CHAPTER TWO

2. LITERUTURE REVIEW

2.1 Introduction

This chapter gives a brief explain about the Concepts, opinions and ideas of research variables
from authors/experts, concepts, opinions and ideas of dv from authors/experts, theoretical
review, empirical review, conceptual framework and research gap.

2.2 CONCEPTS, OPINIONS AND IDEAS OF COVID-19 FROM AUTHORS/EXPERTS

The 2019 novel coronavirus pandemic (COVID-19) is an international public health emergency
unprecedented in modern history (WHO, 2020).

The coronavirus disease 2019 (COVID-19) emerged in Wuhan, China at the end of 2019. Since
then, it has spread to 200 countries and has been declared a global pandemic by the World Health
Organization (WHO). To date, there are more than 2.3 million positive COVID-19 cases
recorded with at least 150,000 deaths globally (WHO,2020).

Coronavirus disease 2019 (COVID -19) is a global public health threat and has evolved to
become a pandemic crisis around the world, which is caused by the severe acute respiratory
syndrome, coronavirus 2 (SARS-CoV-2) (Ruan, S. 2019).

In response to this serious situation, COVID-19 was declared as a public health emergency of
international concern by the World Health Organization (WHO) on January 30 and called for
collaborative efforts of all countries to prevent the rapid spread of COVID-19 (WHO, June
2020).

COVID-19 prompted implementation of public health protocols to control the spread of the
virus, many of them involving social distancing, hand washing, and lockdown procedures, but
has also resulted in creating public anguish and massive fear (Roy, D., Tripathy, S., Kar, SK.,
Sharma, N., Verma, SK., & Kaushal, V. 2020).
2.2.1 Concepts, Opinions and Ideas of Objectives/iv’s from Authors/experts

2.2.1.1 General Objective

To assess the impact of knowledge attitude and practice toward COVID-19 among community
Las-Anod Sool Somalia.

2.2.1.2 Knowledge of COVID-19

The results of the knowledge survey are presented medical students from a government medical
college, in Uttarakhand, India from 22th March to 25th March 2020, the week immediately
before the lockdown of India. the majority of the participants (86.7%) had correct knowledge
about the main symptoms of COVID-19. Furthermost, 92.4% of the participants awared that
early symptomatic and supportive treatment can help most patients recover from the infection.
the majority of the students had correct knowledge about the transmission routes of the virus,
however, only half of the total participants agreed that ordinary residents can wear general
medical masks to prevent the infection by the COVID-19 virus.
Consciousness about the prevention and treatment was high among the participants, such as
nearly everyone (96.9%) knew that COVID-19 can be prevented by avoiding crowded places
such as train stations and avoiding public transportation. Furthermore, 97.2% of participants
realized that people who have contacted with someone infected with the COVID-19 virus should
be immediately isolated in a proper place. In general, the observation period is 14 days
(Maheshwari, S., Gupta, PK., Sinha, R., & Rawat, P. Aug 2022)

2.2.1.3 Attitude of COVID-19

shows that the high percentage of the students (76.6%) agreed that media coverage (e.g.,
newspaper, television, online) give much exposure to news about COVID-19 virus. In addition,
the majority of the participants (94.1%) supported the lockdown of the major cities, and more
than 75% were in favor of “Janta Curfew” as well. (Maheshwari, S., Gupta, PK., Sinha, R., &
Rawat, P. Aug 2022)
2.2.1.4 Practices of COVID-19

presents the health-seeking behavioral intentions and prevention practices of the participants. A
high percentage of the participants (98.6%) avoided unnecessary travel or outing during the
outbreak. Maintaining social distance during the outbreak was the second most prevalent
behavior reported by the participants. Also, a high percentage of participants used hand sanitizer,
washed their hands, used a mask, covered a cough and sneeze with a tissue, which represented a
good practice of the participants towards COVID-19. However, it is recommended to store
helpline number so that they can find help in case of any emergency. (Maheshwari, S., Gupta,
PK., Sinha, R., & Rawat, P. Aug 2022)

2.2.2 CONCEPTS, OPINIONS AND IDEAS OF DV FROM AUTHORS/EXPERTS

2.2.2.1 The Impact of COVID-19 on Community

As the global spread of COVID-19 continues, unprecedented measures are being taken to contain
and delay transmission of the virus. These include travel restrictions and the closure of schools,
universities, bars, restaurants and retail shops (Respir, L. 2020).

The impact on every level of society has been profound and, over the coming weeks and months,
the challenges faced by healthcare services will be compounded by the increased risk of infection
among healthcare workers and ensuing staff absences due to illness or the need to self-isolate
(Willan, J., Jeffery K., & Bienz, N.)

Community pharmacy is one of a number of health professions that has a key role to play in
responding to this public health crisis. It is well established that community pharmacists are one
of the most accessible healthcare professionals.

(Todd, A., Copeland, A., Husband, A., Kasim, A., & Bambra, C. 2020).

COVID-19 outbreak can impact mental health including health care workers. Several studies had
been starting to be published which reported psychological symptoms during COVID-19
outbreak in general population (Liu, S., Luo, P., & Tang, M. 2020).
2.2.2.2 Socio-economic Impact of COVID-19 on Community
The UN’s Framework for the Immediate Socio-Economic Response to the COVID 19 Crisis
warns that “The COVID-19 pandemic is far more than a health crisis: it is affecting societies and
economies at their core. While the impact of the pandemic will vary from country to country, it
will most likely increase poverty and inequalities at a global scale, making achievement of SDGs
even more urgent. Assessing the impacts of the COVID-19 crisis on societies, economies and
vulnerable groups is fundamental to inform and tailor the responses of governments and partners
to recover from the crisis and ensure that no one is left behind in this effort. Without urgent
socio-economic responses, global suffering will escalate, jeopardizing lives and livelihoods for
years to come. Immediate development responses in this crisis must be undertaken with an eye to
the future. Development trajectories in the long-term will be affected by the choices countries
make now and the support they receive.” The United Nations has mobilized the full capacity of
the UN system through its 131 country teams serving 162 countries and territories, to support
national authorities in developing public health preparedness and response plans to the COVID-
19 crisis (UNDP, 2020)

2.2.2.3 Educational Impact of COVID-19 on Community

The pandemic has taken a substantial toll on students’ academic progress as well as on their
mental health. School systems can respond across multiple horizons to help students get back on
track. The pandemic has taken a substantial toll on students’ academic progress as well as on
their mental health. School systems can respond across multiple horizons to help students get
back on track.

we examine the impact of the COVID-19 pandemic on student learning and well-being, and
identify potential considerations for school systems as they support students in recovery and
beyond. Our key findings include the following:

The length of school closures varied widely across the world. School buildings in middle-income
Latin America and South Asia were fully or partially closed the longest—for 75 weeks or more.
Those in high-income Europe and Central Asia were fully or partially closed for less time (30
weeks on average), as were those in low-income sub-Saharan Africa (34 weeks on average).

Access to quality remote and hybrid learning also varied both across and within countries. In
Tanzania, while school buildings were closed, children in just 6 percent of households listened to
radio lessons, 5 percent accessed TV lessons, and fewer than 1 percent participated in online
learning.

Furthermore, pandemic-related learning delays stack up on top of historical learning inequities.

2.2.2.4 Health Impact of COVID-19 on Community

Most people who get coronavirus disease 2019 (COVID-19) recover within a few weeks. But
some people — even those who had mild versions of the disease — might have symptoms that
last a long time afterward. These ongoing health problems are sometimes called post-COVID-19
syndrome, post-COVID conditions, long COVID-19, long-haul COVID-19, and post-acute
sequelae of SARS COV-2 infection (PASC).

Post-COVID-19 syndrome involves a variety of new, returning or ongoing symptoms that people
experience more than four weeks after getting COVID-19. In some people, post-COVID-19
syndrome lasts months or years or causes disability.

Research suggests that between one month and one year after having COVID-19, 1 in 5 people
ages 18 to 64 has at least one medical condition that might be due to COVID-19. Among people
age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19.

Organ damage could play a role. People who had severe illness with COVID-19 might
experience organ damage affecting the heart, kidneys, skin and brain. Inflammation and
problems with the immune system can also happen. It isn't clear how long these effects might
last. The effects also could lead to the development of new conditions, such as diabetes or a heart
or nervous system condition.
The experience of having severe COVID-19 might be another factor. People with severe
symptoms of COVID-19 often need to be treated in a hospital intensive care unit. This can result
in extreme weakness and post-traumatic stress disorder, a mental health condition triggered by a
terrifying event. (Mayo Clinic, 2022)

2.3 THEORETICAL REVIEW

COVID-19 is the most “discussed” disease that ever happened to human beings. The features of
COVID-19 can be accounted for its propensity to spread via air, absence of the verified cure and
lack of medical equipment for mechanical ventilation, masks and protective gear at the beginning
of the pandemic period. Its similarity with usual cold and flu makes it hard to distinguish, and
infected persons can easily misjudge it to be the flu. With the current development of
transportation and globalization, the virus's spread was far quicker than any other known disease
before. The widespread virus had adverse effects on all levels of society, from sustainability of
enterprises (Obrenovac et al., 2020).

2.3.1 The Pandemic Management Theory

The COVID-19 crisis is an individual and genre-specific identity crisis in which basic ethical
attitudes towards life are questioned, where the social distancing and restrictions have a
separating, dissociating effect on the integration process with different levels of life. Therefore,
the inner circle of the model approaches biocentric connections of humans to themselves, to
others and to the “complex of living elements”, to nature. Maintaining a connection in these
three levels is necessary to sustain a healthy identity during pandemics. The causes and
consequences of separations from these levels of life because of biocentric boundaries, which are
defined in the model (Stueck, 2021)

2.3.2 Noy et al Theory

According to (Noy, 2020) The impact of the pandemic on world GDP growth is massive. The
COVID-19 global recession is the deepest since the end of World War.

The global economy contracted by 3,5 percent in 2020 according to the April 2021 World
Economic Outlook Report published by the IMF, a 7 percent loss relative to the 3.4 percent
growth forecast back in October 2019. While virtually every country covered by the IMF posted
negative

growth in 2020 the downturn was more pronounced in the poorest parts of the world. The impact
of the pandemic on world GDP growth is massive. The COVID-19 global recession is the
deepest since the end of World War II The global economy (IMF 2020).

contracted by 3,5 percent in 2020 according to the April 2021 World Economic Outlook Report
published by the IMF, a 7 percent loss relative to the 3.4 percent growth forecast back in October
2019. While virtually every country covered by the IMF posted negative growth in 2020.

The downturn was more pronounced in the poorest parts of the world. The impact of the
pandemic on world GDP growth is massive. The COVID-19 global recession is the deepest since
the end of World War II The global economy contracted by 3,5 percent in 2020 according to the
April 2021 World Economic Outlook Report published by the IMF, a 7 percent loss relative to
the 3.4 percent growth forecast back in October 2019. While virtually every country covered by
the IMF posted negative growth in 2020, the downturn was more pronounced in the poorest parts
of the world (Noy, 2020).

The impact of the shock is likely to be long-lasting. While the global economy is expected to
recover this year, the level of GDP at the end of 2021 in both advanced and emerging market and
developing economies (EMDE) is projected to remain below the pre-virus baseline

As with the immediate impact, the magnitude of the medium-term cost also varies significantly
across countries, with EMDE suffering the greatest loss. The IMF (2021) projects that in 2024
the World GDP will be 3 percent (6 percent for low-income countries (LICs)) below the no-
COVID scenario.

Along the same lines estimate that African GDP would be permanently 1 percent to 4 percent
lower than in the pre-COVID outlook, depending on the duration of the crisis (Djiofack, 2020).
2.4 EMPIRICAL REVIEW

2.4. Impact of COVID-19 Knowledge on Community

n online study conducted in Chinese public shows that the accurate response rate for the
knowledge section ranged from 72.7% (family gatherings may spread infection) to 99.5% (most
people infected present with fever, fatigue, and dry cough as the main symptoms), and the
average accuracy rate 91.2%. The accurate response rate greater than 80% for all items except
for “family gatherings may spread infection” and a suspected case can be ruled only out after two
consecutive negative tests of respiratory pathogenic nucleic acid at least one day apart.

(Gao, H., Hu, R., & Yin, L. et al.) Knowledge, attitudes and practices of the Chinese public with
respect to coronavirus disease (COVID-19): an online cross-sectional survey. BMC Public
Health 20, 1816 (2020)

The multivariable logistic regression model done with backward elimination methods. In this
study, the odds of positive attitude among single students 3-folds higher compared to married
students [AOR=2.78, 95% CI 1.15, 6.68]. Students who were learning Diploma (TVET) level
trainings had 73% less likely to have positive attitudes towards CO VID-19 prevention and
control measures compared to those were learning degree program trainings [AOR=0.27: 95%
CI 0.17, 0.42]. Moreover, year-two students had 4-folds greater odds of positive attitude
compared to year-four and above students [AOR=4.44: 95% CI 1.55, 12.68]. However, age of
participants, residence, sex of participants, study program, field of study, living conditions,
source of income for education, and knowledge level were not significantly associated with
attitude level of students towards COVID-19 pandemic prevention measure.

(Tadesse. AW., Melese, N., Eshetie, S., Chane, M., & Ali, A.). Knowledge, Attitude, and
Practice and Associated Factors towards COVID-19 among College Students in Amhara Region,
Ethiopia; A Cross-Sectional Study.

Study conducted in Mizan Tepi University Students shows that three hundred fifteen (78.4%) of
the students mentioned the causes of Covid-19 as a virus, 306 (76.1%) stated respiratory droplet
and close contact as the method of transmission, the majority (58.2%) identified the correct 9
incubation period and only 153 (38.1%) knew that generally, people are susceptible for Covid19.
Two hundred fifty-seven (63.9%) of the study subjects mentioned fever and dry cough as the
main clinical manifestation of the Covid-19, 171 (42.5%) considered that all persons infected
with Covid-19 show clinical manifestation, while 244 (60.7%) responded that application of
nonpharmacological methods are important for prevention and, and majority (74.4%) knew that
wearing face masks can reduce transmission. One hundred seventy-three (43.0%) considered that
eating garlic or onions cannot prevent the disease, 162 (40.3%) answered that taking antibiotics
is optimal treatment for Covid-19, 205 (51.0%) responded that there is curing or protective
vaccine and effective treatment of Covid-19, while 154 (38.3%) considered that global mortality
rate from Covid-19 is below 5% and majority (71.4%) knew that Covid-19 can be transmitted by
contaminating the eye, nose, or mouth from contaminated surfaces by Covid-19. One hundred
eighty-nine (47.0%) of the study subjects had scored the knowledge score above than the mean
knowledge score (7.1) and had good knowledge about Covid-19.

(Angelo, AT., Alemayehu, DS., & Dacho, AM.) Knowledge, Attitudes, and Practices Toward
Covid-19 and Associated Factors Among University Students in Mizan Tepi University, 2020.
Infection and Drug Resistance. 2021; 14:349.

Study conducted in Somalia Banadir region presented that the knowledge among the participants
on different variable. The results of study indicate that most participants are well aware and have
clear concept of COVID-19 pandemic (when, where and how it occurs and transmit), where
social media play a vital role and only 12.6% (n=56) participants were in contact with COVID19
positive patients. In terms of transmission 85% (n=359) people believe COVID 19 can be
transmitted via close contact while 11.2% (n=47) by food contamination and 3.3 % (n=14) by
insect bite (Abdullahi, SH. 2020) “Knowledge, Attitude and Practice of People Towards
COVID-19 in Banadir Region of Somalia: A Cross-Sectional Study.” IOSR Journal of Dental
and Medical Sciences (IOSR-JDMS), 19(12), 2020, pp. 21-26.
2..4. Impact of COVID-19 Attitude on Community

In online study conducted in Chinese public shows that the proportion of positive attitudes
(strongly agree and agree) ranged from 94.7% (It is believed that the outbreak soon be contained)
to 99.7% (I am willing to cooperate with the relevant departments to take prevention and control
measures), and the average value 98.0% (Gao, H., Hu, R., & Yin, L. et al.).

Knowledge, attitudes and practices of the Chinese public with respect to coronavirus disease
(COVID-19): an online cross-sectional survey. BMC Public Health 20, 1816 (2020).

Study conducted in Amhara region universities of Ethiopia revealed that 230 (56.4%) [95% CI
51.2%, 61%] of college students had positive attitude in the prevention and control strategies of
COVID-19 pandemic.

The multivariable logistic regression model done with backward elimination methods. In this
study, the odds of positive attitude among single students 3-folds higher compared to married
students [AOR=2.78, 95% CI 1.15, 6.68]. Students who were learning Diploma (TVET) level
trainings had 73% less likely to have positive attitudes towards CO VID-19 prevention and
control measures compared to those were learning degree program trainings [AOR=0.27: 95%
CI 0.17, 0.42]. Moreover, year-two students had 4-folds greater odds of positive attitude
compared to year-four and above students [AOR=4.44: 95% CI 1.55, 12.68]. However, age of
participants, residence, sex of participants, study program, field of study, living conditions,
source of income for education, and knowledge level were not significantly associated with
attitude level of students towards COVID-19 pandemic prevention measures

(Tadesse. AW., Melese, N., Eshetie, S., Chane, M., & Ali, A.). Knowledge, Attitude, and
Practice and Associated Factors towards COVID-19 among College Students in Amhara Region,
Ethiopia; A Cross-Sectional Study.

Study conducted in Mizan Tepi University Students presented that about half of the students
agreed that they are worried for might getting Covid-19, 182 (45.3%) agree for preventive
measures should be only applied by risk groups and older adults. Two hundred sixty eight
(66.7%) agree for visiting the health facility when they develop symptoms, 275 (68.4%) agreed
that limit of movement by individuals decreases the disease transmission, and 158 (39.3%)
agreed that students living in the campus are vulnerable for Covid-19. Two hundred five (51.0%)
agreed that the outbreak has impacted their study, and 184 (45.8%) had agreed that eating raw
vegetables and wild animals do not impact the transmission. Overall 217 (54.0%) of the study
participants had scored attitude score greater than the mean attitude score (7.4) and had a positive
attitude towards Covid-19 prevention.

(Angelo, AT., Alemayehu, DS., & Dacho, AM.) Knowledge, Attitudes, and Practices Toward
Covid-19 and Associated Factors Among University Students in Mizan Tepi University, 2020.
Infection and Drug Resistance. 2021; 14:349.

Study conducted in Somalia Banadir region shows that the attitude of participants on different
variables. Regarding attitudes of participants this study, they were unconfident attitude toward
COVID-19 but they believe that gathering or overcrowding in public places can easily spread
COVID-19 and will be the serious threat to public health. In terms of preventing COVID-19
spread, maximum number of participants were agreed with closing of school will be an effective
way while they were disagreed with night curfew. Study also shows that 66.9% (n=281) of 11
participants think healthy and nutritious food along with sufficient rest can reduce the risk of
COVID-19. In terms of overcome from this pandemic, only 14% of participants agree that
Somali government could win the battle, while the other studies showed positive attitude
regarding this. (Abdullahi, SH. 2020) “Knowledge, Attitude and Practice of People Towards
COVID-19 in Banadir Region of Somalia: A Cross-Sectional Study.” IOSR Journal of Dental
and Medical Sciences (IOSR-JDMS), 19(12), 2020, pp. 21-26.
2.4.3 Impact of COVID-19 Practice on Community

In online study conducted in Chinese public presented that the proportion of good practices
(always and often) ranged from 76.1% (home environment disinfection) to99.5% (h hands), and
the average value 96.8%.

The good practice adherence rate of all items more than 80% except for “monitor body
temperature”, “appropriate exercise”, and “home environment disinfection”.

(Gao, H., Hu, R., & Yin, L. et al.) Knowledge, attitudes and practices of the Chinese public with
respect to coronavirus disease (COVID-19): an online cross-sectional survey. BMC Public
Health 20, 1816 (2020)

In study conducted in Amhara region universities of Ethiopia revealed that 265 (65%) [95% CI
60, 70.1%] of college students had good level of prevention practice regarding COVID-19
pandemic. In this study, the students who were living in urban residency had 3-times greater
odds of good practice level towards COVID 19 prevention and control measures compared to
those who were living in rural residency during the pandemic [AOR=2.89, 95% CI 1.85, 4.53]. A
regular program students had 74% less likely to have good practice on the prevention and control
measures compared to extension (evening) program students [AOR=0.26: 95% CI 0.18, 0.81].
Finally, year-one students had 83% less likely good practice on the prevention and 12 control
measures compared to year-four students [AOR=0.17: 95% CI 0.14, 0.82]. However, residence,
sex of participants, education enrollment type, field of study, living conditions, source of income
for education, knowledge level and attitude towards COVID 19 prevention and control measures
were not significantly associated with knowledge level of students towards COVID-19
pandemic. (Tadesse. AW., Melese, N., Eshetie, S., Chane, M., & Ali, A.). Knowledge, Attitude,
and Practice and Associated Factors towards COVID-19 among College Students in Amhara
Region, Ethiopia; A Cross-Sectional Study.

Study conducted in Mizan Tepi University Students shows that two hundred fifty-eight (64.2%)
of the students committed to hing hands regularly, 224 (55.7%) practiced proper method of
coughing, while 221 (55.0%) did not wear face mask, and 246 (61.4%) did not gather in areas
where the mass of people presented. The majority (60.6%) did not maintain social distancing,
209 (52.0%) of the study subjects did not take proactive measure when contacting the active
Covid-19 case, while 265 (65.9%) avoided meeting with cured Covid-19 patients and 206
(51.2%) answered to take proactive measures when developing signs and symptoms of Covid-19.
Overall, 230 (57.2%) of the respondents scored practice below the mean practice score (4.18)
and were having a poor practice of Covid-19 prevention.

(Angelo, AT., Alemayehu, DS., & Dacho, AM.) Knowledge, Attitudes, and Practices Toward
Covid-19 and Associated Factors Among University Students in Mizan Tepi University, 2020.
Infection and Drug Resistance. 2021; 14:349.

Study conducted in Somalia Banadir region Practice related to COVID-19 in selected study area
is presented. Among 420 respondents, 86.4% (n=363) respondent wore mask before leaving
home and 67.6% (n=284) covered their nose and mouth while coughing or sneezing with the
elbow or a tissue but only 56.7% (n=238) respondent uses hand sanitizer. Practices regarding
social distances as well as home quarantine were seen very poor. And also, only 43.1% (n=181)
respondent follows the direction of local authorities.

(Abdullahi, SH. 2020) “Knowledge, Attitude and Practice of People Towards COVID-19 in
Banadir Region of Somalia: A Cross-Sectional Study.” IOSR Journal of Dental and Medical
Sciences (IOSR-JDMS), 19(12), 2020, pp. 21-26.
2.5 CONCEPTUAL FRAMEWORK

Independent Variable Dependent Variable

IMPACT Of COVID-19 COMMUNITY

Knownledge Heath

Attitude Socioeconomic

Practice Education

2.6 RESEARCH GAP

Since the outbreak of COVID-19 it was greatly influenced in the word specially third world
countries such Economic, Health, Travel, Lockdown and Health etc.

Somalia one of these countries It is also a long time without a government and sufficient funds at
this time. Las-Anod Sool Somalia It is one of the districts of the revolutionary government of
Somalia. And also effected the disease. Therefore, to find out the effect of the disease on the
community living in Las Anod, we decided that since nothing has been investigated or written
about it before. to investigate or find out the impact of COVID-19 in Las-Anod Community.