Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : May | Volume : 16 | Issue : 5 | Page : LC21 - LC26 Full Version

Mask-wearing Behaviours among the Public in Saudi Arabia during the COVID-19 Pandemic: A Cross-sectional Study

Published: May 1, 2022 | DOI:
Mysara Alfaki, Ahmed Alkarani

1. Assistant Professor, Department of Nursing, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia. 2. Associate Professor, Department of Nursing, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.

Correspondence Address :
Dr. Ahmed Alkarani,
Associate Professor, Department of Nursing, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.


Introduction: Public behaviour involving the wearing of face masks are influenced by a host of interdependent demographic, economic, and educational factors, therefore, mask-wearing behaviours among the public vary not only in different countries but also from region to region within a country.

Aim: To assess mask-wearing behaviours among the public in Saudi Arabia during the Coronavirus Disease 2019 (COVID-19) pandemic.

Materials and Methods: This cross-sectional study was conducted among the general public of Saudi Arabia who could communicate in Arabic, from 9th August 2021 to 12th October 2021, after approval from Taif University. To collect as many respondents as possible, convenience sampling was used and a total of 481 participants gave consent for the same. A social media platform was used for the data collection. Descriptive statistics and a logistical regression model were employed for data analysis.

Results: A total of 481 participants consented to take part in the current research, with 56.8% being males and 43.2% being females. Most individuals showed poor compliance (67.6%). Female participants, participants who had graduate degree, and people who worked in a confined environment, including a hospital, restaurant or similar place, reported better compliance with the use of a face mask (χ2=13.29; p-value <0.001), (χ2=8.26; p-value=0.041), and (χ2=16.84; p-value <0.010), respectively. Regression analysis defined three characteristics linked with good compliance ie., sex, level of education and present work/living situation.

Conclusion: Most people did not comply with public behaviour concerning the use of face masks. Female participants were more likely to wear a face mask.


Coronavirus disease 2019, Disposal of face mask, Educational level, Poor compliance, Self-quarantine

Wearing a mask should be made a natural aspect of social interactions. To make masks as effective as possible, they must be used, stored, cleaned, and disposed of correctly. Coronavirus disease 2019 (COVID-19) is a severe disease for which there is no cure and is spreading at an alarming rate, especially in the immunologically naive population. From 6th-12th September 2021, approximately 4 million new cases of COVID-19 were recorded globally, representing the first significant drop in weekly occurrences in more than two months. The total number of cases reported globally as of 14th September 2021 were over 224 million, with a death toll of a little over 4.6 million (1). Many countries, notably Saudi Arabia, the United States, and Canada, have forced or advised on the use of face masks in public places (2),(3),(4).

Data supporting the effectiveness and acceptance of various types of face masks in avoiding lung diseases throughout the epidemic is limited (5),(6). Applying a face mask or even other barrier (protective eyewear, shields, veils) to stop the recurrence of respiratory infections such coronavirus, rhinovirus, tuberculosis, or influenza were explored in a preview of a review of the literature issued on 6th April, 2020 (7). Mask use resulted in slight but insignificantly decreases in rates of infection, both in general and among affected members of households. The study concluded that “the data is inadequate to recommend the widespread use of masks as a COVID-19 protection strategy” (7) and called for more high-quality randomised trials. During the COVID-19 pandemic, there has been strong indirect evidence to support the claim that the public should wear masks. When discharged as an aerosol under experimental settings, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has indeed been discovered to survive for several hours in the air, (8) and in field and laboratory trials, face masks seem to protect against such particles (9).

It has been demonstrated that for up to 2.5 days prior to the beginning of symptoms individuals are infectious (10). Furthermore, it appears that up to 50% of infections occur in people who are not yet symptomatic (11). The community incidence of COVID-19 is anticipated to be significant in many countries (12). According to modelling studies, even a minor drop in community transmission of SARS-CoV-2 might have a significant positive impact on other health system components like mechanical ventilators and inpatient bed spaces) (13). The present study aimed to assess the public behaviour in Saudi Arabia involving the wearing of face masks during the COVID-19 pandemic.

Material and Methods

This cross-sectional study was conducted from 9th August 2021 to 12th October 2021, among the general public of Saudi Arabia, who could communicate in Arabic. The affiliated Taif University Ethics Committee accepted the study protocol (Application code: 42-0085). Informed consent was obtained. Convenience sampling was used.

The survey was based on Tan M et al., instrument (14). The questionnaire was validated and the reliability of the English was checked. It was then translated into Arabic by an expert and assessed for linguistic reliability. Due to the serious circumstances of COVID-19, the researcher used Google Forms to establish Arabic questionnaire electronic links. Because WhatsApp is the most popular social media platform in Saudi Arabia, it was chosen to distribute the questionnaire. The online survey was created using Google Forms and it was opened for the study participants for 42 days.

Inclusion and Exclusion criteria: The study participants included people who were aged 14 years or older, lived in Saudi Arabia atleast for one year during the COVID-19 pandemic and could communicate in Arabic, while those who were less than 14 years old, not completed the questionnaire, and could not communicate in Arabic were excluded from the study.

The survey was based on Tan M et al., instrument, which was separated into two parts (14):

First part included:

a) Respondents’ demographical information, such as gender, age in years, etc.
b) Behaviours of mask use, which includes 15 items such public habits on mask-wearing, disposal of face mask methods, etc.

Second part of the instrument contained a Likert-type 4-point scale (never, occasionally, often, always), and also forcible and multiple choice questions, to obtain total scores ranging from 0 to 12.

Study Procedure

Ten participants were chosen (who were not part of the main study) to assess the questionnaire’s reliability, completion time, whether the questions were straight forward and easy to answer, and whether the questionnaire was well-designed. The Cronbach’s α-reliability test to determine the questionnaire’s internal consistency had been 0.709. A score of 1 was assumed for every correct response and a score of 0 was assumed for every incorrect answer on face mask wearing behaviours, to ease the analysis.

• Answers of “never” and “occasionally” were classified as erroneous for items 1, 2, 3, 4-1, 5-1, and 9, while.
• “Often” and “always” were defined as correct.
• For items 4, 5, 6, 7, 11, and 13, the definitions were reversed.
• Items 13-1, 14-1, and 15 were not taken into account, resulting in a total of 13 points.
• The total result was categorised as “good” or “poor” depending on whether a total of 10 or even more points (out from a possible 12) was obtained, which has been employed as a predictor variable in logistical regression study.

Statistical Analysis

The Statistical Package for the Social Sciences (SPSS) software (version 16.0) was employed for data analysis. All the data were categorised and presented as frequencies with percentages. The Chi-square test was used to compare the “good” rate among subgroups and variables with p-value <0.05 being significant.


A total of 481 participants consented to take part in the current research, with 56.8% being male, and 43.2% being female. Most participants reported that they had not experienced flu-like symptoms (86.9%) or were communicating with clients who had been in self-quarantine in the last 15 days (90.4%) respectively (Table/Fig 1).

In general, the public showed poor compliance (67.6%) with regard to wearing face masks. Female participants, participants who were graduates, or people who worked in a confined environment, including a hospital, restaurant, or similar place, reported better compliance with the use of a face mask (χ2=13.29; p-value <0.001), (χ2=8.26; p-value=0.041), and (χ2=16.84; p-value <0.010), respectively (Table/Fig 1).

However, only 15.8% of the participants never touched the mask while using it. The most common source of knowledge regarding face mask use (45.7%) was through social media sites (Table/Fig 2).

Males have been less inclined than females demonstrating greater levels of adherence (OR=2.35, 95% confidence interval CI=1.46:3.79, p-value=0.001). Respondents with a high school education had a lower rate of adherence to face mask using habits than those of other educational levels (ORs=1.26, 95% CI:0.64-2.46, p-value 0.5). Respondents who worked at numerous contexts throughout the day, such as a police officer, showed (95% CI:1.71-176.86, p-value=0.02) greater adherence. Furthermore, participants who lived with people in self-quarantine reported worse compliance than those who did not live with people in self-quarantine (OR=3.30, 95% CI:1.31-8.30, p-value=0.01) (Table/Fig 3).


Among the factors influencing mask-wearing behaviours, we found that respondents with a college education had a lower rate of adherence to face mask using habits than those of the other educational levels. In addition, respondents who worked in different settings throughout the day, such as a police officer, and individuals who worked in indoor office settings showed greater adherence than individuals who were learning or contributing to activities inside a crowded environment, whereas lower adherence was seen in those communicating with clients who had been in self-quarantine. Furthermore, participants who lived with people in self-quarantine , reported, worse compliance than those who did not live with people in self-quarantine. However, another study reported that people working in relatively enclosed or multiple settings and living in self-quarantine or with people in self-quarantine did not show higher compliance than those in outdoor open space. Participants showed lower compliance when studying or participating in events in crowds (14).

Authors also found that factors such as age, place of residence, having flu-like symptoms, and knowledge of the use of face masks had no significant impact on public behaviour involving the use of face masks. This stands in contrast with a study conducted in China by Tan M et al., which found that people who lived in urban areas showed better compliance than those who lived in rural areas. When people have flu-like symptoms like coughing and sneezing, they may feel uncomfortable and touch their face masks more frequently, resulting in lower compliance. The effect of age exhibited different patterns, with those aged 14 years or below demonstrating the best compliance and other groups, displaying increasing trends of better compliance with increasing age (14).

Another issue for the public is a good variety of different sorts of face masks. However, 86.1% of the subjects wore disposable medical masks, few participants (8.1%) wore N95 respirators, which would not be advised for the public at large, while about 13.7% of respondents said they wore numerous masks at the same time. In non healthcare settings, the Centre for Disease Control and Prevention (CDC) does not suggest wearing N95 respirators to guard against COVID-19. Commercially available medical procedure masks (including surgical masks) for community usage are often marketed as “disposable face masks.” Healthcare professionals and other workers who are required to use N95 respirators for protection against additional threats, should be given priority (15).

When there is a mask shortage, face mask reuse is an unavoidable problem. During the period whenever disposable masks were sparse, the public was encouraged to reuse them if they were clean, but to replace them with new ones if they were unclean and had been worn for more than 8 hours (16). Disposable masks were reused by more than half of the present study subjects, although only about a 1/3rd (21.7%) did not replace them even after they had been worn for more than 8 hours. The World Health Organisation (WHO) requires people not to reuse single-use masks and to discard the mask as soon as it becomes moist (17). For the next point, nearly half of the subjects (49.1%) hung their worn masks in well-ventilated areas. Some members of the public used other methods, for example rubbing spirits, heating, steaming, and putting tissue or even a fabric mask on the inside of a one-use mask. But the majority applied no special treatment to the reused mask. Disposable masks should not be disinfected, according to the evidence. To prevent contamination, cloth masks should be cleaned using hot water and soap or with washing powder (18). Cloth masks are constructed from a range of fabrics and come in several styles; to avoid leaks, they should be worn with a suitable fit over the nose and mouth. A nasal wire and multiple layers of closely woven breathable cloth should be employed. This is especially crucial for single-layer materials or lightweight fabrics that do not obstruct light (19).

The disposal of used masks is another concern. The United Nations Children’s Fund (UNICEF) requires people to carefully dispose of masks, gloves, and other items for personal protection, and only in closed bins (20). The present study result showed that 31% placed their masks into a waste basket without even a cover, whereas 25.8% dumped them into any trash barrel that was accessible, irrespective of whether it had a cover. According to UNICEF, the number of used masks that ended up in nature increased during lockdowns. This occured because most of these items are discarded improperly, such as in open garbage cans or on the ground, allowing the very light masks to be carried by the wind and washed into rivers, seas, and oceans by rain, which explains why used masks have been found on the shores of uninhabited islands.

The worn masks and gloves that we find on the ground in practically every community are not only hazardous to the environment, but also to humans. These items have a higher risk of coronavirus infection than other types of garbage (21). Authors discovered that participants who were given instructions on how to apply face masks complied with guidance four times compared to those who weren’t.

Among the factors influencing mask-wearing behaviours, we found that respondents with a college education had a lower rate of adherence to face mask using habits than those of other educational levels. Surprisingly, the higher one’s educational level, the lower one’s compliance on face mask use. As a result, it appeared that good mask-wearing behaviours were determined by the amount of mask use education received rather than educational levels. This outcome further confirmed the premise of Greenhalgh T et al., study inside the framework of COVID-19, individuals may be encouraged to use masks safely and correctly not sacrificing others critical anti-contagion procedures (22). Together along with the findings of the present study, this evidence on how participants obtained related material, implies that institutions and researchers should make every effort to distribute guidance through diverse ways, with social media being the most beneficial to the public.


The responder’s honesty and frankness may be limited due to the nature of the issue. Another limitation of the present study is the questionnaire’s low reliability, which could be due to the small sample size and the fact that we used items from other questionnaires because there were no reliable gold-standard public face mask using questionnaires to measure individual’s mask-wearing behaviours among the public. In addition, the current study’s questionnaire addressed obstacles in general, rather than categorising them as psychological, physical, or cultural. For future research to get a better understanding of this essential health topic, a bigger sample size is needed.


Most people did not comply with public behaviour concerning the use of face masks. Female participants in the present study were more likely than male participants to wear a face mask. It was observed that mask-use education rather than education level seemed to determine the level of good mask-wearing behaviour.


WHO. Coronavirus disease 2019 (COVID-19) situation report? 2020. [Accessed on 02 Nov 2021]. Available online:
Ministry of Health Saudi Arabia. MOH reiterates the importance of wearing face mask and keeping safe distance 08 November 2020. [Accessed on 02 Nov 2021]. Available online:
Centers for Disease Control and Prevention (CDC). Proper N95 respirator use for respiratory protection preparedness. 2020. [Accessed on 02 Nov 2021]. Available online:
Government of Canada. Considerations in the use of homemade masks to protect against COVID-19. Notice to general public and healthcare professionals. 2020. [Accessed on 02 Nov 2021]. Available online: covid19-notice-home-made-masks.html.
Feng S, Shen C, Xia N, Song W, Fan M, Cowling BJ. Rational use of face masks in the COVID-19 pandemic. Lancet Respir Med. 2020;S2213-2600(20)30134-X. [crossref]
National Health Service (UK). Are face masks useful for preventing coronavirus? 2020. [Accessed on 02 Nov 2021]. Available online:
Brainard JS, Jones N, Lake I, Hooper L, Hunter P. Facemasks and similar barriers to prevent respiratory illness such as COVID-19: A rapid systematic review. MedRxiv. 2020.04.01.20049528. Doi: [crossref]
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-67. Doi: 10.1056/NEJMc2004973. Epub 2020 Mar 17. PMID: 32182409; PMCID: PMC7121658. [crossref] [PubMed]
Leung NHL, Chu DKW, Shiu EYC, Chan KH, McDevitt JJ, Hau BJP, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med. 2020;26(5):676-80. Doi: 10.1038/s41591-020-0843-2. Epub 2020 Apr 3. Erratum in: Nat Med. 2020 May 27. PMID: 32371934; PMCID: PMC8238571. [crossref] [PubMed]
Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dörner L, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368(6491):eabb6936. Doi: 10.1126/science.abb6936. Epub 2020 Mar 31. PMID: 32234805; PMCID: PMC7164555. [crossref] [PubMed]
Ganyani T, Kremer C, Chen D, Torneri A, Faes C, Wallinga J, et al. Estimating the generation interval for coronavirus disease (COVID-19) based on symptom onset data, March 2020. Euro Surveill. 2020;25(17):2000257. Doi: 10.2807/1560-7917.ES.2020.25.17.2000257. PMID: 32372755; PMCID: PMC7201952. [crossref]
Spellberg B, Haddix M, Lee R, Butler-Wu S, Holtom P, Yee H, et al. Community Prevalence of SARS-CoV-2 Among Patients With Influenzalike Illnesses Presenting to a Los Angeles Medical Center in March 2020. JAMA. 2020;323(19):1966-1967. Doi: 10.1001/jama.2020.4958. PMID: 32232421; PMCID: PMC7110920. [crossref] [PubMed]
Hellewell J, Abbott S, Gimma A, Bosse NI, Jarvis CI, Russell TW, et al. Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group, Funk S, Eggo RM. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob Health. 2020;8(4):e488-96. Doi: 10.1016/S2214-109X(20)30074-7. Epub 2020 Feb 28. Erratum in: Lancet Glob Health. 2020 Mar 5. PMID: 32119825; PMCID: PMC7097845. [crossref]
Tan M, Wang Y, Luo L, Hu J. How the public used face masks in China during the coronavirus disease pandemic: A survey study. Int J Nurs Stud. 2021;115:103853. Doi: 10.1016/j.ijnurstu.2020.103853. Epub 2020 Dec 6. PMID: 33352496; PMCID: PMC7837163. [crossref] [PubMed]
Centers for Disease Control and Prevention (CDC). Recommendation regarding the use of cloth face coverings, especially in areas of significant communitybased transmission. 2020. [Accessed on 03 Nov 2021]. Available online:
National Health Commission of the People’s Republic of China. Face mask use guidelines for preventing against coronavirus disease (COVID-19) transmission. 2020. [Accessed on 03 Nov 2021]. Available online:
WHO. Coronavirus disease 2019 (COVID-19) situation report. 2020. [Accessed on 03 Nov 2021]. Available online:
Desai AN, Aronoff DM. Masks and coronavirus disease 2019 (COVID-19). JAMA. 2020;323:2103-03. Doi: 10.1001/jama.2020.6437. [crossref] [PubMed]
Feng S, Shen C, Xia N, Song W, Fan M, Cowling B. Rational use of face masks in the COVID-19 pandemic. Lancet Respir Med. 2020;8:434-36. [crossref]
Centers for Disease Control and Prevention (CDC). Proper N95 respirator use for respiratory protection preparedness. 2020. [Accessed on 03 Nov 2021]. Available online:
UNICEF. How to throw away used masks responsibly. Children take action against climate change, at World’s Largest Lesson 2020. [Accessed on 03 Nov 2021]. Available online:
Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. Face masks for the public during the covid-19 crisis. BMJ. 2020;369:m1435. Doi: 10.1136/bmj.m1435. PMID: 32273267. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/53507.16402

Date of Submission: Nov 03, 2021
Date of Peer Review: Jan 12, 2022
Date of Acceptance: Mar 17, 2022
Date of Publishing: May 01, 2022

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Dec 03, 2021
• Manual Googling: Mar 04, 2022
• iThenticate Software: Apr 28, 2022 (15%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)