Factors associated with incorrect facemask use among individuals visiting high-risk locations during COVID-19 pandemic

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Shargunan Selvanthan Gunasekaran
Sera Selvanthan Sundram Gunasekaran
Gobi Hariyanayagam Gunasekaran
Nur Syafina Insyirah Zaimi
Nor Amirah Abdul Halim
Fouzia Hanim Abdul Halim


In December 2019, an outbreak of a novel coronavirus disease (COVID-19, previously known as 2019-nCoV) was determined to be transmitted via respiratory droplets. Thus, health agencies have recommended the use of facemasks as a protective measure. The current study investigated the prevalence and factors contributing to incorrect facemask use among individuals visiting high risk public locations. A cross-sectional observational study of facemask use among individuals visiting high risk public facilities was conducted during a local COVID-19 outbreak from end of April to middle of May 2020 in Sitiawan, Perak, Malaysia. Enrolment in the study included any individuals entering the selected study facilities via a dedicated entry point. Suitable study locations were identified as a local wet market selling freshly slaughtered animals and a district specialist hospital.Trained data collectors were stationed at the entry points to observe individuals entering the selected facilities for the type, category, and correct facemask use. Individuals were categorized into two groups, correct and incorrect facemask users, based on visual observation of facemask use. The Pearson chi-square test was used for differences in investigated variables. Both binary and multiple logistic regression models were used in this study. The study protocol was approved by the institutional review board. The main outcome measure was facemask use (either correct or incorrect).A total of 3322 individuals with a high prevalence of facemask use (98.2%) consisting of a large proportion of medical-grade face masks (75.5%) were included in this study. Male individuals, Malay ethnic people, high-risk age groups, and those wearing a medical grade facemask were more likely to present incorrect facemask use. A high prevalence of facemask use among individuals visiting public facilities was observed. However, incorrect facemask use raises the need for of targeted public health strategy to mitigate the impact of COVID-19 epidemic.


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Original Articles
Author Biographies

Shargunan Selvanthan Gunasekaran, Dental Department, Klinik Pergigian Seri Manjung, 32000 Sitiawan, Perak, Malaysia.

Dental Department, Klinik Pergigian Seri Manjung, 32000 Sitiawan, Perak, Malaysia.

Sera Selvanthan Sundram Gunasekaran, Orthopedic Department, Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Orthopedic Department, Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Gobi Hariyanayagam Gunasekaran, Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Nur Syafina Insyirah Zaimi, Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Nor Amirah Abdul Halim, Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Fouzia Hanim Abdul Halim, Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia

Pharmacy Department , Hospital Seri Manjung, 32040 Seri Manjung, Perak, Malaysia


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