.003</bold></td><td align="left">4.059</td><td align="left">2.196–7.502</td><td align="left"><bold><0.0001</bold></td><td align="left">2.267</td><td align="left">1.460–3.520</td><td align="left"><bold><0.001</bold></td></tr><tr><td align="left"></td><td align="left">University</td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td></tr><tr><td align="left">Employment</td><td align="left">Employed</td><td align="left">1.576</td><td align="left">0.855–2.904</td><td align="left">0.145</td><td align="left">1.026</td><td align="left">0.402–2.617</td><td align="left">0.957</td><td align="left">1.742</td><td align="left">0.938–3.235</td><td align="left">0.079</td></tr><tr><td align="left"></td><td align="left">Unemployed</td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td><td align="left">1</td><td align="left"></td><td align="left"></td></tr></tbody></table><table-wrap-foot><fn><p>OR<sup>†</sup>: Odds ratio. <italic>P</italic><sup>‡</sup> Wald test.</p></fn></table-wrap-foot></table-wrap></p></sec></sec><sec id="sec0050"><title>Discussion</title><p id="par0085">The present study measured epidemiological and clinical knowledge regarding the MERS-CoV disease among the Saudi population in Riyadh city. Approximately 66% of the study participants had overall good knowledge regarding MERS-CoV (66.4%). This frequency is comparable to the reported knowledge score from a study conducted in Al Qaseem (73.2%) but higher than the knowledge score reported in a study conducted in Makah (32.4%) <xref rid="bib0075" ref-type="bibr">[15]</xref>, <xref rid="bib0080" ref-type="bibr">[16]</xref>. However, these two studies enrolled only healthcare workers and had different sample sizes and respondent characteristics. More nurses were included in the study from Makah than in the study from Qaseem. Our study went further to explore the gap in knowledge among the general population regarding the characteristics of the disease and to determine related factors. To the best of our knowledge, this study is the first to comprehensively assess the necessary and required epidemiological and clinical knowledge aspects of the disease. The study highlights gaps in knowledge and the essential elements required to educate and encourage the Saudi public to play active roles in the prevention and treatment of the disease and possibly reverse the course of this rapidly growing, highly infectious and fatal disease. Additionally, our study adopted a unique approach of separately evaluating the epidemiological and clinical knowledge domains, which typically are combined together in similar studies. Combined assessment of these two domains might overstate the overall knowledge score and obscure the identification of areas with a significant lack of knowledge. Reliance mostly on the clinical manifestations of these types of diseases to assess public knowledge might produce biased results. Our approach allowed us to glean information concerning these areas and identify inadequate epidemiological knowledge and skills that need urgent educational interventions. This approach could be useful for similar studies evaluating public knowledge toward infectious diseases other than Mers-Cov, such SARS, H1N1, Zika, and Ebola.</p><p id="par0090">The overall aim of our analysis was to determine whether the epidemiological and clinical features of the disease were well understood by the public. The findings demonstrated that the public was less knowledgeable regarding the epidemiological features of the disease (58.3%), whereas they expressed good knowledge (90.7%) on the clinical aspects of the disease. In a recent study conducted in Riyadh, Al-Mutairi et al. reported a high rate (91.6%) of public awareness of the viral cause of MERS-CoV <xref rid="bib0085" ref-type="bibr">[17]</xref>. Almutairi et al. relied exclusively on the clinical manifestations of the MERS-CoV disease in their assessment of public knowledge. Compared with the Almutairi et al., study, our study adopted a unique approach of separately evaluating the epidemiological and clinical knowledge domains.</p><p id="par0095">Al-Mohrej and his colleagues concluded in a similar study that Saudi public awareness of MERS-CoV was generally satisfactory <xref rid="bib0090" ref-type="bibr">[18]</xref>. A previous study conducted among the Saudi public in Riyadh regarding the swine flu demonstrated that only 56% of the population was knowledgeable of this viral diseases <xref rid="bib0095" ref-type="bibr">[19]</xref>. This issue of insufficient knowledge of the Saudi public regarding frequently emerging outbreaks underscores the level of implementation of public preventive measures related to outbreak control. Many previous studies designed to assess public attitudes and knowledge regarding the nature of diseases causing outbreaks, such as SARS, H1N1 influenza, and recently MERS-CoV, found that the majority of the participants lacked appropriate information about the infectious agents and how to behave adequately toward these infections <xref rid="bib0035" ref-type="bibr">[7]</xref>, <xref rid="bib0045" ref-type="bibr">[9]</xref>, <xref rid="bib0060" ref-type="bibr">[12]</xref>, <xref rid="bib0100" ref-type="bibr">[20]</xref>, <xref rid="bib0105" ref-type="bibr">[21]</xref>, <xref rid="bib0110" ref-type="bibr">[22]</xref>, <xref rid="bib0115" ref-type="bibr">[23]</xref>.</p><p id="par0100">The significant predictors of the participants’ overall good knowledge in our study were an age ≥30 years, a university educational level, and female gender. This pattern suggests that more emphasis should be placed on the young, male participants and those with a low level of education in programs aimed at increasing awareness of the disease among the public to improve their knowledge about the pandemic MERS-CoV disease.</p><p id="par0105">Similar to a recent study regarding information-seeking behavior for MERS-CoV in Saudi Arabia <xref rid="bib0120" ref-type="bibr">[24]</xref>, most of the participants in this study reported the Internet as their main source of information about MERS-CoV. For this particular reason, research is urgently needed to determine how the Internet can be used for health promotion, particularly for emerging infectious diseases in this country or in a similar context. Alarmingly, the previous study found that the individuals who underestimated the fatality rate of MERS-CoV disease received their information from the Internet <xref rid="bib0120" ref-type="bibr">[24]</xref>. This finding may suggest that the quality of information currently available through the Internet is inadequate and in need of revision. Moreover, a very low percentage of participants indicated that their main source of information was healthcare providers. This scenario reflects a lack of engagement of healthcare workers in increasing awareness of the public regarding the different aspects of MERS-CoV. Measures should be taken to ensure that healthcare workers actually assume their role as the main providers of reliable and correct information.</p><p id="par0110">We acknowledge our study limitations. The study was based on a self-reported questionnaire. Therefore, recall bias and social desirability bias cannot be excluded. The impact of these biases in our study is difficult to assess. The inclusion of innovative interventional methods with informative evaluation plans to monitor the level of knowledge among the community, respond to their needs and fill the gaps with better preventive methods would be helpful in prospective research.</p></sec><sec id="sec0055"><title>Conclusion</title><p id="par0115">Promotion of public knowledge, attitudes and behaviors toward MERS-CoV disease is important due to the virulence, high fatality rate and risk of rapid transmission of the virus in the community. Individuals need more information about the MERS-CoV disease, its transmission mode, and the preventive measures required to minimize its impact. Government health systems and institutions should design and implement advanced and motivational health promotion programs to educate the public and healthcare workers about infectious diseases in general that may spread among populations and about all possible future pandemics.</p></sec><sec id="sec0060"><title>Authors’ contribution</title><p id="par0120">The study was conceptualized and designed by AB. The data were collected by EA. The data analysis was conducted by AB, AA and MB. The manuscript was drafted by AB and HJ. All authors critically reviewed and approved the final version of the manuscript.</p></sec><sec id="sec0065"><title>Funding</title><p id="par0125">No funding sources.</p></sec><sec id="sec0070"><title>Competing interests</title><p id="par0130">None declared.</p></sec><sec id="sec0075"><title>Ethical approval</title><p id="par0135">KAIMRC # IRBC/383/15.</p></sec></body><back><ref-list id="bibl0005"><title>References</title><ref id="bib0005"><label>1</label><element-citation publication-type="journal" id="sbref0005"><person-group person-group-type="author"><name><surname>Assiri</surname><given-names>A.</given-names></name><name><surname>Al-Tawfiq</surname><given-names>J.A.</given-names></name><name><surname>Al-Rabeeah</surname><given-names>A.A.</given-names></name><name><surname>Al-Rabiah</surname><given-names>F.A.</given-names></name><name><surname>Al-Hajjar</surname><given-names>S.</given-names></name><name><surname>Al-Barrak</surname><given-names>A.</given-names></name></person-group><article-title>Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study</article-title><source>Lancet Infect Dis</source><volume>13</volume><issue>9</issue><year>2013</year><fpage>752</fpage><lpage>761</lpage><pub-id pub-id-type="pmid">23891402</pub-id></element-citation></ref><ref id="bib0010"><label>2</label><mixed-citation publication-type="other" id="oref0010">Middle East respiratory syndrome coronavirus (MERS-CoV) [http://www.who.int/emergencies/mers-cov/en/].</mixed-citation></ref><ref id="bib0015"><label>3</label><element-citation publication-type="journal" id="sbref0015"><person-group person-group-type="author"><name><surname>Mailles</surname><given-names>A.</given-names></name><name><surname>Blanckaert</surname><given-names>K.</given-names></name><name><surname>Chaud</surname><given-names>P.</given-names></name><name><surname>van der Werf</surname><given-names>S.</given-names></name><name><surname>Lina</surname><given-names>B.</given-names></name><name><surname>Caro</surname><given-names>V.</given-names></name></person-group><article-title>First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013</article-title><source>Euro Surveill</source><volume>18</volume><issue>24</issue><year>2013</year></element-citation></ref><ref id="bib0020"><label>4</label><mixed-citation publication-type="other" id="oref0020">Middle East respiratory syndrome coronavirus (MERS-CoV) Summary of Current Situation: Literature Update and Risk Assessment [http://www.who.int/emergencies/mers-cov/en/].</mixed-citation></ref><ref id="bib0025"><label>5</label><mixed-citation publication-type="other" id="oref0025">Middle East Respiratory Syndrome [http://www.cdc.gov/coronavirus/mers/].</mixed-citation></ref><ref id="bib0030"><label>6</label><element-citation publication-type="journal" id="sbref0030"><person-group person-group-type="author"><name><surname>Askarian</surname><given-names>M.</given-names></name><name><surname>Danaei</surname><given-names>M.</given-names></name><name><surname>Vakili</surname><given-names>V.</given-names></name></person-group><article-title>Knowledge, attitudes, and practices regarding pandemic H1N1 influenza among medical and dental residents and fellowships in Shiraz, Iran</article-title><source>Int J Prev Med</source><volume>4</volume><issue>4</issue><year>2013</year></element-citation></ref><ref id="bib0035"><label>7</label><element-citation publication-type="journal" id="sbref0035"><person-group person-group-type="author"><name><surname>Alsolamy</surname><given-names>S.</given-names></name><name><surname>Arabi</surname><given-names>Y.M.</given-names></name></person-group><article-title>Infection with Middle East respiratory syndrome coronavirus</article-title><source>Can J Resp Therapy</source><volume>51</volume><issue>4</issue><year>2015</year><fpage>102</fpage></element-citation></ref><ref id="bib0040"><label>8</label><element-citation publication-type="journal" id="sbref0040"><person-group person-group-type="author"><name><surname>Bermingham</surname><given-names>A.</given-names></name><name><surname>Chand</surname><given-names>M.</given-names></name><name><surname>Brown</surname><given-names>C.</given-names></name><name><surname>Aarons</surname><given-names>E.</given-names></name><name><surname>Tong</surname><given-names>C.</given-names></name><name><surname>Langrish</surname><given-names>C.</given-names></name></person-group><article-title>Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012</article-title><source>Euro Surveill</source><volume>17</volume><issue>40</issue><year>2012</year></element-citation></ref><ref id="bib0045"><label>9</label><element-citation publication-type="journal" id="sbref0045"><person-group person-group-type="author"><name><surname>Ki</surname><given-names>M.</given-names></name></person-group><article-title>2015 MERS outbreak in Korea: hospital-to-hospital transmission</article-title><source>Epidemiol Health</source><volume>37</volume><year>2015</year><fpage>1</fpage><lpage>4</lpage></element-citation></ref><ref id="bib0050"><label>10</label><mixed-citation publication-type="other" id="oref0050">Infection prevention/control and management guidelines for patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection [www.moh.gov.sa/en/CCC/.../GuidelinesforCoronaPatients.pdf].</mixed-citation></ref><ref id="bib0055"><label>11</label><mixed-citation publication-type="other" id="oref0055">Infection prevention and control of epidemic-and pandemic-prone acute respiratory diseases in health care: WHO interim guidelines [http://whqlibdoc.who.int/hq/2007/WHO_CDS_EPR_2007.6_eng].</mixed-citation></ref><ref id="bib0060"><label>12</label><element-citation publication-type="journal" id="sbref0060"><person-group person-group-type="author"><name><surname>Reusken</surname><given-names>C.B.</given-names></name><name><surname>Haagmans</surname><given-names>B.L.</given-names></name><name><surname>Muller</surname><given-names>M.A.</given-names></name><name><surname>Gutierrez</surname><given-names>C.</given-names></name><name><surname>Godeke</surname><given-names>G.J.</given-names></name><name><surname>Meyer</surname><given-names>B.</given-names></name></person-group><article-title>Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study</article-title><source>Lancet Infect Dis</source><volume>13</volume><issue>10</issue><year>2013</year><fpage>859</fpage><lpage>866</lpage><pub-id pub-id-type="pmid">23933067</pub-id></element-citation></ref><ref id="bib0065"><label>13</label><element-citation publication-type="journal" id="sbref0065"><person-group person-group-type="author"><name><surname>Gautret</surname><given-names>P.</given-names></name><name><surname>Benkouiten</surname><given-names>S.</given-names></name><name><surname>Salaheddine</surname><given-names>I.</given-names></name><name><surname>Belhouchat</surname><given-names>K.</given-names></name><name><surname>Drali</surname><given-names>T.</given-names></name><name><surname>Parola</surname><given-names>P.</given-names></name></person-group><article-title>Hajj pilgrims knowledge about Middle East respiratory syndrome coronavirus, August to September 2013</article-title><source>Euro Surveill</source><volume>18</volume><issue>41</issue><year>2013</year><fpage>20604</fpage><pub-id pub-id-type="pmid">24135123</pub-id></element-citation></ref><ref id="bib0070"><label>14</label><element-citation publication-type="journal" id="sbref0070"><person-group person-group-type="author"><name><surname>Memish</surname><given-names>Z.</given-names></name><name><surname>Al-Tawfiq</surname><given-names>J.</given-names></name><name><surname>Makhdoom</surname><given-names>H.</given-names></name><name><surname>Al-Rabeeah</surname><given-names>A.</given-names></name><name><surname>Assiri</surname><given-names>A.</given-names></name><name><surname>Alhakeem</surname><given-names>R.</given-names></name></person-group><article-title>Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study</article-title><source>Clin Microbiol infec</source><volume>20</volume><issue>5</issue><year>2014</year><fpage>469</fpage><lpage>474</lpage><pub-id pub-id-type="pmid">24460984</pub-id></element-citation></ref><ref id="bib0075"><label>15</label><element-citation publication-type="journal" id="sbref0075"><person-group person-group-type="author"><name><surname>Khan</surname><given-names>M.U.</given-names></name><name><surname>Shah</surname><given-names>S.</given-names></name><name><surname>Ahmad</surname><given-names>A.</given-names></name><name><surname>Fatokun</surname><given-names>O.</given-names></name></person-group><article-title>Knowledge and attitude of healthcare workers about middle east respiratory syndrome in multispecialty hospitals of Qassim, Saudi Arabia</article-title><source>BMC Public Health</source><volume>14</volume><issue>1</issue><year>2014</year><fpage>1</fpage><pub-id pub-id-type="pmid">24383435</pub-id></element-citation></ref><ref id="bib0080"><label>16</label><element-citation publication-type="journal" id="sbref0080"><person-group person-group-type="author"><name><surname>Nour</surname><given-names>M.O.</given-names></name><name><surname>Babilghith</surname><given-names>A.O.</given-names></name><name><surname>Natto</surname><given-names>H.A.</given-names></name><name><surname>Al-Amin</surname><given-names>F.O.</given-names></name><name><surname>Alawneh</surname><given-names>S.M.</given-names></name></person-group><article-title>Knowledge, attitude and practices of healthcare providers towards MERS-CoV infection at Makkah hospitals, KSA</article-title><source>Int Res J Med Med Sci</source><volume>3</volume><issue>4</issue><year>2015</year><fpage>103</fpage><lpage>112</lpage></element-citation></ref><ref id="bib0085"><label>17</label><element-citation publication-type="journal" id="sbref0085"><person-group person-group-type="author"><name><surname>Almutairi</surname><given-names>K.M.</given-names></name><name><surname>Al Helih</surname><given-names>E.M.</given-names></name><name><surname>Moussa</surname><given-names>M.</given-names></name><name><surname>Boshaiqah</surname><given-names>A.E.</given-names></name><name><surname>Alajilan</surname><given-names>A.S.</given-names></name><name><surname>Vinluan</surname><given-names>J.M.</given-names></name></person-group><article-title>Awareness, attitudes, and practices related to coronavirus pandemic among public in Saudi Arabia</article-title><source>Fam Community Health</source><volume>38</volume><issue>4</issue><year>2015</year><fpage>332</fpage><lpage>340</lpage><pub-id pub-id-type="pmid">26291193</pub-id></element-citation></ref><ref id="bib0090"><label>18</label><element-citation publication-type="journal" id="sbref0090"><person-group person-group-type="author"><name><surname>Al-Mohrej</surname><given-names>O.A.</given-names></name><name><surname>Al-Shirian</surname><given-names>S.D.</given-names></name><name><surname>Al-Otaibi</surname><given-names>S.K.</given-names></name><name><surname>Tamim</surname><given-names>H.M.</given-names></name><name><surname>Masuadi</surname><given-names>E.M.</given-names></name><name><surname>Fakhoury</surname><given-names>H.M.</given-names></name></person-group><article-title>Is the Saudi public aware of Middle East respiratory syndrome?</article-title><source>J Infect Public Health</source><volume>9</volume><issue>3</issue><year>2016</year><fpage>259</fpage><lpage>266</lpage><pub-id pub-id-type="pmid">26589657</pub-id></element-citation></ref><ref id="bib0095"><label>19</label><mixed-citation publication-type="other" id="oref0095">WHO's high-level mission to Saudi Arabia on Middle East respiratory syndrome coronavirus (MERS-CoV)-updates [http://www.emro.who.int/pdf/surveillance-forecasting-response/surveillance-news/mers-mission-january2016.pdf?ua=1].</mixed-citation></ref><ref id="bib0100"><label>20</label><mixed-citation publication-type="other" id="oref0100">Middle East Respiratory Syndrome: Risk assessment [http://www.health.govt.nz/our-work/diseases-and-conditions/middle-east-respiratory-syndrome-coronavirus-mers-cov].</mixed-citation></ref><ref id="bib0105"><label>21</label><element-citation publication-type="journal" id="sbref0105"><person-group person-group-type="author"><name><surname>Di Giuseppe</surname><given-names>G.</given-names></name><name><surname>Abbate</surname><given-names>R.</given-names></name><name><surname>Albano</surname><given-names>L.</given-names></name><name><surname>Marinelli</surname><given-names>P.</given-names></name><name><surname>Angelillo</surname><given-names>I.F.</given-names></name></person-group><article-title>A survey of knowledge, attitudes and practices towards avian influenza in an adult population of Italy</article-title><source>BMC Infect Dis</source><volume>8</volume><issue>1</issue><year>2008</year><fpage>1</fpage><pub-id pub-id-type="pmid">18171470</pub-id></element-citation></ref><ref id="bib0110"><label>22</label><element-citation publication-type="journal" id="sbref0110"><person-group person-group-type="author"><name><surname>Seale</surname><given-names>H.</given-names></name><name><surname>McLaws</surname><given-names>M.-L.</given-names></name><name><surname>Heywood</surname><given-names>A.E.</given-names></name><name><surname>Ward</surname><given-names>K.F.</given-names></name><name><surname>Lowbridge</surname><given-names>C.P.</given-names></name><name><surname>MacIntyre</surname><given-names>C.</given-names></name></person-group><article-title>The community's attitude towards swine flu and pandemic influenza</article-title><source>Med J Aust</source><volume>191</volume><issue>5</issue><year>2009</year><fpage>267</fpage><lpage>269</lpage><pub-id pub-id-type="pmid">19740048</pub-id></element-citation></ref><ref id="bib0115"><label>23</label><element-citation publication-type="journal" id="sbref0115"><person-group person-group-type="author"><name><surname>De Zwart</surname><given-names>O.</given-names></name><name><surname>Veldhuijzen</surname><given-names>I.K.</given-names></name><name><surname>Elam</surname><given-names>G.</given-names></name><name><surname>Aro</surname><given-names>A.R.</given-names></name><name><surname>Abraham</surname><given-names>T.</given-names></name><name><surname>Bishop</surname><given-names>G.D.</given-names></name></person-group><article-title>Avian influenza risk perception, Europe and Asia</article-title><source>Emerg Infect Diseases</source><volume>13</volume><issue>2</issue><year>2007</year><fpage>290</fpage><pub-id pub-id-type="pmid">17479894</pub-id></element-citation></ref><ref id="bib0120"><label>24</label><element-citation publication-type="journal" id="sbref0120"><person-group person-group-type="author"><name><surname>Hoda</surname><given-names>J.</given-names></name></person-group><article-title>Identification of information types and sources by the public for promoting awareness of Middle East respiratory syndrome coronavirus in Saudi Arabia</article-title><source>Health Educ Res</source><volume>31</volume><issue>1</issue><year>2016</year><fpage>12</fpage><lpage>23</lpage><pub-id pub-id-type="pmid">26612051</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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