Knowledge, attitude, and practice towards COVID-19 and associated factors among students in Ethiopia: Systematic review and meta-analysis

Introduction: The World Health Organization (WHO) has not confirmed the eradication of the COVID-19 pandemic or the development of a cure. Ongoing research is necessary to update public understanding, attitudes, and behaviors. Therefore, this study aims to evaluate the knowledge, attitudes, and practices related to COVID-19 among students in Ethiopia. Objective: To estimate the pooled proportions and associated factors of knowledge, positive attitude, and prevention practice toward COVID-19 among students in Ethiopia. Methods: The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and was registered on the PROSPERO database. Data extraction was done using an Excel spreadsheet, and analysis was conducted using STATA. The quality of the articles was assessed using the Joanna Briggs Institute (JBI) grading approach. A narrative summary and random-effects model with a 95% confidence interval were used. Heterogeneity and publication bias were also assessed. The results were presented using a forest plot and tables. Result: Out of 2089 studies reviewed, only 16 met the inclusion criteria. The pooled proportions of COVID-19 good knowledge, positive attitude, and good prevention practice among students in Ethiopia were found to be 62.68% [95% CI 50.96–74.40, I2 = 98.93%], 60.22% [95% CI 51.64–68.80, I2 = 97.68%], 48.47% [95% CI, 44.16–52.78, I2 = 91.45%] respectively. Factors that affected knowledge included marital status, family size, sex, study year, and residency. Knowledge and residency were identified as predictors of attitude. Determinants of practice included knowledge, attitude, sex, study program, and residency. Conclusion: The pooled proportion of students in Ethiopia with good knowledge, positive attitudes, and good practices regarding COVID-19 was low. Policymakers, the Ministry of Health, Public Health Institutions, and other stakeholders should intensify their efforts on COVID-19 and develop interventions aimed at females, rural residents, and extension students. The protocol was registered on the PROSPERO database with ID = CRD42023478234.