Misconceptions About COVID-19 Among Older Rohingya Adults (Forcefully Displaced Myanmar Nationals) in Bangladesh: Findings from a Cross-Sectional Study (preprint)

Background: Rohingya (Forcefully Displaced Myanmar Nationals or FDMNs) in Bangladesh are at increased risk of 2019 coronavirus disease (COVID-19), especially the older population. Given low health literacy among the FDMNs and the adverse situation of their residential camps, there are possibilities of misinformation related to COVID-19 among the older FDMNs who are at greater risk. Therefore, the present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh.   Methods: This cross-sectional study was conducted among 416 FDMNs, aged 60 years and above, from a Rohingya camp situated in Cox’s Bazar, a South-Eastern district of Bangladesh. We collected information on 14 different locally relevant misconceptions related to the spread, prevention, and treatment of COVID-19, scored each misconception as one, and obtained a cumulative score of the 14-items, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. With backward selection based on the Akaike information criterion, a multiple linear regression model explored the factors associated with misconceptions.  Findings: The participants had an average of five misconceptions. The most prevalent misconceptions were related to the prevention of COVID-19, i.e., everyone should wear personal protective equipment when outside (86.6%), and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less-religious person (31.5%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions, and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by the pandemic, having COVID-19 diagnosed friends or family members, and receiving information from friends and family.  Interpretation: Overall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programs to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions.  Funding: No funding was received for this study. Declaration of Interests: The authors have no conflict of interest to disclose. Ethics Approval Statement: The institutional review board of the Institute of Health Economics, University of Dhaka, Bangladesh, approved the study protocol. Informed written consent was sought from the participants (thumb impressions from those who could not read and write) before administering the survey. Participation was voluntary, and participants did not receive any compensation. Written approval was also sought from the Office of the Refugee Relief and Repatriation Commissioner (RRRC) prior to accessing the camps and conducting the survey.