title: Public response to MERS-CoV in the Middle East: iPhone survey in six countries.
abstract: Gulf Cooperation Council (GCC) countries bear the heaviest brunt of MERS-CoV. This study aims to compare public awareness and practice around MERS-CoV across GCC countries. A cross-sectional survey was conducted using the Gulf Indicators (GI) smartphone app among people in the six GCC countries, namely Saudi Arabia, Kuwait, the United Arab Emirates, Qatar, Bahrain, and Oman. A total of 1812 participants recruited. All were aware of MERS-CoV, yet the perception and practice around MERS-CoV varied widely between countries. Over two thirds were either "not concerned" or "slightly concerned" about contracting MERS-CoV; believing that they were under Allah's (God's) protection (40%) was the most cited reason. While 79% were aware that the disease can transmit through droplet from infected person, only 12% stated that MERS-CoV transmits via camels; people in Saudi Arabia were better aware of the transmission. Nevertheless, only 22% of respondents believed that camels are the zoonotic reservoir of MERS-CoV. Those who were concerned about contracting MERS-CoV (aOR: 1.6, 95% CI: 1.2-2.1, p<0.01) and those who thought MERS-CoV to be a severe disease only for those with high-risk conditions (aOR: 1.5, 95% CI: 1.1-2.1, p<0.01) were more likely to believe that camels are the zoonotic source. However, residents of KSA (aOR: 0.03, 95% CI: 0.01-0.07, p<0.01), UAE (aOR: 0.01, 95% CI: 0.004-0.02, p<0.01) and Kuwait (aOR: 0.03, 95% CI: 0.01-0.07, p<0.01) were less likely to believe that camels are the main zoonotic source compared to respondents from the other countries. Hygienic measures were more commonly adopted than avoidance of camels or their raw products, yet there was a discrepancy between the countries. This study highlights that despite being aware of the ongoing MERS-CoV epidemic; many people lack accurate understanding about MERS-CoV transmission, prevention, and are not fully compliant with preventive measures.
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, New South Wales, Australia; School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: amani.alqahtani@health.nsw.gov.au.
authors.forename: Amani S
authors.initials: AS
authors.lastname: Alqahtani
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, New South Wales, Australia.
authors.forename: Harunor
authors.initials: H
authors.lastname: Rashid
authors.affiliation: Department of Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Mada H
authors.initials: MH
authors.lastname: Basyouni
authors.affiliation: College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Tariq M
authors.initials: TM
authors.lastname: Alhawassi
authors.affiliation: Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
authors.forename: Nasser F
authors.initials: NF
authors.lastname: BinDhim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002162:Camelus; D040421:Cell Phone; D018352:Coronavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission / Q000662:veterinary; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D065207:Middle East Respiratory Syndrome Coronavirus; D055815:Young Adult; D015047:Zoonoses / Q000635:transmission / Q000821:virology
keywords: Camel; Gulf Cooperation Council; Knowledge; MERS-CoV; Practices; Public response