Perceived risk of COVID-19 infection and associated protective behaviours during the early phase of the pandemic in Uganda: A Cross-sectional online survey

Introduction: Since the first confirmed SARS-CoV-2 infection in Uganda on March 21, 2020, government efforts emphasized individual protective behaviours. However, the extent to which perceived risk of infection influenced adoption of such behaviours remains unclear. We assessed individual risk perception of COVID-19 infection and protective behavioural responses early in the outbreak to inform interventions to reduce COVID-19 spread. Methods: We conducted a cross-sectional online survey from April 27 to May 2, 2020, distributed via social media. Respondents reported on their perceived risk of contracting COVID-19 and preventive behaviours adopted since March 21. We used descriptive statistics, bivariate and multivariate analyses through modified Poisson regression to identify factors associated with perceived risk. Results: Amongst 430 respondents, mean age=37 years (SD = 9.6years), 217 (51%) were males, 344 (80%) were university-educated, and 199 (46%) had >5 household members. Nearly all (97%) self-reported washing their hands regularly, and 412 (96%) believed that regular handwashing prevented COVID-19 spread; 244 (57%) reported that regular handwashing was easy for them. Although 352 (82%) believed face masks prevented spread of COVID-19, only 106(25%) reported wearing them in public; 371 (86%) said they could not easily access masks. Additionally, 400 (93%)believed that using alcohol-based hand sanitizers would prevent COVID-19 spread but only 324 (75%) said they used them. Three hundred and forty-eight (81%) reported being worried about contracting COVID-19. Being worried about contracting COVID-19 was more frequent among participants who washed their hands with soap and water regularly (adjusted prevalence ratio: 4.22, 95%CI: 1.34–13.7). Conclusion: Perceived risk of COVID-19 infection was high and positively associated with regular handwashing behaviour. While nearly all respondents reported regular handwashing, only half found it easy, suggesting that access may have been a challenge for some. Similarly, despite high awareness, mask use was low due to limited access. Efforts should focus on improving mask availability and ensuring that existing handwashing infrastructure remains accessible and sustainable.