(SARS-Cov-2) in SECONDARY SCHOOLS and SURROUNDING COMMUNITIES in GAYAZA TOWN

LEVEL OF AWARENESS AND ADHERENCE TOWARDS SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-CoV-2) IN SECONDARY SCHOOLS AND SURROUNDING COMMUNITIES IN GAYAZA TOWN

BY:

NAKITTO SHARIFAH

17\U\775

217001531

A DISSERTATION SUBMITTED TO THE DEPARTMENT OF SCIENCE, TECHNICAL AND VOCATIONAL EDUCATION (DSTVE), IN PARTIAL FULFILMENTFOR THE AWARD OF A BACHELORS DEGREE OF SCIENCE IN EDUCATION OF MAKERERE UNIVERSITY

MARCH 2021

DEDICATION I dedicate this project to my mum Mrs. Nantume Cissy and my husband who have been there for me in all tough and good academic moments.

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ACKNOWLEDGEMENT I acknowledge my lecturers especially my project supervisor Mr. Mulabi N icholas Elijah for the academic guidance he offered to me throughout the struggle to produce this great work. I also acknowledge my relatives who have supported my financially and psychologically.

TABLE OF CONTENTS

DECLARATION ...... i

APPROVAL ...... ii

DEDICATION ...... iii

ACKNOWLEDGEMENT ...... iv

LIST OF TABLES ...... viii

LIST OF FIGURES ...... ix

LIST OF ABBREVIATIONS ...... xi

ABSTRACT ...... xii

CHAPTER ONE:INTRODUCTION ...... 1

1.1 BACKGROUND OF THE STUDY ...... 1

1.2 Problem statement ...... 4

1.3 Justification of the study; ...... 4

1.4 Aim of the study; ...... 5

1.4.1 Objectives of the study; ...... 5

1.4.2Research Questions; ...... 5

1.4.3 Significance of the study ...... 6

1.4.4 Scope of the study; ...... 6

CHAPTER TWO ...... 7

LITEATURE REVIEW ...... 7

2.1 Introduction ...... 7

The situation of COVID-19 in Uganda ...... 8

2.2 Structure of SARS-CoV-2 ...... 8

2.3 Classification of coronaviruses ...... 9

2.4 Replication and lifecycle of coronavirus...... 10

2.5 Transmission, host range and epidemiology...... 10

2.6 Signs and symptoms ...... 11

2.7 Prevention and control...... 12

2.8 Treatment of COVID-19 ...... 12

2.9 Sources of awareness ...... 13

2.10 Role of schools in control of the pandemic ...... 14

CHAPTER THREE ...... 15

RESEARCH METHODOLOGY...... 15

3.1 Description of the study area ...... 15

3.1.1 Study design ...... 16

3.1.2 Study Population ...... 16

3.1.3 Sampling procedure ...... 17

3.1.4 Data collection tools ...... 17

3.2 Data analysis ...... 17

3.2.1Ethical considerations ...... 17

CHAPTER FOUR ...... 19

DATA PRESENTATION ...... 19

4.0 Introduction ...... 19

4.1 Demographic characteristics ...... 19

4.2 The level of awareness of the people in Gayaza Town about SARS-CoV2...... 20

4.3 The avenues through which the people in Banda Town acquire awareness about SARS- CoV2...... 27

4.4 The effectiveness of the strategies put forward to stop the spread of SARS-Covid 19Town. 28

CHAPTER FIVE ...... 35

5.0 Discussion of results ...... 35

5.1 Introduction ...... 35

5.3 level of awareness about COVID 19 among respondents ...... 35

5.3.1 Level awareness about existence of COVID 19 ...... 35

5.3.2 Awareness about how someone can get covid 19 ...... 35

5.3.3 Awareness about signs and symptoms of covid 19...... 36

5.3.5 Major source of awareness about covid 19 among the respondents...... 36

5.4 Adherence to the standard operating procedures (S.O.Ps) ...... 36

5.4.1 putting on a mask ...... 36

5.4.2 Use of sanitizer ...... 37

5.4.3 Washing hands with soap and water ...... 37

5.4.4 Adherence to the standard operating procedures at schools...... 37

5.5 challenges faced when adhering to the standard operating procedures ...... 37

5.5.1 Challenges with mask use ...... 37

CHAPTER SIX ...... 39

CONCLUSIONS AND RECOMMENDATIONS...... 39

6.1 conclusions ...... 39

6.2 recommendations ...... 39

REFERENCES ...... 40

APPENDICES ...... 46

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LIST OF TABLES Table 1: Gender of respondents ...... 19 Table 2: Those who know about Covid ...... 21 Table 3: Those who know how covid 19 is transmitted ...... 22 Table 4: Respondents who knew the signs and symptoms of Covid 19 ...... 23 Table 5: Percentage of respondents who knew how to control covid 19 ...... 25 Table 6: Methods of controlling the spread of Covid 19 ...... 26 Table 7: How respondents got the information of Covid 19 ...... 27 Table 8: Respondents response on how often they put on face masks ...... 29 Table 9: Respondents response on how often they wash hands ...... 30 Table 10: Observation checklist In schools ...... 31 Table 11: Checklist for business centres ...... 32 Table 12: How often people sanitize ...... 32 Table 13:Number of respondents who have a challenge in fulfilling the SOPs ...... 33

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LIST OF FIGURES Figure 1: structure of coronavirus ...... 9 Figure 2: Map of Gayaza Town ...... 15 Figure 3: Percentage of the respondents gender ...... 20 Figure 4: Percentage of Respondents who know about Covid ...... 21 Figure 5: Percentage of respondents who know how covid is transmitted ...... 22 Figure 6: Percentage of respondents who know the signs and symptoms of Covid 19 ...... 24 Figure 7: Percentage of respondents who know the measures to control covid 19 ...... 25 Figure 8: Percentage of different sources of Covid 19 information ...... 28 Figure 9: Percentage of how often respondents put on masks ...... 29 Figure 10: Percentage of how often respondents wash their hands ...... 30 Figure 11: percentage of how often respondents sanitize ...... 33 Figure 12: Percentage of respondents with and without challenges in practicing the standard ... 34

LIST OF APPENDICES

APPENDIX 1: THE SURVEY QUESTIONARE FOR THE SCHOOL ADMINISTRATORS...... 46

APPENDIX 2: THE SURVEY QUESTIONARE FOR THE LEARNERS...... 47

APPENDIX 3: THE OBSERVATION SHEET FOR THE SECONDARY SCHOOLS...... 48

APPENDIX 4: THE SURVEY QUESTIONARE FOR THE SURROUNDIING COMMUNITY MEMBERS...... 49

LIST OF ABBREVIATIONS

ACE 2 : Angiotensin Converting Enzyme-2

CDC : Center for Disease Control and Prevention

COVID-19 : Coronavirus Disease-2019

MERS-C0V : Middle East Respiratory Syndrome Coronavirus

MoH : Ministry of Health

RNA : Ribonucleic Acid

SARS-CoV : Severe Acute Respiratory Syndrome Coronavirus

SARS-CoV-2 : Severe Acute Respiratory Syndrome Coronavirus-2

SOPs: Standard Operating Procedures

WHO: World Health Organization

ABSTRACT This study was carried out to establish the level of awareness and adherence towards Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in secondary schools and surrounding communities in Gayaza town. 150 respondents were selected, among those; 100 were from the surrounding communities, 40 were secondary school learners, and 10 were secondary school administrators, 5 secondary schools were selected for the study. Data was collected using structured questionnaires and observations sheets. Results from the study shown that, 91.3%% of the respondents were aware about the existence of COVID-19. 83%, 100% and 100% of the community members, learners, and secondary school administrators had knowledge about how someone can get COVID-19 while 17% of community members didn’t have knowledge about how someone can get COVID-19. The frequently mentioned way of transmission was ―contact with an infected person‖. The study also revealed that; 90.3%, 100% and 100.0% of the community members, learners and school administrators respectively had knowledge about the signs and symptoms of COVID-19 while 9.6% of community members didn’t have knowledge about the signs and symptoms of COVID-19. 83%, 100% and 100.0% of the community members, learners and school administrators respectively had knowledge about how the spread of COVID-19 while 17% of community members didn’t have knowledge about the spread of COVID-19.95%, 84.3% and 100% of community members, learners and administrators respectively had knowledge about how to control covid 19 and 5%, 15.6% of the learners and community members respectively didn’t know how to control covid 19.The major sources of awareness about COVID-19 was revealed to be television and radio. The results revealed that, 53%and 0% and 0% of the community members learners, and administrators respectively put on a face mask when they are in public, 36.14%, 100% and 100% of community members, learners, and administrators respectively put on a face mask the whole day, 10.84%, 0% and 0% of community members, learners, and administrators respectively never put on a face mask. 71.1%, 92.5%, and 100%of the community members, learners and administrators respectively wash their hands with soap and water many times a day. 25.3%, 7.5% and 0% of the community members, learners and administrators respectively wash their hands only once a day and 3.61% of the community members never wash their hand. 6.02%, 0% and 100%of the community members, learners and administrators respectively use hand sanitizers

xii many times a day. 36.14%,37.5% and 0%of community members, learners and administrators respectively use hand sanitizers once a day, 45.78%,62.5% and 0% of community members, learners and administrators respectively never use sanitizers.

According to the results obtained from the secondary school administrators of the respective secondary schools; 80% of the secondary schools provide face masks to the learners while 20% do not,100.0% of the secondary schools have temperature guns, hand washing facilities with soap and water, and sanitizers. On the issue of social distancing in class; 71.4% of the secondary schools did it by re-streaming the learners, 28.6% did it by assigning private positions to each learner in class.

The study revealed that; 86.75%, 87.5% and 100% of the community members, learners and secondary school administrators face challenges when implementing the S.O.Ps, while; 15.7%, 12.5% and0% of the community members, learners and secondary school administrators don’t face challenges when implementing the S.O.Ps. Majority of the learners and community members face challenges with the use of face masks. The challenges of secondary schools are mainly financial and managerial.

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CHAPTER ONE: INTRODUCTION

1.1 BACKGROUND OF THE STUDY Coronaviruses are a group of pathogenic viruses (Lavi & Weiss, 2012), enveloped, positive sense single stranded RNA viruses. There are various species of coronaviruses, these are; SARS-CoV- 2, HCoV-OC43, SARS-COV, HCoV-HKU1, MERS-CoV. The viruses are spherical in structure with a diameter of 125nm (Malik, 2020). These viruses infect human beings, causing upper respiratory tract diseases, they also infect a wide range of animals (Velavan & Meyer, 2020). The animals being infected by coronaviruses include camels, cattle, cats, and bats (Sahin, 2020). Coronaviruses have a spherical shape (Burrell, 2017)They have spike proteins on their envelops, the envelops are made up of a lipid bilayer, with randomly inserted glycoproteins, they have club like projections on their surfaces which give them a crown like appearance hence the name ―Coronaviruses‖ (Shereen et al., 2020a).

The novel coronaviruses can be briefly classified in order Nidovirales, family Coronaviridae, and subfamily Orthocoronaviridae, and then four genera which are gamma, beta, alpha, and delta coronaviruses (Gautam & Hens, 2020). The coronaviruses happen to be the major pathogens of outbreaks of respiratory diseases (Cascella et al., 2020). These viruses have been hitting the world in the last two decades. The first was Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), this started in Guangdong, China in 2002 and it spread to 26 countries in the Southern Asia, Europe, South Africa, and North America (Guarner, 2020). As recorded by World Health Organization (WHO), SARS-CoV affected a total of 8089 people all over the world, 7322 of them recovered from the virus and 776 patients died of the virus indicating a mortality rate of 9.6% (Shereen et al., 2020). The second was Middle East Respiratory Syndrome Coronavirus (MERS-CoV), this emerged in 2012 in Saudi Arabia. MERS-CoV infected more than 2428 people, 838 patients died of the virus. The recent outbreak of the novel coronavirus called was Severe Acute Respiratory Syndrome Coronavirus 2 (SERS-CoV-2) which causes COVID-19 occurred in Wuhan, China on 30th December 2019 (Guarner, 2020). On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization (Arafa et al., 2020).

This has spread to over 100 countries worldwide in only two months after its outbreak, and affected more than 1,000,000 people, more than 600,000 patients have delivered from the virus and more than 4,000 patients have died of the virus (Shereen et al., 2020).

COVID-19 is a disease caused by a new novel coronavirus called Severe Acute Respiratory syndrome Coronavirus 2 (SARS-CoV-2) (Mbabazi et al., 2020). At the end of 2019, a novel coronavirus was identified in Wuhan city found in the Hubei province of china (Mcintosh, 2020). It caused a range of pneumonia symptoms. This virus was isolated and named SARS-COV-2 it’s the one responsible for the covid-19 pandemic (Guarner, 2020).The initial cases of COVID-19 are said to be from zoonotic transmissions and environmental exposure, for the case of COVID- 19, people got exposed to the virus in the Huanan Seafood market (Q. Li et al., 2020). The preceded cases of COVID-19 were due to human-to-human transmission through direct body contact between a health and an infected person, and also through respiratory droplets from an infected person. The droplets come out when a person sneezes or coughs without covering their mouth and nose with any tissue, these droplets may settle on surfaces, when someone touches that surface, they pick a virus from there and they the virus may enter the body when someone touches his eyes, mouth, or nose with unwashed or un sanitized hand (Sahin, 2020).

This pandemic has impacted many dimensions in the world. Starting in education; all education institutions were closed temporarily in the fight against the pandemic, this impacted both the institutions and the learners, the institutions have registered decreased cash inflows and reduction in enrolment, learners have lost learning time, it’s only a few who continued to have some form of learning, most students have lost their social interactions and psychological support provided by the school settings. There has been also increasing cases of domestic violence, (Centre, 2020). School dropouts especially among girls due to high rates of early pregnancy (Clark et al., 2020). As a consequence of this pandemic, many countries declared state of lockdown to hinder the spread of infection, this resulted into a depression atmosphere and anxiety worldwide associated with social isolation, fears of getting infected, breaks in the supply chains, financial distress, disrupted travel plans, and future uncertainty (Arafa et al., 2020). There was a perception that the virus would be localized in China, but unfortunately, there was a global spillover and it led to economic constraints, people were asked to stay at home and this impacted many economic sectors. There were travel bans, prohibition of mass gatherings which

2 led to sporting and entertainment event cancellation. Social distancing which aimed at preventing the spread of the virus led to shutdown of financial markets, corporate offices, businesses and events (Ozili, Peterson and Arun, 2020). COVID-19 has made many workers lose their jobs, and others working on reduced work schedules. The lockdown greatly putdown small-scale and medium scale enterprises (Kanu, 2020). The pandemic has psychological and social impacts, which include distress, anxiety, fear of getting infected, depression, insomnia and economic difficulties (Serafini et al., 2020). These might lead to substance use and other psychiatric disorder and they are associated with suicidal behavior (Sher, 2020).

1.2 Problem statement Severe Acute Respiratory Syndrome Coronavirus 2 (SERS-CoV2) which is reported to have infected over 46 million people, and more than 1.2 Million deaths in the world. In Uganda, 12,495 COVID-19 cases were identified, with 111 deaths by 1st November (WHO., 2020). When someone gets infected with this virus, they experience muscle pain, fever, dry cough, headache, difficulty in breathing, low white blood cell count and many other life devastating conditions and that person won’t be able to do his/her activities in the community (Huang et al., 2020). These devastating conditions are even worse in individuals with chronic illnesses like diabetes mellitus and those with immuno-complications (R. & S., 2020). Unfortunately, there is no antiviral drugs have been develop yet for the treatment of coronaviruses (Saif et al., 2019). This implies that, there has to be put preventive strategies to fight the virus, these include a lockdown and this greatly impacts the economy of the nation (Kanu, 2020). In Uganda, there is a high prevalence of SERS-CoV2 because the cases are increasing on a daily basis as reported by the Ministry of Health, this puts the citizens at risk of getting infected. Despite of that situation, schools were allowed to open for students in their final years of study, starting from 17th October 2020 in their respective levels of education that is; Primary, Secondary and Tertiary. Therefore, it’s of great importance to carry out this study to establish the level of awareness towards SERS-CoV-2 in schools and neighboring communities and the level of adherence to the Standard Operating Procedures set for the operation of schools (New Vision Thursday, 1st October 2020).

1.3 Justification of the study; School workers coming from neighboring communities where the standard operating procedures aimed at curbing the spread of the corona virus are highly violated, the students and other school residents are susceptible to contracting SARS-CoV-2 as they come into contact with outsiders. Therefore, this study will be conducted to establish the level of awareness and adherence towards corona viruses in schools and the surrounding community.

1.4 Aim of the study; This study is aimed at establishing the level of awareness of Severe Acute Respiratory Syndrome Coronavirus 2 among people in Gayaza Town.

1.4.1 Objectives of the study; a) Establish the level of awareness of the schools and surrounding communities about SARS-CoV-2. b) To establish the extent of adherence to the standard operating procedures in the reopened schools and the community. c) To identify the challenges faced by schools and communities in adhering to the Standard Operating Procedures.

1.4.2 Research Questions; a) What is the level of awareness of the schools and surrounding communities about SARS- CoV-2? b) What is the extent of adherence to the standard operating procedures in the reopened schools and the community? c) What are the challenges faced by schools and communities in adhering to the Standard Operating Procedures?

1.4.3 Significance of the study Findings from this study will help health workers, administrators, and the entire community of Gayaza Town and the country Uganda at large with relevant knowledge about causes, transmission, and prevention of COVID-19.

1.4.4 Scope of the study; The study will be carried out in Gayaza Town. The study will be performed in selected schools and people within the surrounding community in Gayaza Town.

CHAPTER TWO

LITEATURE REVIEW

2.1 Introduction Coronaviruses are a large family of positive sense, single stranded RNA viruses, they are also known to cross species barriers (Cascella et al., 2020), this is mainly due to the fact that these viruses have high mutation rates (Sahin, 2020).There are four known genera of coronaviruses, Alpha, Beta, Delta, and Gama coronaviruses, among the alpha coronaviruses we have HCoV- 229E and NL63, among the Beta coronaviruses we have MERS-CoV, SARS-CoV, HCoV- OC43, and HCoV-HKU1 (X. Li et al., 2020). Coronaviruses are host specific, they infect humans and a variety of various animals (Wu & McGoogan, 2020). When coronaviruses infect their respective hosts, they damage respiratory and gastrointestinal systems (Khan & Fahad, 2020).

For the past 20 years, coronaviruses has become the major pathogens of emerging viral respiratory disease outbreaks in the world (Cascella et al., 2020). According to World Health Organization (WHO), these viral respiratory diseases represent a serious issue to public health. Many viral epidemics have been occurring, for example the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) which occurred in Jeddah, Saudi Arabia (Al-Muhafda et al., 2019). This novel coronavirus caused severe acute respiratory illness in humans and it had a zoonotic origin (Oboho et al., 2015). The other one is Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), this occurred in China in 2003, and it had a zoonotic origin from bats which are the natural reservoirs of this virus (X. Li et al., 2020).

The recent outbreak of the epidemic caused by a coronavirus started in Wuhan, in the Hubei province of China in December 2019. The Chinese Center for Disease Control and Prevention (CDC) did an intensive outbreak investigation program, and the causative agent of the illness was found to be a novel virus of the coronavirus family. On 11th February 2020, WHO announced that the disease caused by this novel virus is called COVID-19, meaning Coronavirus Disease 2019 (Cascella et al., 2020).

The situation of COVID-19 in the world

COVID-19 is one of the epidemics caused by coronaviruses to hit the world, it has spread to over 100 countries worldwide (Shereen et al., 2020). This pandemic has become a global health threat (F. et al., 2020).

By 3rd April 2020, there were 972,303 confirmed COVID-19 cases worldwide, with 50,321 deaths. The European region had the highest number of cases and deaths, 541,808 and 37,103 respectively. The African region had the lowest number of cases and deaths, 55,262 and 164 respectively (WHO., 2020).

The situation of COVID-19 in Africa

By 20th April 2020, 52 out of the 56 African countries had confirmed COVID-19 cases. There were only two virus free African countries which were Lesotho and Comoros. There were 22,313 confirmed COVID-19 cases, with 1,124 deaths and 5,492 recoveries. The Republic of South Africa was the country with the highest number of cases in Africa, there were 3,158 cases. South Sudan was the country with the lowest number of cases, they had only 4 cases (Abdur. R., 2020).

The situation of COVID-19 in Uganda

Fortunately, COVID-19 has not yet spread to many regions in Uganda, its still contained in only the Central Region, in Kampala Capital City and Entebbe Town. By 20th April 2020, there was 55 confirmed COVID-19 cases, with no deaths, and 12 recoveries (MOH., 2020).

2.2 Structure of SARS-CoV-2 SARS-CoV-2 is a spherical Beta coronavirus, its structure is composed the following key parts; the spike glycoprotein (S protein) , membrane (M protein), envelope (E protein), nucleocapsid (N protein) (Luan et al., 2020), and hemagglutinin-esterase (HE protein) dimer glycoproteins along with positive sense single stranded RNA as its genetic material (Poduri et al., 2020). The spike glycoprotein projects as club shaped spikes from the surface of the virus giving it the appearance of a solar corona, hence the name; ―coronavirus.‖ (Shereen et al., 2020). The S proteins assist in the entry of the virus into the host cell. The E protein is a transmembrane protein which acts a channel for the release of viral genomic material to the host cell. The M protein possesses a triple helical bilayer, its main function is development of virus-specific

8 humoral response, it can neutralize the antibodies developed by the patient. The HE dimer glycoproteins play a role in the release of coronaviruses from the infected cells. The N protein is a phosphorylated protein which enables binding of viral RNA in a bead on string conformation, it also aids in the encapsulation of genomic material into the virus particles.(Poduri et al., 2020).

Figure 1: structure of coronavirus

2.3 Classification of coronaviruses Coronaviruses are classified under order Nidovirales, then with three families; Arteriviridae, Coronaviridae, and Mesoviridae. Under family Coronaviridae, there are two subfamilies; Orthocoronavirinae and Torovirinae. Under subfamily Orthocoronavirinae, there are four genera; Alpha coronaviruses, Beta coronaviruses, Gama coronaviruses, and Sigma coronaviruses (Malik, 2020). Among the Beta coronaviruses, we have various species of coronaviruses, these are; SARS-CoV-2, HCoV-OC43, SARS-COV, HCoV-HKU1, MERS-CoV. Under the genus of alpha coronaviruses, there are two species, HCoV-229E, and HCoV-NL63. All of the species of coronaviruses are capable of infecting human beings. SARS-CoV-2 is the one which is responsible for the cause of COVID-19 pandemic (Burrell, 2017).

2.4 Replication and lifecycle of coronavirus. The lifecycle of the coronavirus starts when the virus attaches to the host cell, this attachment is initiated by the S proteins, they interact with the receptor of the virus at the cell membrane of the host cell called Angiotensin Converting Enzyme-2 (ACE 2), the virus uses the host cell’s machinery to manufacture its RNA (Poduri et al., 2020). After attachment, the virus enters the host cell’s cytosol. This occurs by acid dependent proteolytic cleavage of the spike proteins, and this leads to the fusion of the viral membrane and the host cell membrane, after fusion of these membranes, them the viral genome is released into the cytoplasm of the host cell. Then the replicase gene from the viral RNA genome is translated which leads to formation of nonstructural proteins called replicase polyproteins (X. Li et al., 2020). These proteins assemble into a replicase-transcriptase complex to create an environment suitable for genomic RNA synthesis, these complexes are responsible for RNA replication and transcription of the sub- genomic RNAs. After assembly of the replicase complexes, viral RNA synthesis takes place, it produces both genomic and sub-genomic RNAs. The sub-genomic RNAs act as mRNAs for the structural and accessory genes of the virus (Cascella et al., 2020). After the replication and sub- genomic RNA synthesis, the spike, envelope and membrane proteins are translated and inserted into the endoplasmic reticulum, they move along the secretory pathway into the endoplasmic reticulum-Golgi intermediate compartment, in there; the viral RNA genome which is encapsulated by the nucleocapsid protein will bud into the membrane and mature virions are formed, they are transported to the cell surface in vesicles and released by exocytosis (Malik, 2020).

2.5 Transmission, host range and epidemiology. The reason behind getting insight about the host range of SARS-CoV-2 is that, some domestic species might be reservoirs of the virus and transmit it back to humans. The two subgroups of coronaviruses; alpha coronaviruses and beta coronaviruses infect mammals and have a wide host range spanning from bats which are considered to be natural reservoir hosts of many novel coronaviruses, domestic animals, humans and rodents (Y. Li et al., 2020). The domestic animals include camels, pigs, cattle, horses, rabbits, goats, sheep and cats; these might serve as potential intermediate hosts for the virus before it infects humans (Sahin, 2020). Pangolins can also serve as intermediate hosts for SARS-CoV-2. The phylogenetic analyses of coronaviruses have shown that, the bat species is the most probable source of SARS-CoV-2 (Damas et al., 2020). But its

10 intermediate hosts are not clear yet. The angiotensin-converting enzyme 2 (ACE-2) acts as the receptor of SARS-CoV-2 on the human cell, it interacts with the S protein which acts as the epitope of SARS-CoV-2, after this interaction; the virus enters the cell. (Luan et al., 2020).

The initial infections of SARS-CoV-2 are said to be from zoonotic transmissions (X. Li et al., 2020), and environmental exposure in the Huanan Seafood market. The preceded Infections were due to human-to-human transmission through direct body contact between a health and an infected person, and also through respiratory droplets from an infected person, droplets are spread when an infected person sneezes or coughs without covering their mouth and nose with any tissue (Rothan & Byrareddy, 2020). These droplets may settle on surfaces, when a health person touches that surface, they pick a virus and it may enter the body when someone touches his eyes, mouth, or nose with unwashed or un sanitized hands (Sahin, 2020). Transmission can also occur through the fecal-oral route (Q. Li et al., 2020). Both symptomatic and asymptomatic individuals are infectious and are capable of spreading the virus because in both of them there is viral shedding (Mcintosh, 2020).

2.6 Signs and symptoms When someone gets infected with SARS-CoV2, there are manifested signs and symptoms within 1-14 days, and it mainly causes death in the elderly and chronically ill patients (Watkins, 2020). Chronic illnesses include diabetes, hypertension, cardiovascular diseases, and immune complications (F. et al., 2020). At the onset of the infection, the following may occur; fever, dry cough, fatigue (myalgia) where there is pain in one or more muscles. Less common signs and symptoms include; sputum production where there is production of a thick liquid from the lungs, headache, hemoptysis where there is expectoration of blood from some parts of the respiratory tract, diarrhea, dyspnea where there is difficult or labored breathing, leucopenia where there is a low white blood cell count (<1.0*109/l). Dyspnea makes patients need to be supported by high level oxygen supply. (Huang et al., 2020).

The relationship between age and COVID-19-associated morbidity and mortality has also been addressed among health professionals and the general population. The perception that young people's morbid condition is relatively less severe lowered their awareness of preventing infection. One of the most critical issues dealt by clinical and public health professionals during the pandemic is the spectrum of illness severity, understanding COVID-19-associated morbidity

11 and mortality according to age is important. However, the data published in each country are inconsistent because of multiple reasons such as different populations, extent of available laboratory tests, and medical systems. According to the reviewed COVID-19 epidemiology data published from several countries to identify any consistent trends in the relationship between age and COVID-19-associated morbidity or mortality, studies explain the difference in the patient’s response to SARS-CoV-2 infection according to age (Kang & Jung, 2020). Individuals with diabetes mellitus (DM), hypertension, and severe obesity (BMI ≥ 40 kg/m2) are more likely to be infected and are at a higher risk for complications and death from COVID-19(R. & S., 2020).

2.7 Prevention and control. To survive this pandemic we must think beyond containment of the virus, we must try to avoid it from being contracted by other people who never had it before (Watkins, 2020). The transmission can take place in a hospital; this is termed as nosocomial transmission, health workers, caretakers and other support staff might get infected (Mulabi. N., 2020). This can be avoided through knowledge training, sanitizing, disinfection, hand washing with soap, and protection of confirmed cases (Adhikari et al., 2020). Generally, person to person transmission can be avoided through proper use and disposal of face masks, covering coughs and sneezes with tissues and safely disposing the tissues, regular hand washing with soap and water, disinfecting hands and surfaces using alcohol based sanitizers (at least 60% alcohol) and avoiding direct body contacts among people for example handshakes and hugs and appropriate distancing between people (at least 2 meters between) (Mcintosh, 2020). In countries where there is COVID-19, control efforts usually focus on reducing the number of infections in people. In doing this, there is containment of the virus. The strategies put in place aim at controlling the spread of the virus, this can be done through; case isolation and contact tracing of the isolated cases. This may prevent further transmission of the virus. Additional strategies may include lockdown of the epidemic areas, travel restrictions, postponed school and work resumption (He, 2020).

2.8 Treatment of COVID-19 There is no antiviral drugs have been develop yet for the treatment of coronaviruses (Saif et al., 2019). The available treatment for COVID-19 patients is appropriate symptomatic treatment and supportive care (Adhikari et al., 2020). Since COVID-19 is characterized by an extremely

12 inflammatory response, and the Viral load is correlated with worsening of the symptoms (Justin. S, et al, 2020), an anti-inflammatory agent like chloroquine can be used to treat that symptom and reduce the viral load of COVID-19. Chloroquine is well known drug as an anti-malarial and an anti-inflammatory agent. The State Council of China recommended chloroquine phosphate due to its superiority in inhibiting pneumonia effects brought about by COVID-19 (Gao et al., 2020). There are also clinical trials against COVID-19 of post-exposure drug prophylaxis in the United States, though they are not recommended outside clinical settings (Mcintosh, 2020).

2.9 Sources of awareness During the first outbreaks of infections caused by coronaviruses, these were MERS and SARS, people used to get awareness about those infections through various ways. During the outbreak of MERS-CoV, medical students in Saudi Arabia obtained awareness about the infection via different avenues, which included; clinical studies, awareness campaigns in the hospital and on social media, and use of the internet (Ahmad. A and Sajda. A., 2017). Health workers in the Kingdom of Saudi Arabia obtained information about MERS-CoV from the Ministry of Health memo and Webpage, medical journals, and colleagues (Alsahafi & Cheng, 2016). In this COVID-19 pandemic which is the recent one, public health awareness is assessed as the tool that is highly effective to protect the masses in this crisis, it reduces the rate at which the pandemic is spreading, and also its death rate is reduced. There are various information channels through which information about COVID-19 is passed through to the public while ensuring social distancing. They include; Mobile apps, these provide people with basic knowledge about the pandemic from the internet and this reduces the influx load to the health care centers incase people need to make consultations. Social media platforms, these are known to spread information within a very short period of time, they include WhatsApp, Facebook, twitter, Instagram, and others. People can get updates about the pandemic through those. Video-Based Lectures on You Tube which are posted by the infectious disease experts, they share video clips about coronavirus symptoms, possible prevention measures and others. Electronic sources, for example online journals and other documents from internet sources like Elsevier, Emerald, Cambridge and others. (Ali & Gatiti, 2020).

2.10 Role of schools in control of the pandemic Due to covid-19 pandemic, Schools have been closed temporarily worldwide as part of measures to prevent SARS-CoV-2 transmission (Centre, 2020).The closure had harmful impacts on young people’s education, social development and relationships (Bonell et al., 2020). Even though schools are closed, they have placed a heavy emphasis on ensuring students continue to learn and many distance or online learning strategies have been done (Phelps & Sperry, 2020). Some countries have reopened their schools; they are now entitled to fight the pandemic when they are operating. Schools have fought the pandemic through various avenues; ensuring social distancing by having reduced class sizes and students attending in shifts, frequent cleaning, reinforce wearing of face masks (Bonell et al., 2020). The schools literally should be with nurses, and these nurses are important in the fight against the pandemic, school nurses should take on COVID-19 specific roles in advising, planning and implementing, they are also health educators (McDonald, 2020). Teachers in school may integrate environmental and health concepts when teaching the learners, this increases learners’ awareness and it can fight the pandemic, the teachers need to be retooled with new knowledge. The administration should strengthen hygiene standards at school, like putting in place soap and water, sanitizers so that learners continually disinfect their hands and the surfaces (Toquero, 2020). Schools also have to provide the learners with guidance and counselling in order to help them cope up with the new normal of social distancing and minimal gatherings, this will be catering for students’ psychological wellbeing (Centre, 2020).

CHAPTER THREE

RESEARCH METHODOLOGY

3.1 Description of the study area Gayaza is a town in Wakiso district in Buganda region of Uganda.

Gayaza is in the North Kyaddondo Constituency, Kyaddondo County. The town is approximately 2.5 kilometres (2 mi), north-east of Kasangati, on the Kampala–Ziroobwe Road.This is approximately 18 kilometres (11 mi), by road, north-east of Kampala, the capital and largest city of Uganda. The coordinates of Gayaza are 0°27'03.0"N, 32°36'42.0"E (Latitude:0.450833; Longitude:32.611667).Gayaza lies at an average elevation of 1,146 metres (3,760 ft), above sea level.

Figure 2: Map of Gayaza Town

3.1.1 Study design The study will have a qualitative survey research design to obtain information about the level of awareness of COVID-19 among the people of GayazaTown, and the avenues through which they acquire awareness. The study requires ideas, perceptions and views of the people in Gayaza Town about causes, transmission, and prevention of COVID-19.

3.1.2 Study Population The study population of the study will comprise of health workers in health centers, business operators, and people to be found in their homes in Gayaza town.

Sample Size Determination

The sample size, N will be estimated using the formula below;

N = ( Z2*S.D(1-S.D))/C2

Where;

Z = z-score for the chosen level of significance.

Level of significance = 95% Z= 1.96

S.D = Standard deviation

S.D = 0.5

C = Margin of error.

C=8%

N = (1.962*0.5(1-0.5))/0.82

=150.0625

Therefore, N = 150

3.1.3 Sampling procedure During the study, both simple random and convenient sampling techniques will be employed. Convenient sampling will be used on the learners and the administrators in the schools who will be readily available to the researcher will be selected to be respondents. Simple random sampling will be used to get a representative sample of people in the homes and business operating in the community.

3.1.4 Data collection tools Well-structured questionnaires will be used to collect data during the study. These questionnaires will contain open format questions which lack predetermined responses and closed format questions which have predetermined responses and take a form of multiple choice, these will be designed in line with the objectives of the study. The questionnaires will be administered to the respondents and for those who are unable to read and interpret English, the researcher will translate the questions to the local language so that the respondent gives authentic information, the researcher will also write those responses in the response entries of the questionnaires. This tool was chosen because it saves time and more respondents can be handled.

The study will also involve use of direct observation and interview as tools of data collection. The data about strategies put in place to fight COVID-19 will be collected using these tools.

3.2 Data analysis Both qualitative and quantitative data will be collected during the study. Since the study will be mostly descriptive, the researcher will mostly use qualitative methods. The data collected by the se of questionnaires and interview guides will be coded and entered into a computer program called Statistical Package for Social Scientists (SPSS) this is because this program can accommodate multiple variables concurrently.

Qualitative data analysis will involve use of descriptive statistics, this will be in form of frequencies and percentages presented in form of tables.

3.2.1Ethical considerations Permission will first be asked from the local leaders of the places from which data will be collected. Consent will be obtained from the respondents by the researcher where each

17 respondent will be required to sign a short consent form on the top of the questionnaire before participating in the study. Confidentiality will be ensured as the information collected will be used for only research purposes, the questionnaires won’t contain the name of the respondents at any point and no one will be blamed for any response made.

CHAPTER FOUR

DATA PRESENTATION

4.0 Introduction This chapter contains findings based on level of awareness of severe acute respiratory syndrome coronavirus 2 among people in Gayaza town

4.1 Demographic characteristics Respondents were requested to indicate their gender and class for school going students, and gender for respondents in surrounding communities Frequencies were obtained and computed into and percentages are shown in Table 1.

Table 1: Gender of respondents Frequency Percent Gender for Surrounding Community Male 40 40

Female 60 60 Gender for Students Male 13 32.5 Female 27 67.5 For administrators Male 2 20 female 8 80 For students class Senior four 31 77.5 Senior Six 9 22.5

A GRAPH SHOWING PERCENTAGES OF THE RESPONDENTS GENDER 120 100 80 60 40 20 0 learners community members administrators

male perentage female percentage

Figure 3: Percentage of the respondents gender

The biggest percentage of respondents were female both in school and in the community except for the administrators where the males outnumbered the females. The percentages of the females in the community, school, and administrators were 60%, 67.5% and 20% respectively while the percentages of the males in the community, among learners and the administrators were 40%, 32.5% and 80% respectively. The reason as to why the females outnumbered the males in the community is that women were more willing to give us time than men since most of them were found at their homes. For schools, female learners had a bigger percentage because in most of the sample schools had more female learners than the males and then the male administrators outnumbered the females since most of the schools appoint males in the administrative positions.

4.2 The level of awareness of the people in Gayaza Town about SARS-CoV2. In this sections respondents were requested to reveal their level of awareness about SAR-COV 2, how it is transmitted, if they had seen someone with Covid 19, the signs of Covid 19, how it can be controlled.

Table 2: Those who know about Covid Frequency Percentage

For students YES 40 100%

NO 0 0%

For Surrounding communities Yes 83 83%

No 17 17%

For the administrators YES 10 100%

NO 0 0%

A GRAPH SHOWING PERCENTAGE OF RESPONDENTS WHO KNOW ABOUT COVID 120 100 80 60 40 20 0 learners administraors community members

yes% no%

Figure 4: Percentage of Respondents who know about Covid

The biggest percentage of respondents knew about Covid 19 given the massive sensitization in Gayaza town. The percentages of the respondents who knew about Covid 19 in the community, among learners and the administrators were 90%, 100% and 100% respectively

Table 3: Those who know how covid 19 is transmitted Item Variable Frequency Percentage

For students YES 40 100%

NO 0 0%

For Surrounding communities YES 83 83%

NO 17 17%

For the administrators YES 10 100%

NO 0 0%

A GRAPH SHOWING PERCENTAGE OF RESPONDENTS WHO KNOW HOW COVID IS TRANSMITTED

100 80 60 40 20 0 students administrators commuity members

ways of transmission ways of transmission

Figure 5: Percentage of respondents who know how covid is transmitted

A very big number of respondents revealed that they knew how covid 19 I transmitted and their percentages in the community, among learners and administrators were 83%, 100%, and 100%. Those who did not know about how covid is transmitted were very few and these gave us the

22 same reasons and this was that they stay home all the time and that they are not concerned about covid. Secondly they told us that covid is a disease for the whites.

Some respondents revealed that the most effective ways of transmitting Covid 19 were sharing masks, fluids of cough and sneezing from infected people whereby more than 90% and 100% of the student and administrators revealed them as the most effective ways of transmitting Covid 19, then 87.9% in the surrounding communities revealed that shaking hands and coughing were the most effective ways of transmitting Covid. Other ways of transmitting Covid included overcrowded places, close contact, hugging, and Kissing.

Respondents who revealed that they knew the signs and symptoms of Covid 19 are shown in the table below

Table 4: Respondents who knew the signs and symptoms of Covid 19 Item Variable Frequency Percentage

For students YES 40 100%

NO 0 0%

For Surrounding communities YES 75 90.3%

NO 8 9.6%

For administrators YES 10 100%

NO 0 0%

A GRAPH SHOWING PERCENTAGE OF RESPONDENTS WHO KNOW THE SIGNS AND SYMPTOMS OF COVID19

100%

95%

90%

85% learners administrators commnity members

YES NO

Figure 6: Percentage of respondents who know the signs and symptoms of Covid 19

The research results show that most of the respondents knew the signs and symptoms of covid and their percentages in the community, among students, and the administrators were 90.3%, 100%, and 100% respectively. The percentage of those who did know about signs and symptoms of covid was 9.6%. Most of the people knew about the signs and symptoms due to the great sensitization done both in the community and in schools.

The symptoms of covid 19 which were revealed by respondents included the following

For the surrounding communities sneezing and coughing were main signs and symptoms of covid 19 while difficulty in breathing and sore throat were the main signs and symptoms revealed by students and administrators. All the study groups revealed coughing, sneezing, fever and headache as some of the signs and symptoms of Covid 19.

Majority of respondents revealed that they knew how to control Covid 19 as shown in the table below

Table 5: Percentage of respondents who knew how to control covid 19 Item Variable Frequency Percentage

For students YES 38 95%

NO 2 5%

For Surrounding communities YES 70 84.3

NO 13 15.6%

For administrators YES 10 100%

NO 0 0%

A GRAPH SOWING THEPERCENTAGE OF RESPONDENTS WHO KNOW THE MEASURES TO CONTROL COVID 19

100

0 learners administrators commnity members

YES NO

Figure 7: Percentage of respondents who know the measures to control covid 19

95% of students revealed that they knew how to control Covid 19 while 84.3% of respondents in the surrounding communities also revealed they know how to control covid 19.

Very many reasons were mentioned by the different respondents however these were common to all respondents; washing of hands regularly with soap, wearing a mask, avoiding close contact with other people and staying at home.

For example, many of the administrators revealed that

“There is need to disinfect the surfaces regularly in order to kill the virus to ensure safety. They also add and say they do this twice a week since its costly but they would prefer doing it daily.

The methods of controlling the spread of covid 19 that were raised by the respondents are shown in the figure below.

Table 6: Methods of controlling the spread of Covid 19 Frequency Percentage

Students Washing hands/sanitizing 35 87.5

Sanitizing 5 12.5

Administrators Washing hands\sanitizing 10 100

Wearing a mask 40 100 schools Regular disinfecting of surfaces 5 100

Surrounding communities Washing hands 40 48.2

Sanitizing 26 31.3

Wearing a mask 17 20.5

Almost all respondents revealed that washing hands and wearing a mask controlled Covid 19 transmission. Also regular disinfecting of surfaces like cleaning the schools regularly was also raised by administrators in stopping the spread of Covid 19 in schools.

4.3 The avenues through which the people in Banda Town acquire awareness about SARS- CoV2.

Respondents were requested to reveal how they got the information of Covid 19

Table 7: How respondents got the information of Covid 19 Radio Television Newspapers Local Internet Posters Others health workers

Students 5 20 1 3 6 5 2(religious leaders)

Surrounding 30 23 9 11 7 3 6(religious communities leaders)

For 00 1 3 0 6 0 0 administrators

A GRAPH SHOWING THE PERCENTAGE OF THE DIFFERENT SOURCES OF COVID INFORMATION ACCORDING TO DIFFERENT RESPONDENTS 35 30 25 20 15 10 5 0 radios televisions newspapers local health internet posters others workers

learners administrators commnity members

Figure 8: Percentage of different sources of Covid 19 information

The common source of information about covid 19 to the people of Gayaza town was television and Radio where the number of community members who got the information on radio were 30 and 23 for those who got the information from the television.students.5students revealed that they got information about Covid 19 from radio, and 20 received information from Televisions, 6 administrators got the information from the internet and a few respondents got the information from newspapers, local health workers, posters and from religious leaders

4.4 The effectiveness of the strategies put forward to stop the spread of SARS-Covid 19 Town. Here respondents were requested to reveal their adherence to standard operating procedures like wearing a mask, washing hands, sanitizing, and the challenges they face in adhering to the SOPs

Table 8: Respondents response on how often they put on face masks All day When in Never public

Students Frequency 40 0 0

Percentage 100% 0 0

Surrounding communities Frequency 44 30 9

Percentage 53% 36.14% 10.84%

For administrators frequency 10 0 0

percentage 100% 0% 0%

A GRAPH SHOWING THE PERCENTAGES OF HOW OFTEN RESPONDENTS PUT ON MASKS 120

100

60 40

0 All day in public never

learners administrators commnity members

Figure 9: Percentage of how often respondents put on masks

All the learners and administrators put on masks all the day and this totals up to 100% and for the surrounding community 53% put on masks all day, 36.14% put on masks when in public and 10.84% do not put on masks

Table 9: Respondents response on how often they wash hands Once a day Many times a Never day

Students Frequency 3 37 0

Percentage 7.5% 92.5% 0

Surrounding communities Frequency 21 59 3

Percentage 25.3% 71.1% 3.61%

For administrators Frequency 0 10 0

percentage 0% 100% 0%

A GRAP SHOWING PERCENTAGES OF HOW OFTEN RESPONDETS WASH THEIR HANDS 100%

80%

60%

40%

20%

0% once many times never

learners administrators community members

Figure 10: Percentage of how often respondents wash their hands

The biggest number of respondents wash their hands many times a day. 92.5% of the students wash their hands all day, 71.1% of the community members was their hands many times and 100% of the administrators wash their hands many times. A few students and community members wash their hands once a day and their percentages are 7.5% and 25.3% respectively. Those who never wash their hands are 3.61% for community members and 0% for students.

Through observation a number of key Standard Operating Procedures were seen in schools and big business centers

Table 10: Observation checklist In schools Item Variable Frequency Percentage

Presence of a Yes 5 100% temperature gun

No 0 0%

Presence of Soap and Yes 5 100% water

No 0 0

Presence of sanitizer or Yes 5 100% hand wash

No 0 0%

Through observation, it was revealed that all schools had soap and water for washing hand in Gayaza town.

Through observation it was revealed that all schools owned a temperature gun and sanitizers however the sanitizers were for administrators. In addition to all the above measures, schools added sitting arrangements that encourage social distance together with providing masks to learners.

Table 11: Checklist for business centres Item Variable Frequency Percentage

Presence of a YES 8 30.8% temperature gun

NO 18 69.23%

Presence of soap and YES 20 76.9% water

NO 6 23.1%

Presence of sanitizer YES 6 23.1%

NO 20 76.9%

Out of the 26 big shops, 30.8% hand temperature guns, 76.9% had soap and water and 76.9% had sanitizers. Very few shops had temperature guns because they are expensive but at least many tried to provide water, soap and sanitizers.

Table 12: How often people sanitize Once a day Many times a Never day

Students Frequency 15 0 25

Percentage 37.5% 0% 62.5%

Surrounding communities Frequency 30 5 38

Percentage 36.14% 6.02% 45.78%

For administrators Frequency 0 10 0

Percentage 0% 100% 0%

A GRAPH SHOWING PERCENTAGE OF HOW OFTEN RESPONDENTS SANITIZE 120

100 80

0 once many times never

learners administrators community members

Figure 11: percentage of how often respondents sanitize

The biggest percentage of students do not sanitize since schools do not provide sanitizers for learners and a few of them who buy their own sanitizers use them once so that it takes them throughout the term since most of them are boarders. Many of the community members do not sanitize because they cannot afford buying sanitizers however some big business centers have them since they interact with many people and they can at least afford buying them. All administrators use sanitizers because they can afford them.

Table 13:Number of respondents who have a challenge in fulfilling the SOPs Item Variable Frequency Percentage

For students YES 35 87.5

NO 5 12.5 For Surrounding communities YES 70 86.75 NO 13 15.7 For administrators YES 10 100 NO 0 0

A GRAPH SHOWING PERCENTAGES OF RESPONDENTS WITH AND WITHOUT CHALLENGES IN PRACTICING THE STANDARD OPERATING PRCEDURES 120 100 80 60 40 20 0 learners administrators commnity members

NO YES

Figure 12: Percentage of respondents with and without challenges in practicing the standard operating procedures

Most of the learners did not have challenges in fulfilling the standard operating procedures however a few who had a challenge of discomfort when wearing masks and some Muslims find it irritating using alcohol based sanitizers. People from the community find very many challenges which include the cost of sanitizers being high, difficulty in breathing when putting on the mask, curfew which limits their duties among others. Administrators also face many challenges which include the cost of masks for all staff and learners, buying sanitizers for staff, sanitizing surfaces, and maintaining social distance among others.

CHAPTER FIVE

Discussion of results

5.1 Introduction The study was about establishing the level of awareness about covid 19 among the people of Gayaza town and their adherence towards the standard operating procedures. The results of the study were then used to deduce conclusions.

5.2 Background information about the respondents

The biggest percentage of respondents who included the community members, learners, and administrators made up to the following percentages;40% male and 60% female community members,32.5 male and 67.5% female students then 80% male and 20% female administrators. Females have a bigger percentage compared to the males except for administrators because the females were more willing to provide information unlike the males. For the administrators the male percentage was higher than the female’s because most of the administrative positions are always given to men.

5.3 level of awareness about COVID 19 among respondents

5.3.1 Level awareness about existence of COVID 19 The largest number of respondents knew about covid 19 except 10% of the community members who said they didn’t know anything about covid 19. The biggest percentage is attributed to the massive sensitization in Gayaza town. The 10% who didn’t know about COVID 19 claim that the disease is for whites and therefore they don’t take time to know about it. These research results therefore correspond with the national wide cross-sectional survey made in Uganda that revealed that 97.6% of participants knew about covid 19 (Ssebufu et al. 2020)

5.3.2 Awareness about how someone can get covid 19 100% of the learners, 100% of the administrators, and 83% of the community members knew about how covid 19 is transmitted. The most common way of covid transmission according to respondents was close contact with an infected person. This is related to the research conducted in USA which revealed that the most common way of transmission of covid 19 was person to

35 person which occurs through direct contact or through droplets spread by coughing or sneezing from an infected person (Rothan & Byrareddy, 2020a). A South- Western Saudi Arabia showing that 97.7% of the respondents reported human to human transmission as the most common transmission way.

5.3.3 Awareness about signs and symptoms of covid 19.

100%, 100% and 90.3% of the learners, administrators, and community members respectively had knowledge about signs and symptoms of covid19. This attributed to the serious sensitization of masses in Gayaza town over the different communication avenues. They reported very many signs and symptoms which included sore throat, difficulty in breathing, sneezing and this are in correspondence to the study conducted in USA which also reported the same signs and symptoms (Rothan & Byrareddy, 2020a). This level of awareness indicates that people in Gayaza can easily isolate a covid 19 patient therefore can prevent spread by contact.

5.3.5 Major source of awareness about covid 19 among the respondents. Radios and televisions were the major sources of information about covid 19 according to the respondents. This is because the above means of communication are easily accessible unlike the internet that requires data charges (Macleod et al., 2020). This is in correspondeny with a cross sectional survey done in Uganda which revealed that television is the predominant source of information about covid 19 with a percentage of 77.4% (Okello et al. , 2020). However a study conducted in Jordan revealed that social media was the commonest source of information about covid 19 (Alzoubi et al., 2020). Newspapers were not commonly used because they require the illiterates.

5.4 Adherence to the standard operating procedures (S.O.Ps)

5.4.1putting on a mask 100%, 100% and 83% of the learners, administrators and community members wear masks. Learners and administrators wear masks all day unlike some community members who put them on once a day and then wear them all day when in public. This corresponds to a study carried out in South Western Saudi Arabia where 82.7% of the participants wear face masks while going out

36 of their homes (Tripathi et al., 2020). This high percentage of people putting on face masks is advantageous because it reduces exposure of people to covid 19 (Nannyonga et al., 2020) and it can be attributed to the recommendation by WHO and CDC, they recommend that wearing of face masks is the most important prevention measure of covid 19 in places where maintaining social distance is impractical (Mboowa et al., 2021). There is an improvement in the face mask wearing behavior among the masses according to the study done in Kampala in the first two months of covid 19 in Uganda, it was only 33% of the participants who reported wearing a face mask when going in public (Amodan et al. ,n. d.).

5.4.2 Use of sanitizer 57.8% of the community members reported that they never use sanitizers due to the high costs. 82% of the learners do not use sanitizers since he schools do not provide them and they are too costly or them to maintain. 100% of the administrators use sanitizers many times a day because they are provided to all staff members.

5.4.3 Washing hands with soap and water 92.5%, 7.1% and 98.35% of the learners, administrators, and community members respectively wash their hands many times a day. This is attributed to the costs of water and soap which are low and the materials are easily accessible. The method is also effective according to the Ministry of health (Afhea, 2020).

5.4.4 Adherence to the standard operating procedures at schools. 100% of the schools had temperature guns hand washing facilities, sanitizers and class room arrangements that encourage social distance. The above measures were strictly followed following the directions of ministry of education and that of health which had to be put in place before schools open.

5.5 challenges faced when adhering to the standard operating procedures

5.5.1 Challenges with mask use 5%, 100% and 90% of the learners, administrators and community members respectively had challenges with mask use. Very man learners revealed that they had no challenges since they were comfortable with the masks. The biggest percentage of community members and

37 administrators had challenges and among the most of them said masks make them uncomfortable. This matches the results of the study conducted in Africa (Amodan et al., n.d.) which revealed that many Africans find wearing a mask uncomfortable. The uncomfortability way in very many forms according to respondents and these include; itching nose, difficulty in breathing, covering their makeup (females).

CHAPTER SIX

CONCLUSIONS AND RECOMMENDATIONS

6.1 conclusions From this study, the following conclusions were made;

The level of awareness in Gayaza town is greatly high except the 10% among the community members who didn’t know about covid 19. All learners and administrators knew about covid 19 and its signs and symptoms. About practicing the standard operating procedures, most of the respondents have tried their level best put them into consideration. According to results, all schools had temperature guns, sanitizers, masks, hand washing facilities and kept social distance. For the community members, most of them had masks, hand washing materials and few hand sanitizers (big business operators)

6.2 Recommendations According to the study results, the following can be recommended;

 Government and non-government organizations together with media houses should carry out more sensitization in order to ensure 100% awareness and to change people’s attitude towards covid 19.  Government should financially assist public service providers like schools to help them meet the standard operating procedures  Ministry of health offer simple materials like soap, taps, and water to people who gather big crowds so that people find it easy to practice the standard operating procedures.

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APPENDICES

APPENDIX 1: THE SURVEY QUESTIONARE FOR THE SCHOOL ADMINISTRATORS.

Dear Sir/Madam, this study is aimed at establishing awareness and adherence towards severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in schools and surrounding communities in Wakiso district. You are humbly requested to respond to the following questions as honestly as possible. The information you will provide will be treated with confidentiality and used only for the purpose of this research.

Please tick the most appropriate answer and write a brief answer to the spaces provided.

1. Social demographics. a) Gender. Female Male

b) Responsibility. …………………………………………………………………. 2. Status of school. Private government aided.

3. Level of awareness about SARS-CoV2.

a) i)Do you know the disease called Covid-19? Yes No

b) i)Do you know how the disease is transmitted? Yes No

ii) If yes, how is it transmitted?

APPENDIX 2: THE SURVEY QUESTIONARE FOR THE LEARNERS.

Dear respondent, this study is aimed at establishing awareness and adherence towards Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in schools and surrounding communities in Wakiso district. You are humbly requested to respond to the following questions as honestly as possible. The information you will provide will be treated with confidentiality and used only for the purpose of this research.

Please tick the most appropriate answer and write a brief answer to the spaces provided.

4. Social demographics. c) Gender. Female Male

d) Class. ………………………………………………………………….

5. Level of awareness about SARS-CoV2.

c) i)Do you know the disease called Covid-19? Yes No

d) i)Do you know how the disease is transmitted? Yes No

ii) If yes, how is it transmitted?

………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

e) i)have you ever seen someone suffering from Covid-19? Yes No

APPENDIX 3: THE OBSERVATION SHEET FOR THE SECONDARY SCHOOLS. 1. Presence of a temperature gun YES

2 Was there soap and water for washing hands?

YES

3. was there sanitizer?

YES

APPENDIX 4: THE SURVEY QUESTIONARE FOR THE SURROUNDIING COMMUNITY MEMBERS.

Please tick the most appropriate answer and write a brief answer to the spaces provided.

6. Social demographics. Gender. Female Male

7. Level of awareness about SARS-CoV2.

f) i)Do you know the disease called Covid-19? Yes No

g) i)Do you know how the disease is transmitted? Yes No

ii) If yes, how is it transmitted?

h) i)have you ever seen someone suffering from Covid-19? Yes No