Int J Biol Sci 2020; 16(15):2895-2905. doi:10.7150/ijbs.47075 This issue

Research Paper

Disease knowledge and attitudes during the COVID-19 epidemic among international migrants in China: a national cross-sectional study

Cheng Wang1,2#, Qi Tian3#, Peizhen Zhao1,2, Mingzhou Xiong1,2, Carl A Latkin4, Yiqun Gan5, Brian J Hall4,6✉, Bin Yang1,2✉

1. Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China.
2. Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China.
3. Guangzhou Health Information Center, Guangzhou, Guangdong, China.
4. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
5. School of Psychological and Cognitive Sciences, Peking University, Beijing, China.
6. Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China.
#These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Wang C, Tian Q, Zhao P, Xiong M, Latkin CA, Gan Y, Hall BJ, Yang B. Disease knowledge and attitudes during the COVID-19 epidemic among international migrants in China: a national cross-sectional study. Int J Biol Sci 2020; 16(15):2895-2905. doi:10.7150/ijbs.47075. Available from

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Graphic abstract

Background: There are more than 258 million international migrants worldwide and the majority reside in countries with ongoing novel coronavirus disease 2019 (COVID-19) epidemic outbreaks. International migrants may not receive adequate and timely disease information during epidemics, increasing vulnerability to disease transmission. This is one of very limited studies focusing on international migrants' COVID-19 prevention knowledge and attitudes during the epidemic.

Methods: A national cross-sectional online survey was conducted across 100 cities and 26 regions in China from February 17 and March 1, 2020. The sample included 1,426 international migrants representing 77 countries and 6 continents. Knowledge was defined as the number of correct responses to questions about COVID-19. Attitudes included worries, expectations, and general preparedness. Multivariable ordinal logistic regressions evaluated correlates of knowledge and attitudes including information channels and preferences, and trust in Chinese institutions and groups.

Results: Just half of the sample, 730/1426 (51.2%) had a good level of knowledge and 656/1426 (46.0%) had a positive attitude towards the COVID-19 epidemic. Knowledge was associated with receiving information through social media (aOR: 2.0, 95%CI: 1.2-3.2), the Internet (aOR: 1.4, 95%CI: 1.2-1.8), the community (aOR: 1.5, 95%CI: 1.2-1.8), and encountering language barriers when receiving medical services (aOR: 0.8, 95%CI: 0.7-1.0). Positive attitude was associated with the level of trust in various Chinese institutions and groups.

Conclusions: Roughly half of the sample reported inadequate knowledge and poor attitudes toward prevention and control of COVID-19. Tailored public health campaigns are needed to ensure that international migrants possess adequate knowledge to protect their health during future epidemics and disasters.

Keywords: knowledge, attitude, COVID-19, international migrants