Facemask Usage Among Pedestrians in Most Crowded Urban Districts of Kabul, Afghanistan, During the Third COVID-19 Wave: An Observational Study

COVID-19 has spread worldwide since its emergence from Wuhan. In countries with a low vaccination rate, the use of facemasks is essential to limit the risk of COVID-19 transmission. We have conducted this study in June 2021 to estimate the prevalence of facemask usage, and investigate the use of different types of facemasks and their dis-tribution among pedestrians in the most crowded urban districts of Kabul during the third COVID-19 wave in Afghanistan. Using a multistage sampling method, a total of 5,000 pedestrians were selected from five most crowded urban districts of the city. The data was gathered by an observational method. The percentage, mean, and standard deviation were used to describe the variables. The X-2 test analysis was used to assess the relationship between two categorical varia-bles. Of the 5,000 observations, the most common age group was 10-39 years with high participation of male (87.2%). A total of 2,013 (40.3%) people used facemasks (95% CI). Females used facemasks significantly more than males (64.6% versus 36.7%, P , 0.001). Among the pedestrians who used a facemask, most of them (88.6%) wore their facemask correctly. In conclusion, the prevalence of facemask use in Kabul was fairly low especially among elderly people ($ 60 years). Hence, the observed rates probably cannot protect the community against COVID-19. Therefore, it is important to emphasize the public health recommendations via educational programs and national campaigns to support the strict use of facemasks in public places.