|ORIGINAL RESEARCH ARTICLE
|Year : 2021 | Volume
| Issue : 2 | Page : 139-143
Knowledge and attitude of global pandemic coronavirus among dental health professionals in North India
Iqbal Singh1, Robindera Kour2, Ashish Bali3, Aditya Bali4, Amarpreet Singh5
1 Department of Public Health Dentistry, Indira Gandhi Dental College and Hospital, Jammu, Jammu and Kashmir, India
2 Directorate of Health Services, Government College of Engineering and Technology, Jammu, Jammu and Kashmir, India
3 Department of Periodontology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
4 Department of Electronics and Communication, Government College of Engineering and Technology, Jammu, Jammu and Kashmir, India
5 Department of Public Health Dentistry, Himachal Dental College and Hospital, Himachal Pradesh, India
|Date of Submission||29-Oct-2020|
|Date of Decision||18-Feb-2021|
|Date of Acceptance||20-Jun-2021|
|Date of Web Publication||2-Aug-2021|
Department of Periodontology, Pacific Dental College and Hospital, Udaipur, Rajasthan
Source of Support: None, Conflict of Interest: None
Background: Coronavirus has posed a greater risk of occupational transmission to dental professionals as it can spread through the aerosols. Aim: This syudy aimed to assess knowledge and awareness of private dental health-care professionals regarding coronavirus disease-2019 (COVID-19) disease in India. Materials and Methods: A cross-sectional study was conducted among 320 private dentists practicing in north India. A self–administered, anonymous, multiple-choice type questionnaire was administered to gather information. The questionnaire contained 12 questions on knowledge and awareness regarding coronavirus keeping in view the time constraints. Statistical analyses were done using analysis of variance and Student t-test. Results: Awareness regarding the mode of transmission of COVID-19 was reported positively by 93.3% of subjects. Only 3.3% of subjects reported about having encountered a corona patient at their clinic. Preventive measures to prevent the spread of COVID-19 were known to 77.7% of subjects. A statistically significant association of mean knowledge scores was noted with education level (P = 0.013) and working profile (P = 0.016) of the subjects. Conclusion: The results of the present study showed that some knowledge gaps existed among dentists regarding some important aspects of COVID-19. Therefore, there is an urgent need for training and continuous education programs regarding infectious diseases.
Keywords: Awareness, coronavirus disease-2019 virus, dentist, knowledge, preventive measures
|How to cite this article:|
Singh I, Kour R, Bali A, Bali A, Singh A. Knowledge and attitude of global pandemic coronavirus among dental health professionals in North India. J Indian Assoc Public Health Dent 2021;19:139-43
|How to cite this URL:|
Singh I, Kour R, Bali A, Bali A, Singh A. Knowledge and attitude of global pandemic coronavirus among dental health professionals in North India. J Indian Assoc Public Health Dent [serial online] 2021 [cited 2022 Aug 20];19:139-43. Available from: https://www.jiaphd.org/text.asp?2021/19/2/139/322860
| Introduction|| |
The eruption of coronavirus disease-2019 (COVID-19) in the region of Wuhan, China, has developed speedily into a population health emergency and has fanned out to different countries of the world. According to the World Health Organization situation report (March 27, 2020) update on COVID-19, there have been more than 500,000 reported cases and 23,000 deaths worldwide and this number continues to increase. The typical clinical symptoms of the patients who suffered from the novel viral pneumonia were fever, cough, and myalgia or fatigue with abnormal chest computed tomography, and the less common symptoms were sputum production, headache, hemoptysis, and diarrhea. A high-resolution chest computed tomography scan can show bilateral impairment of lung parenchyma. Biomolecular diagnosis is performed through reverse transcription–polymerase chain reaction of samples taken from the upper airways; thus far, this procedure is the gold standard for correctly diagnosing severe acute respiratory syndrome coronavirus-2 positivity. Due to the characteristics of dental settings, the risk of cross-infection may be high between dental practitioners and patients. For dental practices and hospitals in countries/regions that are potentially affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces the essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in potentially affected areas. It should be understood that the natural history of the virus or the reaction outcomes associated with the same is not routinely familiar to the practitioners. In this situation, prevention through absolute barriers is the only way we can recommend with confidence. The biggest question in a dental fraternity is “What next?” Several organizations and specialty societies are coming out with protocols and guidelines based on present scientific pieces of evidence. However, there are newer insights into the COVID-19 virus emerging daily. This gives an unprecedented opportunity for the dental community to understand the human oral microbiome, drug interaction, oral immunology, and evidence-based practice. Furthermore, in other spheres, this disruption enables us to revisit our infection control and sterilization protocols, practice and research ethics, emergency protocols, teledentistry, cost-effectiveness as well as economic analysis of dental practice management. The opportunity has engaged the Internet to the maximum. Most of the dental schools have shifted to online/distance mode teaching, using all novel methods of teacher–student interactions. All such disruptions will help to innovate and bring new models and opportunities. Such ideas and thought processes need to be validated by research and evidence, so the present research is conducted with the aim to assess the knowledge/awareness of the global pandemic coronavirus among dental health professionals in north India. The Indian dental community should seize the opportunity and emerge successful, as in the past. As health-care workers, we must consider the phase of pandemic as an opportunity to expand our knowledge and engineer better ways to overcome its effects by joining hands with the local governing bodies, health authorities, and state/Indian dental councils.
| Materials and Methods|| |
Study design, study population, and study sample
This is a descriptive cross-sectional study conducted among health professionals residing in north India. Local Indian Dental Association provided the list of professionals. A pilot study was done on 30 subjects to check the feasibility of the study. The sample size required for the study was calculated using the following equation:
Where Z is the standard normal score with a 95% confidence interval (a = 0.05), S is the standard deviation of the variable, and d is the maximum acceptable error. To take account of potential errors and sample loss, which is common in cross-sectional studies, a final sample size was estimated to be 320. Simple random sampling methodology was employed to pick the study subjects from our sampling frame (list of all practicing dentists).
Assessment tool and method of administration
Research Instrument: A self-designed questionnaire written in English language (assessment by a specialist) was made specifically for the study. The questionnaire was pretested for validity and reliability. The reliability of the questionnaire was good (0.84). The questionnaire was divided into two sections – Section A was “General section” which comprised sociodemographic and professional details of the subjects (gender, educational status, type of practice, etc.) and Section B comprised 12 questions depicting knowledge and awareness regarding COVID-19 (mode of transmission, availability of vaccine, various preventive measures, complications, etc.)
The questionnaire was mailed over to study subjects and a personal number was provided to each subject for clearing the doubts regarding filling of the questionnaire. Adequate amount of time was provided to each subject to fill the form. Total knowledge/awareness score was calculated on the basis of each participant's response. Each positive response was scored as “1” and negative as “0.” The total score of the participant was calculated by adding the sum of responses which ranged from 1 to 12, on a Likert Scale. The final scores were categorized at three levels – low (0–4), medium (5–8), and high (8–12).
Ethical clearance and informed consent: The present study was conducted after obtaining ethical clearance from registrar Jammu and Kashmir State Dental Council. Prior permission was obtained from the concerned health authorities and informed consent was obtained from the subjects for their willingness to participate in the study.
Completed questionnaires were collected on the same day and prospectively analyzed. The present study conducted descriptive statistical analysis. Number and percentages were used to compute results on categorical measurements. The results were statistically analyzed using SPSS package version 21 (SPSS, Chicago, IL, USA). Analysis of variance was employed to find the significance of study parameters between three or more groups of participants and Student's t-test was used to find significance between two groups. The significance was set at < 0.05.
| Results|| |
Everything is checked and made according to journals guidelines.
The results of this present study showed male subjects comprised more than half (189 out of 320, i.e. 59%) of the total study population as compared to the female subjects (131 out of 320, i.e. 41%) [Table 1]. In addition, majority of the study subjects were graduates (202 out of 320, i.e. 63.1%) as compared to postgraduates. Working profile of the subjects depicted that 49.3% (158) were engaged in both academic and private practice. About 15.6% (50) of subjects were seeing more than 15 patients per day [Table 3]. Awareness regarding the mode of transmission of COVID-19 was reported positively by 93.3% of subjects. When asked about the awareness regarding undergoing vaccines to prevent COVID-19 vaccine to prevent COVID-19, only 19% gave the correct answer. Surprisingly, only 3.3% of subjects reported about having encountered a COVID-19 patient at their clinic. Regarding preventive measures to prevent the spread of COVID-19, 77.7% of subjects answered correctly. More than 80% of subjects had knowledge regarding the availability of diagnostic tests. In addition, 67% of subjects were aware of undergoing treatment of COVID-19 in government institutes near their clinic [Graph 1]. When the educational qualification of subjects was compared with their knowledge regarding COVID-19, it was revealed that 58.4% of graduates had low knowledge scores. Strangely, only 33.6% of postgraduate dental practitioners had comprehensive knowledge (high scores) regarding COVID-19 [Graph 2]. It was also found that 40.3% (129) had low knowledge scores, 28.7% (92) had medium knowledge scores, and high knowledge scores were reported by only 99 (30.9%) study subjects [Table 2].
|Table 1: Sociodemographic and professional profile of study participants|
Click here to view
|Table 2: Knowledge scores regarding coronavirus disease-2019 among study subjects (according to Likert scale)|
Click here to view
|Table 3: Subjects' mean knowledge scores according to different sociodemographic variables|
Click here to view
| Discussion|| |
The global pandemic coronavirus is proving to be very fatal and resulting in the biggest threat to the entire human race. The COVID-19 is highly infectious has got a very high mortality rate. The statistics of our study showed that majority of the sample reported of having fairly low knowledge for COVID-19. We have used close ended questionnaire as we expect immediate responses from the participants plus they are simple to analyze and interpret. Coronaviruses materialize to be disseminating between different persons through close association with each other in a similar manner as other influenza viruses. The description of details of the report as of July 2020 suggests that approximately two million of the world's population are affected due to COVID-19.
Our research suggests that a generous amount of sample (93.3%) reported awareness in reference to the transmission of coronavirus, which is in coherence to the findings of study conducted by Quadri et al. whose reports suggested that the knowledge of COVID-19 among the DHCWs in Saudi Arabia is hefty (above the mean score). Similar reports were predicted by a study conducted by Kaipa et al. A survey performed on dental health-care workers in Georgia conceded that more than 50% of subjects (dental students, residents, and specialists) have no information regarding knowledge/awareness of viral infections that are spread by human immunodeficiency virus and hepatitis B virus. A survey performed on urban dental fraternity demonstrated that seldom 50% of the study samples had knowledge regarding awareness of spread of viral infections. The information provided is very compelling and can direct dental health workers to inadequately Emphasize patients. After pandemic warning from the WHO, the Government of India granted diagnostic and treatment dexterity at several hospitals in all states of the country. This study has shown that about 67% of the study samples were bearing awareness of these kinds of facilities undergoing nearby their clinic. Our study has focused that only 19% of the study subjects were aware regarding undergoing vaccine trials for COVID-19. Our results are not in agreement with some other research done on health-care providers in Delhi by Rajoura et al. which quoted that 90% of subjects had proper knowledge. The reason for this low knowledge is that all vaccines are yet on a trial basis and till now not a single vaccine has been developed in the world. All the health-care workers should work with an objective to halt the spread of viral infection to other health-care providers as well as to the patients. The results of our study have quoted that around 71% of the subjects were aware of numerous preventive procedures used to prevent the spread of coronavirus. It has been observed from our research that postgraduates had more information and awareness regarding coronavirus as compared to graduates. Furthermore, there are very limited data or reports present showing the knowledge of coronavirus among dental health-care workers based on their degree of qualification. Similarly, a study conducted by Quadri et al. has shown that the knowledge score on COVID-19 was significantly related to their level of qualification, and dental specialists displayed the highest knowledge score, followed by dental auxiliaries and dental interns. Contrastingly, one published report investigating the overall infection control knowledge, attitude, and practices suggested that there was no statistically significant difference between the level of knowledge among the dental students and dental faculty in a university of Saudi Arabia. The reasoning behind this is that the knowledge rises with education status; also, the health-care workers who were engaged in combined practice had higher knowledge than those who were just engaged in private practice only. This may be due to the fact that subjects doing academic teaching were more exposed to learning procedures than doing private practice only. Furthermore, there was a statistically significant relationship of overall knowledge scores with education level (0.013) and working profile of the subjects (P = 0.016). Similar results were reported earlier by a study done by Singh et al.
| Conclusion|| |
The present survey highlights that the knowledge regarding coronavirus among oral health-care workers was fair. The present study features that there is a need for special training and workshops regarding the COVID-19 disease to halt the disease in initial stages only and also to prevent them from getting involved with COVID 19. Government should organize more and more health campaigns and educational programs regarding the transmission and prevention of COVID-19 disease. It is the responsibility of the primary care physician that various myths and misconceptions about this disease are cleared from the minds of the people.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Coronavirus disease 19 (COVID-19): Implications for clinical dental care. J Endod 2020;46:584-95.
Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci 2020;12:9.
Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res 2020;99:481-7.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al
. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
Checchi V, Bellini P, Bencivenni D, Consolo U. COVID-19 dentistry-related aspects: A literature overview. Int Dent J 2020;10.1111/idj.12601. doi: 10.1111/idj.12601.
Balaji SM. COVID-19-Future of dentistry. Indian J Dent Res 2020;31:167-8.
] [Full text]
Hasan F, Khan MO, Ali M. Swine flu: Knowledge, attitude, and practices survey of medical and dental students of Karachi. Cureus 2018;10:e2048.
Quadri MFA, Jafer MA, Alqahtani AS, Al Mutahar SA, Odabi NI, Daghriri AA, et al.
Novel corona virus disease (COVID-19) awareness among the dental interns, dental auxiliaries and dental specialists in Saudi Arabia: A nationwide study. J Infect Public Health 2020;13:856-64.
Kaipa S, Epari V, Gupta S. Knowledge and attitude towards swine influenza (2009) among dental practitioners in Nellore district of Andhra Pradesh, India. J Educ Ethics Dent 2011;1:52-8. [Full text]
Kochlamazashvili M, Kamkamidze G, McNutt LA, DeHovitz J, Chubinishvili O, Butsashvili M. Knowledge, attitudes and practice survey on blood-borne diseases among dental health care workers in Georgia. J Infect Dev Ctries 2018;12:864-70.
Palwankar P, Mehta V, Sheokand V, Palwankar D, Anand P. Knowledge, awareness, perception of H1N1 flu in urban dental fraternity. Res J Pharm Biol Chem Sci 2015;6:1566-72.
Rajoura OP, Roy R, Agarwal P, Kannan AT. A study of the swine flu (H1N1) epidemic among health care providers of a medical college hospital of Delhi. Indian J Community Med 2011;36:187-90.
] [Full text]
Alharbi G, Shono N, Alballaa L, Aloufi A. Knowledge, attitude and compliance of infection control guidelines among dental faculty members and students in KSU. BMC Oral Health 2019;19:7.
Singh I, Munjal S, Kumar M, Jha M, Gambhir RS, Talukdar B. H1N1 Influenza: Assessment of knowledge and awareness of private dental health professionals of a Tricity. J Family Med Prim Care 2019;8:2229-33.
] [Full text]
[Table 1], [Table 2], [Table 3]