General public’s knowledge and practices on face mask use during the COVID-19 pandemic: a cross-sectional exploratory survey from Dharan, Nepal

Background:   Facemasks are considered a cheap, effective, and safe method to control the spread of coronavirus disease-19 (COVID-19). This study assessed the knowledge and practice of face mask use amongst the Nepalese public during the COVID-19 lockdown.   Methods:   A cross-sectional study using a self-developed, validated questionnaire (Cronbach alpha 0.556) was conducted in Dharan, Nepal during May 2020. Pharmacists from ten pharmacies throughout Dharan city administered and recorded responses from a selected sample, stratified across age, gender, education, and place of residence. Completed questionnaires were entered in SPSS, coded, and normality tested using a one-sample K-S test. Demographic characteristics were described using descriptive statistics. Median scores among subgroups were compared using inferential statistics. Descriptive analyses were performed for demographic parameters and inferential statistics for outcome variables, calculating median scores among subgroups which were further compared using non-parametric tests at alpha=0.05.   Results:   381 individuals participated - 211 males (55.4%) and 170 females (44.6%) . 93 (24.5%) respondents were between 20-30 years of age and three (0.8%) were over 70. 200 (52.5%) participants were educated between classes VIII to XII; seven (1.8%) having postgraduate education. 129 (33.9%) participants were from hill tribes. Knowledge scores were high (median score 16; maximum score 18).  Around 20% of participants had never used a face mask before the pandemic; most knew about the ongoing pandemic (80%), about washing hands before using a mask (92.6%), and covering the mouth and nose (78.7%),  Under half knew to avoid touching the mask while wearing it (42.3%). Knowledge scores were higher among men (p=0.038), younger age groups (p=0.010), and those with greater education (p=0.048).  Conclusion:   Knowledge was good, and the public were aware of the proper use of face masks. Educational interventions could be targeted to those with lesser knowledge, and steps to promote sustained face mask use could be beneficial.