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Assessment of Risk Factors of Covid-19 in Peshawar Pakistan: A Cross Sectional Study

Muhammad Ishtiaq1, Rashid Ahmad2, Nadia Qazi3 Adeela Mustafa4*, Syed Shahmeer Raza5, Danial Tahir6, Muhammad Hakim7, Said Akbar Khan8

1Muhammad Ishtiaq-Professor &Chairperson, Department of Community Medicine & Public Health, North West School of Medicine, Hayatabad Peshawar, Pakistan

2Rashid Ahmad-Assistant Professor, Department of Medicine, Lady Reading Hospital/MTI Peshawar Pakistan

3Nadia Qazi-Assistant Professor, Department of Community Medicine & Public Health, North West School of Medicine, Hayatabad Peshawar, Pakistan

4*Adeela Mustafa-Assistant Professor, Department of Community Medicine & Public Health, Khyber Medical College, Peshawar, Pakistan

5Syed Shahmeer Raza-Lecturer, Department of Physiology, Khyber Medical College/Teaching Hospital, Peshawar, Pakistan

6Danial Tahir-Ayub Medical College, Abbottabad Pakistan

7Muhammad Hakim-Institute of Public Health & Social Sciences, Khyber Medical University Peshawar, Pakistan

8Said Akbar Khan-Associate Professor, Department of Earth & Environmental Sciences,Bahria University, Islamabad, Pakistan

Correspondence Author

4*Adeela Mustafa-Assistant Professor, Department of Community Medicine & Public Health, Khyber Medical College, Peshawar, Pakistan.

Cell: +92-345-2909019 Email: [email protected]

ABSTRACT

Background:The Covid-19 pandemic is spreading like a forest fire among the developed and developing countries. The epidemiology of Covid-19 is still unclear and the public health specialist is adding evidence day by day.

Objectives: To identify the risk factors of Covid-19 infection in Peshawar Khyber Pakhtunkhwa, Pakistan.

Study Design: A descriptive Cross-Sectional Study

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Place and Duration of Study:This study was conducted by the Department of Community Medicine North West School of Medicine, Hayatabad, Peshawar, with collaboration of Lady Ready Hospital, and Khyber Medical College, Peshawar, Khyber Pakhtunkhwa Pakistan; from November 2020 to May 2021.

Methodology:A sample size of 139 was selected based upon 10% prevalence with 95%

confidence interval with 5% prevision. A comprehensive structured questionnaire was used to collect information regarding the selected individuals regarding the demographics and risk factors of Covid-19 infection.

Results:Of 139 Covid-19 cases; 117(84.27%) were male, 57.55% had age above 40 years, 54%

had monthly income of less than 30, 000 PKR, 35.97% were unemployed, and 34.53% were illiterate. Regarding BMI status; 17.27 % were overweight and 32.37% were obese. 41.01% had positive tobacco smoking history and only 16.55% had substance abuse. 81% of Covid-19 cases reported that they got infection from the interaction with close contacts; and 94.24% has received information regarding the benefits of PPEs. Only 32.37% know the routes of transmission of Covid-19; and 12.23% reported that social gatherings are responsible for getting Covid-19.

Moreover, 15.83% and 25.90% of Covid-19 are not using face masks before and after Covid-19 infection respectively; whereas the hand hygiene compliance increased from 67.63% to 84.89%

respectively for before and after getting Cvoid-19. The most common symptoms among Covid- 19 cases were fever, cough, sore throat, shortness of breath, myalgia, and abnormal smell etc.

75.54% considered quarantine and only 29.50% revealed isolation as protective measures against Covid-19. Furthermore, 82.73% revealed contact with Covid-19 positive case, 42.45%

with suspected case, and 30.22% reported contact with recovered Covid-19 case.

Conclusion:The Covid-19 infection showed strong relationship with age, gender, socio- economic, important determinants like chronic co-morbidities, obesity, tobacco smoking, PPEs knowledge, health information, and supplements intake, and thus comprehensive preventive and promotive strategies are needed to prioritize the vulnerable communities to reduce the spread and transmission of Covid-19 along with coordination and cooperation from all stakeholders.

KeyWords:Covid-19, Isolation, Quarantine, Socio-Economic, Obesity, Co-morbidities, Personnel Protective Equipments

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INTRODUCTION

The Covid-19 pandemic has resulted in public health security threat; with millions of cases and related deaths being recorded globally. The First case of Covid-19 was reported in December 2019 from China, and since then covid-19 has spread globally and resulted in pandemic(1); and till 5th April 2021, total of 131, 548, 086cases of COVID-19 has been reported, with 2, 856, 237deaths(2, 3). In Pakistan, the first case was reported on February 26, 2020 from Pakistan; and currently according to NCOC Pakistan Covid-19 statistics, total of 692, 231 cases were reported with 14, 821 deaths(4). The Covid-19 has rapidly crossed borders, throughout the whole world and has led to a massive public reaction(5). Since December 2019,this Covid-19 pandemic has triggered a Public Health Emergency of International Concern(6-8).

The Covid-19 pandemic is currently affecting more and more individuals throughout the globe, and everyone is susceptible to the virus. Moreover, the epidemics as well pandemics have impacts on the vulnerable and lower socioeconomic communities(9, 10). Recent researchers revealed that the infectious diseases are more prevalent among adults and common among the overweight, obese and immune-suppressed individuals(11). Moreover, obesity increases risk of Covid-19 infection. The virus shedding is also increased among obese individuals and thus resulting in mutant strain development (12, 13).

The Covid-19 confirmed cases revealed different rates of infection among males and females;

and among 10 to 50 years age groups of females showed increased incidence(14). The determinants of Covid-19 include literacy, employment status, financial resources(8), and the social living habitat. The Covid-19 showed strong significant association with more disadvantaged socio-economic position(15), old age, male, with low monthly income, unhygienic outdoor air quality, and other facilities necessary for daily living purposed(8, 11).

Pandemics are more of a social problem than a health care problem, and only poverty resulting in overcrowding and are a major determinant of Covid-19. The different social determinants of health are interrelated and played major role during Covid-19 pandemic i.e. education level, occupation, income level(8).The confirmed cases of Covid-19 showed variations when compared with different strata of age groups among males and females. Moreover, in 10 to 50 years age groups, the female showed increased incidence(14). Male, aged more than sixty years, with

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history of tobacco smoking is known as a risk factor to Covid-19(16, 17). It is also believed that the chronic conditions i.e. chronic obstructive pulmonary disease, chronic bronchitis, and asthma increases risk of Covid-19 infection(18, 19). Those with chronic diseases like hypertension(11), diabetes mellitus, cardiovascular disease(20), chronic kidney disease(21), and respiratory diseases greatly affect the risk and prognosis of the Covid-19(22, 23); and hypertension is considered as an important determinant of Covid-19 infection(24).

The Covid-19 pandemic called for more close investigations of the family transmission; and the risk of Covid-19 infection is related to duration of exposure to positive Covid-19 case(25). The familial clusters suggested that person-to-person transmission among casual contacts and social gatherings are important transmission routes. Moreover, the index cases have also been linked to recent Wuhan travel history, or to close contacts(14, 26). Furthermore, the clinical manifestations such as fever, fatigue, shortness of breath, myalgia, etc. were associated with the progression of disease(6).

The Covid-19 infection is highly contagious and infectious and is transmitted through droplet nuclei, aerosol and also having indirect routes(22). Although the droplet nuclei are large but the aerosol particles remain airborne due to their small size. The Covid-19 infectious agent remains in air for short time and when gets entry into the respiratory tract results in Covid-19 infection(22, 27). Thus the Covid-19 can be transmissible through contaminated air, direct contact and also via nonliving fomites(28)(29, 30).In case of Covid-19, there is prolonged shedding of Cvoid-19 agent and thus requires strict isolation and proper quarantine measures for effective containment, control and management(17). Thus monitoring and surveillance of close contacts are of utmost importance from public health point of view regarding Covid-19 pandemic(31). Moreover, in order to contain, limit and reduce the transmission of Covid-19, all the preventive measures are applied along with basic protocol for prevention of air borne infections(29). Covid-19 risk can be reduced by personal protective equipment(27, 32). The World Health Organization (WHO) has recommended that all the close contacts and health care workers should use face masks and respirators for prevention of air borne infections(29, 33).

Moreover, the physical activity reduces the risk of high blood pressure, cardio-vascular events, stroke, diabetes mellitus, depression, and accidents; and thus reduces the risk of obesity, and strengthens the immune system(2).

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The WHO acknowledgedthat the general public must wear face mask during the Covid-19 pandemics, and such interventions had an enormous impact on the transmission of secondary cases(34). The face masks are easily available, simple to use, are cheap, and proved highly effective in homes& outside the home; and helps in breaking the chain of infection of Covid-19 transmission. For example, an ecological study conducted in Hong Kong, revealed that face masks for the general public helped a lot in the prevention of Covid-19(34). In healthy populations, the cost effective benefits of using face masks are more when compared to the negative effects. The Centers for Disease Control and Prevention recommended that individuals must wear a face mask in public; and the masks are specifically designed to prevent the respiratory routes of transmission during breathing, speaking, or coughing(35).

Proper hand hygiene i.e. hand sanitization and hand washing with soap and water is effective for prevention of covid-19(36). The mandatory compliance of wearingaface mask has started in many communities(29); and the correct use of different personnel protective equipments proved more effective in case of Covid-19 pandemic(37). According to CDC, the disinfection of hands with soap and water, with gel or foams, or any other antiseptic solution comprises proper and effective hand hygiene measures(30). Furthermore, the healthcare workers are at a higher risk Covid-19infection(27, 29). Social distancing is the preventive measure against COVID-19; and proved highly effective in breaking the chain of transmission(13). Public health researchers also revealed that rural individuals are badly affected due to unhygienic socio-economic conditions as compared to urban individuals. Moreover, the current studies revealed that the high infectiousness and contagiousness of Covid-19 is due to transmission through asymptomatic and pre-symptomatic case following the super spreaders phenomenon(23). An international study also revealed that the Covid-19 infected individuals might have insufficient vitamin D(38), and thus in addition to vitamin D;VitaminB, E& C, along with Omega -3, plays important role and reduces the risk of Covid-19 infection(38-40).

Pakistan is a developing country and has poor social and economic determinants of health. In Pakistan there are limited resources and the health system is weak to control and contain Covid- 19 pandemic. The Covid-19 has spread to each and every part of the country; and thus this cross sectional study was carried out to identify the risk factors of Covid-19 and its important socio- economic determinants in Khyber Pakhtunkhwa province of Pakistan; and to suggest measures

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for the effective prevention and control of Covid-19 infection in order to reduce the further spread, and transmission of Covid-19 infection among the vulnerable communities and also to communicate public health measures and guidelines in the best interest of public.

METHODOLOGY

This descriptive cross-sectional study was conducted by the Department of Community Medicine North West School of Medicine (NWSM) Hayatabad, Peshawar, Khyber Pakhtunkhwa Pakistan; from November 2020 to May 2021. Ethical approval was not required as the Covid-19 self-reported positive cases were assessed regarding the demographic and socio-economic characteristics along with significant dependent and independent variables. A sample size of n=139 was selected based on 95% confidence interval and 5% precision with 10% prevalence.

All the individuals with Covid-19 positive test were included in the study and those who are not the permanent residents of Khyber Pakhtunkhwa were excluded from the study. The structured questionnaire was developed and consists of information regarding demographics, and a comprehensive assessment of risk factors of Covid-19 along with assessment of knowledge and practices of personnel protective equipment’s among the Covid-19 positive cases. There are also questions regarding the behavior, lifestyle factors, pre-existing comorbidities, and symptoms (20). The continuous variables were converted into categories so to make comparisons and the categorical variables were presented in frequency and percentage(2, 24). The obesity was calculated from measurements of height and weight; and the individual was labeled as obese if the calculated BMI was more than 30 kg/m2. Beside the demographics, the socio-economic status was assessed via several questions(24).

RESULT& DISCUSSION

In our study population of n=139; n=117 (84.17%) were males while the remaining 15.83% were females; whereas in a study conducted internationally showed that 59.6% of females were infected by Covid-19(11). Many international studies also revealed that being male gender is a risk factor of Covid-19(6, 16, 41). According to our study findings, the frequency of Covid-19 was high among the male gender as was supported by a study conducted by Wolff et al., 202;

showed higher prevalence among male gender (20). Moreover, in our study, 57.55% of Covid-19

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cases had age 40 or above; whereas in many international studies, the 55 years and above age groups showed higher frequency(20, 22).Furthermore, in our study; 15.83% were females, whereas in a study conducted internationally showed that 50.7% of females were infected by Covid-19(26).In an international study, it was found that among Covid-19 cases 75.2% revealed positive marital history; and in our study, 69.78% had positive marital history(42), and thus showed similarity with international findings as was shown with other demographic characteristics in Table No 1.

According to our study results, the source of information regarding PPEs use was through different resources i.e. internet (46.04%), newspaper (26.62%), TV&Radio (46.04%), Friends/

Colleagues (49.64%), family members (74.10%) and health personnel (38.13%), as shown in Table No 2. Moreover, international studies also revealed online internet source, health care workers(42); and TV&Radio(23).

According to our study results, 84.17% used face mask before Covid-19 infection, and only 74.10% were currently using face mask after getting Covid-19 infection. Only 67.63% were properly following hand hygiene practices before covid-19 infection and 84.89% after covid-19 infection. Moreover, majority of the cases, (n=83, 59.71%) had used face mask before Covid-19 infection (Table No. 3).According to our study findings, 79.14% of cases were following protective measures at their homes or offices against Covid-19 infection. Moreover, in our study, 79.86% presented with fever, 46.04% with cough, 27.34% with shortness of breath, and only 19.42% presented with myalgia (Table No 4); whereas in international studies, the same fever was reported as the most common type symptom i.e. 82.3%; followed by cough (66.3%); and shortness of breath (47.5%) (19). The similar type of symptoms were also revealed by international studies of Song et al., 2020; Wolff et al., 2020; &Shen et al., 2020(19, 20, 26).

The presence of pre-existing non-communicable diseases had an increased risk for Covid-19 infection and found that preexisting hypertension, cardiovascular and renal diseases along with diabetes mellitus showed significant relationship with risk of Covid-19(19, 21). According to our study findings, 46.04% of Covid-19 cases reported chronic diseases beside Covid-19 infection, with diabetes mellitus at top followed by hypertension; whereas in an international study, it was found that 48% of Covid-19 had co-morbidities and hypertension at top followed by diabetes

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mellitus(20). Those individuals having diabetes mellitus have a significantly higher risk of Covid-19 as compared to non-diabetics(21). Thus our study confirmed and supported the findings of many international studies that co-morbidities are approximately 20-51% among the Covid-19 cases(6, 15, 25, 43). In an international it was found that respiratory diseases were prevalent among 9% and 6.75% of Covid-19 cases respectively(24); as was reported by our study findings by showing 9.35% of respiratory problems among the Covid-19 reported cases (Table No 5). Furthermore, according to China CDC reported 2.4% of Covid-19 had chronic respiratory diseases(24). In our study, 6.48% of Covid-19 cases had cardiovascular problems, whereas in many international studies reported that coronary heart disease had 7 to 15 % prevalence among the Covid-19 cases(9)(22). According to our study findings, n=10 (7.19%) of Covid-19 cases reported major or minor type of mental problems, whereas in a study conducted internationally reported 7% of stress symptoms among the Covid-19 cases(7). Moreover, in another study conducted by Solomou&Constantinidou, 2020; revealed that 41% of Covid-19 cases had anxiety problems(44).

The association between COVID-19 positive cases, and overweight and obesity is plausible.

According to our study findings, the obesity was prevalent among 32.37%; and overweight among 17.27% of Covid-19 positive cases; whereas in an international study showed 29.58%

(24). Thus our study supported international studies and revealed similar findings (Table No. 1).

Moreover, our study also showed strong relationship of Covid-19 with obesity and supported international studies conducted by Rozenfeldet al., 2020, and Caciet al., 2020 (11, 12).

In our study, n=57 (41.01%) of Covid-19 cases had positive history of tobacco current status and only 16.55% had history of substance abuse; as was reported by international studies, the Covid- 19 cases showing strong relationship of tobacco smoking, substance abuse and alcoholism(15)(45).Besides public health preventive measures, the social distancing has helped in reduction of Covid-19 transmission (Table No 2). Moreover, there is strong evidence regarding transmission of that Covid-19 in close social and causal contacts with a Covid-19 positive case(8, 26). As we know that socio-economic and demographic features played a key role in the causation and also increase the likelihood of getting Covid-19 infection.Therefore many international studies revealed the importance of avoiding social gatherings and close contacts during the Covid-19 pandemic(11, 31). In a study published bySingu et al., 2020; in

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Journal of Frontiers in Public Health; revealed that 71% of individuals avoid social gatherings and proved helpful in the Covid-19 pandemic (8). Moreover, reduce social contacts along with face masks compliance reduced the transmission of Covid-19 in communities(35, 46).

The determinants of Covid-19 infection are multidimensional and are strongly related to low house hold income(47). According to our study results, 54.68% of Covid-19 cases had monthly income of less than 30, 000, and similar findings were also reported by an international study showing strong relationship with monthly income and socio-economic status of the family (48).

Moreover, in our study; 30.94% had monthly income in between 30, 000 to 70, 000, and only 14.38% had monthly income above 70, 000. In our study, 35.97% of Covid-19 was not employed as shown in Table No 1, and many international studies revealed strong relationship between Covid-19 and unemployed status(8, 23).

In our study, approximately all types of major important medicines along with supplements were used i.e. anti-malarial (53.24%), antiviral (5.04%), antibiotic (42.45%), multivitamins 67.63%, and mixed types (75.54%)(49)(50). Similarly many international studies also revealed antibiotics, antivirals, therapeutic supplements and micronutrients(51)(52). Moreover, the hand safety and hand hygiene compliance proved one of the most effective and beneficial measure for prevention and spread of Covid-19 infection and kills many types of microorganisms, , as shown in Table No 4 (30). According to our study, 74.82% and 38.13% reported used of gloves and sanitizers whereas in an international study; 72 % reported use of glovesand sanitizers(5).

CONCLUSIONS

Covid-19 infection showed strong relationship with age, gender, and socio-economic characteristics. Moreover, Covid-19 also showed relationship with important determinants i.e.

chronic co-morbidities, obesity, tobacco smoking, personnel protective equipments knowledge, health information, and prophylactic medicines and supplements intake. Thus comprehensive preventive and promotive measures should prioritize vulnerable communities and individuals in order to reduce the spread and transmission of Covid-19. Moreover, policies be implemented focusing on the social and economic characteristics of populations, along with coordination and cooperation from key stakeholders and organizations.

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STUDY LIMITATIONS

This study has some limitations. First, the study was conducted on the already Covid-19 positive casesand thus having chances of systematic error due to the laboratory tests conducted by different institutions. Secondly, although it’s a cross sectional study and the issues related to the generalizability cannot be excluded as the sample size was less due to many ethical and social reasons. Thirdly, due to the shortage of time, errors during filling of the questionnaire cannot be ruled out. Fourthly, in this study, only the frequencies and percentages of the respondents were presented and the possibility of the ecological fallacy can be kept in mind. Finally, due to different and specific socio-economic characteristics the results might be impossible to generalize on other communities.

Research Funding

This work had no financial support Ethical Approval

This study was given approval by the Ethical Review Committee of the NWSM Hayatabad Peshawar. Moreover, the respondents were assured that the confidentiality will be maintained at each step of the research and the main aim of the study was for the benefit of the public.

Declaration of competing interest

The authors declared that they have no competing interest regarding this research work REFERENCES

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Table No 1. Frequency &Percentages of Covid-19 Cases (n=139) of Khyber Pakhtunkhwa Pakistan

Demographics of Covid-19 Variables f %

Gender Male 117 84.17

Female 22 15.83

Age Groups < 25 years 18 12.95

(14)

25 - 40 years 41 29.50 40 - 55 years 49 35.25 55 & above 31 22.30 Monthly Income

< 30000 76 54.68 30000 - 700000 43 30.94 70000 &Above 20 14.39 Occupations

Private Job 51 36.69

Govt Job 27 19.42

Housewife 21 15.11

Students & others 40 28.78

Employment Yes 89 64.03

no 50 35.97

Educational Status Literate 91 65.47

Illiterate 48 34.53

Social Setup Rural 38 27.34

Urban 101 72.66

Marital Status

Married 97 69.78

Unmarried 37 26.62

Divorced/

Separated 5 3.60

No of Children

None 51 36.69

1 or 2 43 30.94

3 or 4 28 20.14

> 4 17 12.23

tobacco smoking yes 57 41.01

no 82 58.99

Other Substance abuse yes 23 16.55

no 116 83.45

family system Joint 85 61.15

Nuclear 54 38.85

BMI

< 19 6 4.32

19-24 64 46.04

24-29 24 17.27

30 & above 45 32.37 Table No 2. Frequency &Percentages of Risk Factors of Covid-19 Cases (n=139) of Khyber

Pakhtunkhwa Pakistan

Risk Factor of Covid-19 Response Frequency Percentage

Who was the 1st case affected in your family? You 27 19.42

Parents 31 22.30

(15)

Siblings 23 16.55

Children 8 5.76

Friends 19 13.67

Relatives 15 10.79

Neighbors 16 11.51

Are you having any problem/s after recovering from Covid-19? Yes 36 25.90

No 103 74.10

Have you experienced severe complaints during Covid-19 infection?

Yes 43 30.94

No 96 69.06

Have you received any information regarding PPE use during Covid-19 epidemic?

Yes 131 94.24

No 8 5.76

Source of information regarding PPE use during Covid-19 epidemic

Internet 64 46.04

Watsapp 103 74.10

Newspaper 37 26.62

TV/ Radio 64 46.04

Friends/

Colleagues 69 49.64

Family members 103 74.10 Health

Personnel’s 53 38.13

Any idea, how you got this Covid-19 infection? Yes 45 32.37

No 94 67.63

Any idea that you got Covid-19 infection from contacts with?

Parents 28 20.14

Family members 23 16.55

Friends 15 10.79

Social

Gatherings 17 12.23

Health

Personnel’s 11 7.91

Job Place 32 23.02

Travel 13 9.35

Table No 3. Frequency of Risk Factors of Covid-19 Cases (n=139) of Khyber Pakhtunkhwa Pakistan

Risk Factor of Covid-19 Response Frequency Percentage

Have you used face mask before getting Covid-19 infection? Yes 117 84.17

(16)

No 22 15.83 Are you using face mask after getting Covid-19 infection?

Yes 103 74.10

No 36 25.90

You followed proper hand hygiene practices before getting Covid-19 infection?

Yes 94 67.63

No 45 32.37

You are following hand hygiene practices after getting Covid- 19 infection?

Yes 118 84.89

No 21 15.11

You used PPEs before getting Covid-19 infection?

Yes 107 76.98

No 32 23.02

You are using PPEs after getting Covid-19 infection?

Yes 109 78.42

No 30 21.58

Which type/s of PPEs you used before getting Covid-19 infection?

Face Mask 83 59.71

N 95 Mask 14 10.07

Cloth Face Mask 23 16.55

Google 5 3.60

Gloves 14 10.07

Table No 4. Frequency of Risk Factors of Covid-19 Cases (n=139) of Khyber Pakhtunkhwa Pakistan

Risk Factor of Covid-19 Response Frequency Percentage

Are you following protective measures in your homes/

offices/ work place against Covid-19 infection?

Yes 110 79.14

No 29 20.86

From where did you work during Covid -19 lockdown?

Home 41 29.50

Office 27 19.42

Field Work 20 14.39

None 51 36.69

Common Covid-19 infection symptoms? Fever 111 79.86

Cough 64 46.04

(17)

Sore throat 35 25.18 Shortness of Breath 38 27.34

Myalgia 27 19.42

Abnormal Taste 56 40.29

Abnormal smell 76 54.68

Heart Problems 12 8.63

Renal Problems 8 5.76

What are the protective measures against Covid-19 infection?

Face Masks 123 88.49

Hand Washing 93 66.91

Hand Sanitizing 104 74.82

No Hands Shake 112 80.58

Gloves 53 38.13

No Social Contacts 76 54.68 No Social

Gatherings 47 33.81

No Contact with

Children 14 10.07

Proper Quarantine 105 75.54 Proper Isolation 41 29.50

Used which type of prophylactic medicine against Covid- 19 infection?

Anti-Malarial 74 53.24

Anti-Viral 7 5.04

Anti-Biotic 59 42.45

Multivitamins 94 67.63

Vitamin - C 31 22.30

Vitamin - D 27 19.42

Mixed 105 75.54

Table No 5. Frequency of Risk Factors of Covid-19 cases (n=139) of Khyber Pakhtunkhwa Pakistan

Risk Factor Response Frequency Percentage

Any close contact with Covid-19 case? Yes 115 82.73

No 24 17.27

Visited any confirmed or and suspected Covid-19 case? Yes 59 42.45

No 80 57.55

Visited any recovered confirmed Covid-19 patient? Yes 33 23.74

No 106 76.26

(18)

Visited health facility for other health issue beside Covid- 19 infection?

Yes 42 30.22

No 97 69.78

Are you admitted in hospital for Covid-19 infection? Yes 35 25.18

No 104 74.82

Duration of your admission in hospital

< 10 days 17 12.23

10-20 days 10 7.19

21 & above 8 5.76

Had any acute disease/s beside Covid-19 infection? Yes 27 19.42

No 112 80.58

Had any Chronic disease/s beside Covid-19 infection? Yes 74 53.24

No 65 46.76

Name the Chronic disease/s beside Covid-19 infection?

Diabetes Mellitus 12 8.63

Hypertension 10 7.19

Stroke 4 2.88

Myocardial

infarction 5 3.60

HBV/ HCV 15 10.79

Renal Problem 3 2.16

Respiratory

Problem 13 9.35

Co-morbidity 2 1.44

Mental Illnesses 10 7.19

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