Face mask use among pedestrians during the COVID-19 pandemic in Northeast Iran: A survey on 223,848 pedestrians

Background: Despite the mass vaccination of people in countries, preventive health guidelines of coronavirus disease 2019 (COVID-19) are still one of the most critical factors for pandemic control. The objectives of this study were to assess the overall use of face masks and investigate the diverse kinds of face masks used among pedestrians in northeast Iran. Methods: This cross-sectional study was designed in Torbat Heydariyeh, northeastern Iran, from February 19 to May 13, 2020. A total of 223 848 pedestrians were selected from 25 points of the city, using a multistage sampling method in 10 stages. Descriptive statistics were presented with frequencies and percentages. Chi-square test and Fisher exact test were used to assess the association between two categorical variables. Results: The overall percent of face mask usage was 78.68%. Women used face masks considerably higher than men (88.32% vs. 69.02%, P < 0.001). Among the male and female pedestrians who used the mask, 6.27% and 2.04% wore face mask incorrectly, respectively. Surgical masks (73.7%) were the most common face masks worn by pedestrians. Overall, the face mask usage was significantly lower during a.m. (88.34%) compared to p.m. (78.52%) (P < 0.001). Also, the face mask usage was significantly higher in the center sections of the city (86.49%) compared to the outskirts (43.67%) (P < 0.001). Conclusion: Women use face masks significantly more than men. Using educational programs and establishing laws and regulations to prevent pandemics in cities is considered as a key factor.