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Although countries in sub-Saharan Africa have so far avoided large-scale outbreaks of COVID-19, as of June 2021, the number of new cases has been surging in multiple nations. The official case count in Kenya was 179 876 confirmed cases in June 2021, including 1597 cases in Siaya county.1 One explanation for the relatively low spread of COVID-19 is the strict lockdown measures that were imposed early but were eventually eased because of their harsh socioeconomic consequences.2 Masks emerged as a prominent strategy to reduce SARS-CoV-2 transmission before widespread vaccinations and have been legally mandated in Kenya since April 2020.3 Yet compliance with public health guidelines is not guaranteed and motivating people to adopt new preventive health behaviors is inherently difficult. In this cross-sectional study, we examine the extent to which mask mandates are followed and quantify the bias of self-reported mask usage.
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Accepted for Publication: May 25, 2021.
Published: July 30, 2021. doi:10.1001/jamanetworkopen.2021.18830
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Jakubowski A et al. JAMA Network Open.
Corresponding Author: Aleksandra Jakubowski, PhD, Center for Effective Global Action, University of California, Berkeley, University Hall, 714B, Berkeley, CA 94720 (jakubowski(@berkley.edu).
Author Contributions: Drs Jakubowski and Egger had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Conflict of Interest Disclosures: None reported.
Funding/Support: This research was supported by the Weiss Family Foundation and the International Growth Centre.
Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We thank the research assistants from Vyxer Remit Kenya for their tremendous effort in collecting the data used in this study. The research assistants were compensated for their time.
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