Knowledge, Attitudes, and Practices toward COVID-19 among University Students Worldwide: A Systematic Review


1 Associate Professor of Otorhinolaryngology, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

2 Assistant Professor of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

3 Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.


Background: Lack of accurate information about epidemic diseases or lack of a comprehensive clinical picture of the disease and its ways of transmission in the past decades have resulted in high fatalities. This study was designed to determine the knowledge, attitude, and practice (KAP) of students worldwide toward COVID-19.
Materials and Methods: In this systematic review, a systemic search of online databases (Medline, EMBASE, Scopus, Web of Science, Cochrane Library, CIVILICA, and Google Scholar search engine) was conducted for related studies with no time limit up to November 2021. Two reviews evaluated the quality of eligible studies and carried out the selection procedure.
Results: A total of 33 studies from 19 countries across all continents assessing the COVID-19 KAP of 28,081 participants were included. The overall correct answers for knowledge, good attitude, and good practice across worldwide studies ranged from 29.8-97.2%, 28.1-91.15%, and 51.5-99.5%, respectively. The highest and lowest knowledge scores were related to Indian and Indonesian students. The highest positive attitude was related to Indian students, and the lowest positive attitude was related to Malaysian students. The results also showed that the highest positive performance was related to Indian students, and the lowest rate was related to Indonesian students. In addition, gender, university year, level of education, and field of study were determined as factors associated with the overall KAP of students (P<0.05).
Conclusion: The results showed that medical students had higher knowledge and attitude on COVID-19, but non-medical students had more acceptable performance. KAP scores were higher in Indian students than students in other countries.