|Year : 2020 | Volume
| Issue : 4 | Page : 99-103
Awareness and attitude toward COVID-19 among the students of a rural tertiary care center and dental college: A cross-sectional study
AR Adhershitha1, Prasanth Viswambharan2, Sheela Virginia Rodrigues3
1 Assistant Professor, Department of Prosthodontics, Government Dental College, Alappuzha, Kerala, India
2 Associate Professor, Department of Prosthodontics, Government Dental College, Alappuzha, Kerala, India
3 Professor, Department of Prosthodontics, Government Dental College, Alappuzha, Kerala, India
|Date of Submission||06-Nov-2020|
|Date of Acceptance||22-Nov-2020|
|Date of Web Publication||29-Dec-2020|
Dr. Prasanth Viswambharan
Department of Prosthodontics, Government Dental College, Alappuzha, Kerala
Source of Support: None, Conflict of Interest: None
Introduction: Awareness, attitude, and practice play a major role in containing any infectious disease. Coronavirus disease 2019 (COVID-19) has no definitive treatment or vaccines; hence, it is momentous to spread awareness regarding the prevention strategies. It is crucial for the government and concerned authorities to understand the students' perception and attitude in the time of the current pandemic.
Aim: The aim of this study is to assess the level of awareness among the students of Government Dental College Alappuzha, a rural tertiary care center and Dental College in Kerala, India, regarding COVID-19 and their attitude toward the pandemic.
Methodology: Questionnaire which included 21 items was used for the research. Observed data were coded, tabulated, and analyzed using IBM SPSS Statistics for Windows (Version 20.0. Armonk, NY, USA: IBM Corp.). The total awareness score calculated was 20. Comparison between gender (males/females) and study groups (preclinical students/clinical students) was made using the Chi-square test. Comparison of total awareness scores between study groups was made using independent t-test.
Results: Most of the study participants across study groups regularly kept track of the latest news on COVID-19 and perceived it to be of moderate or very dangerous risk though they were quite optimistic of its control. About 96% of males and 82% of females felt it is necessary to get mental health help if one panics in lieu of the pandemic situation. The mean total awareness score (out of 20) was 15.16 ± 1.81. There was no significant difference in total awareness score based on gender (15.23 ± 2.24 for males and 15.15 ± 1.71 for females) and also among the category of students (14.88 ± 1.94 for preclinical students and 15.35 ± 1.69 among clinical students).
Conclusions: Attempts should be made for increasing the awareness regarding the preferred method of hand hygiene, protocol for performing aerosol-generating procedures, and airborne infection isolation room.
Keywords: Attitude, awareness, coronavirus disease 2019
|How to cite this article:|
Adhershitha A R, Viswambharan P, Rodrigues SV. Awareness and attitude toward COVID-19 among the students of a rural tertiary care center and dental college: A cross-sectional study. Int J Prev Clin Dent Res 2020;7:99-103
|How to cite this URL:|
Adhershitha A R, Viswambharan P, Rodrigues SV. Awareness and attitude toward COVID-19 among the students of a rural tertiary care center and dental college: A cross-sectional study. Int J Prev Clin Dent Res [serial online] 2020 [cited 2022 Aug 17];7:99-103. Available from: https://www.ijpcdr.org/text.asp?2020/7/4/99/305292
| Introduction|| |
Globally, as of September 20, 2020, >30.6 million confirmed cases, including 9.5 lakh deaths of coronavirus disease (COVID-19) were reported to the WHO. In December 2019, COVID-19 emerged as a series of pneumonia-like cases in Wuhan, Hubei, China, with clinical presentations considerably simulating viral pneumonia.,, Deep sequencing analysis from lower respiratory tract samples of affected patients indicated a novel coronavirus, which was named 2019 novel coronavirus and later renamed as severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) by the International Committee on Taxonomy of Viruses.,,
The mode of transmission of SARS-COV-2 is through inhalation of respiratory droplets from infected individuals. As there is no definite curative treatment or vaccine that has been found effective for COVID-19 preventive practices including regular hand washing, social distancing, and respiratory etiquette, become momentous for controlling this rapidly growing global health challenge. Hence, awareness regarding the mode of spread, clinical manifestations, and prevention strategies are of great importance even for the general population. Lack of knowledge regarding the disease among medical professionals who are at the front line can result in delayed diagnosis and treatment, leading to the rapid spread of infection among them and within the community.
India's COVID-19 burden continues to scale new peaks every day. Country's first positive case of COVID-19 was reported in Kerala, the state with a population density as high as 859/km2. Kerala's model of controlling epidemic was appreciated worldwide and by the WHO. “Break the Chain” was an awareness campaign successfully implemented in Kerala in advertising the vital role of hand hygiene, social distancing, and cough etiquette in controlling this pandemic. The high literacy rate in the state and the strong health system built over the years helped to contain the gravity of the situation immensely.
The dental practice is a potential source of cross-contamination in the absence of adequate preventive measures. Being highly contagious and with the airborne mode of transmission, COVID-19 is of great risk to dental professionals. Dental students and professionals should be competent with knowledge and understanding regarding this evolving pandemic, and moreover, it is momentous for them to be updated with the preventive measures and practices that have to be adapted to identify a potential COVID-19 infection and refer patients with suspected, confirmed, or a history of COVID-19 infection to appropriate treatment centers. It is incontestable that awareness, attitude, and practice play a major role in containing any infectious disease and it has been a subject of inquiry during several previous epidemics such as swine influenza, Middle East Respiratory Syndrome and Dengue fever. Improved awareness and positive attitude toward these calamities have proved to restrain the spread of infection in a greater extend.
Across the globe, a few researchers have probed the awareness and attitude of medical students, medical professionals, and the general population since the onset of the COVID-19 outbreak.,, It is crucial for the government and concerned authorities to understand the students' perception and attitude in the time of the current pandemic. This study was intended to investigate students' attitude, awareness, and knowledge toward COVID-19.
| Methodology|| |
The study was conducted among the enrolled students of Government Dental College, Alappuzha, a rural tertiary care center and Dental College in the state of Kerala. The questionnaire to evaluate the awareness and attitude of students towards COVID-19 was designed in accordance with previously published literatures.,, The questionnaire which was distributed online using Google Forms, consisted of two main sections; the first section focused on background information such as gender and year of study of the participants. While the second section inquired about the participants' level of awareness (13 items) and attitude (8 items). The survey featured multiple-choice questions that were capable of assessing the attitude of the participants toward the pandemic and the knowledge regarding the modes of transmission, clinical manifestations, the prevention strategies, and management of suspected or confirmed cases of COVID-19. Attitude and awareness among male and female students were compared. Similar comparisons were made between preclinical and clinical students. Observed data were coded, tabulated, and analyzed using IBM SPSS Statistics for Windows (Version 20.0. Armonk, NY: IBM Corp.). Descriptive data were reported as frequency and percentages for categorical variables. Responses of COVID-19 awareness questions were further classified as Correct response (score: 2), partially correct response (score: 1) and incorrect response (score: 0) as applicable. The total awareness score calculated was 20. Comparison between gender (males/females) and study groups (preclinical students/clinical students) with COVID-19 awareness and attitude questions were made using the Chi-square test. Comparison of total awareness scores between study groups was made using independent t-test. A value of P < 0.05 was considered statistically significant.
| Results|| |
A total of 228 students participated in the study. Two responses contained missing information and were excluded, and the final sample size was 226. Females constituted about 82.3% of the sample (n = 186). Clinical students comprised 58.8% of the participants, while the rest were undergoing their preclinical dental training (1st and 2nd years of BDS course).
[Figure 1] and [Figure 2] illustrate the responses for questions related to attitude toward COVID-19. Most of the study participants across study groups regularly kept track of the latest news on COVID-19 and perceived it to be of moderate or very dangerous risk though they were quite optimistic of its control. No statistically significant difference between the groups was noted.
[Table 1] describes the awareness among study participants regarding COVID-19. The mean total awareness score (out of 20) was 15.16 ± 1.81. There was no significant difference in total awareness score based on gender (15.23 ± 2.24 for males and 15.15 ± 1.71 for females) and also among the category of students (14.88 ± 1.94 for preclinical students and 15.35 ± 1.69 among clinical students).
| Discussion|| |
This descriptive cross-sectional study revealed the positive attitude of students toward the dreaded pandemic. Majority of students agreed with the accepted practices for control of COVID-19 such as social distancing, ban on traveling and they were willing to quarantine themselves in case of suspicion of illness. Majority of students perceive COVID-19 as moderate to very dangerous and are cautiously optimistic of its control. This was in accordance with a previous study conducted in China. Regarding the effectiveness of nationwide-lockdown, there was a conflict of interest among students. About 67.5% of the study population think the nationwide lockdown reduced the spread of COVID-19 in India; the rest were either not sure about the matter or completely denied its effect on controlling the pandemic. This study revealed a statistically significant difference among the genders regarding the necessity of mental health help in case of panic arise due to the pandemic situation. About 96% of females felt it is necessary to get mental health help, whereas only 82% of males admitted that it is necessary.
The level of awareness regarding COVID-19 was similar irrespective of gender or categories of students. It is surprising that even preclinical students scored similar to clinical students, which implies the greater awareness levels of the general population by means of media and public awareness programs. Only about 30% or less of participants across study groups identified correctly the different names of virus causing COVID-19 infection. Almost 98% of participants were aware that Wuhan city reported the first cases of COVID-19. More than 80% of the participants identified correctly the mode of virus transmission. Similarly, around 85% of the participants identified correctly all the symptoms of COVID-19. Recommendations for isolation of a patient with confirmed COVID-19 and those under investigation for COVID-19 was known to <75% of participants across the study groups. 93.5% of the study population were aware that clinical management of COVID-19 includes prompt implementation of recommended infection prevention and control measures and supportive management of complications. No specific treatment for COVID-19 is currently available. No statistically significant difference was noted between gender for any of the questions on awareness. However, a significant difference was observed between preclinical and clinical students with respect to the correct identification of preferred method of hand-hygiene (P < 0.001), current clinical management of COVID-19 (P < 0.001) and recommendation on aerosol procedures (P = 0.001). Clinical students fared better in hand hygiene awareness and clinical management, while preclinical students reported more correct responses with regard to aerosol procedure recommendations. Airborne infection isolation room (AIIR) should be used for Patient isolation and performing aerosol-generating procedures. These are rooms without exhaust and are kept under negative pressure. A high-efficiency particulate air filter is used to filter Air from these rooms. Only (48.7%) of the respondents recorded a correct response regarding this question, which points fingers toward the need of awareness in this regard.
| Conclusions|| |
With the evolving knowledge regarding this novel disease, we hope this descriptive study will provide a reference for the conduct of more extensive investigations not only among students but also for the general population. Recommendations could be given to increase awareness regarding the preferred method of hand hygiene, protocol for performing aerosol-generating procedures and AIIR. Mental health help programs may be initiated and made available for all those who need it. Preclinical students need to be trained well in proper hand hygiene practices and clinical management, including infection prevention, infection control, and treatment of complications before they start routine clinical posting.
We would like to acknowledge the authors of the articles cited as 18, 19 and 20 in the references for publishing the questionnaire from which we partially adopted questions used for this research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al
. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382:1199-207.
Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020;92:401-2.
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www. ncbi.nlm.nih.gov/books/NBK554776/
. [Last accessed on 2020 Oct 04].
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al
. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.
Sahin AR. 2019 novel coronavirus (COVID-19) outbreak: A review of the current literature. Eurasian J Med Oncol 2020;41:1-7.
Olum R, Chekwech G, Wekha G, Nassozi DR, Bongomin F. Coronavirus disease-2019: Knowledge, attitude, and practices of health care workers at Makerere University Teaching Hospitals, Uganda. Front Public Health 2020;8:181.
Praveen Kumar B, Kumar SY, Ugargol A, Naik V, Mallapur M, Shilpa K. Study on awareness regarding swine flu (influenza A H1N1) pandemic in an urban community of Karnataka. Med J Dr DY Patil Univ 2014;7:732.
Alkot M, Albouq M, Shakuri M, Subahi M. Knowledge, attitude, and practice toward MERS-CoV among primary health-care workers in Makkah Al-Mukarramah: An intervention study. Int J Med Sci Public Heal 2016;5:952.
Hairi F, Ong CH, Suhaimi A, Tsung TW, bin Anis Ahmad MA, Sundaraj C, et al
. A knowledge, attitude and practices (KAP) study on dengue among selected rural communities in the Kuala Kangsar district. Asia Pac J Public Health 2003;15:37-43.
Alahdal H, Basingab F, Alotaibi R. An analytical study on the awareness, attitude and practice during the COVID-19 pandemic in Riyadh, Saudi Arabia. J Infect Public Health 2020;13:1446-52.
Fernandes G. Corona virus (COVID-19) awareness assessment – A survey study amongst the Indian population. Clin Med Res 2020;1-10. 10.37191/Mapsci-2582-4333-2(3)-042.
Gao Z, Ying S, Liu J, Zhang H, Li J, Ma C. A cross-sectional study: Comparing the attitude and knowledge of medical and non-medical students toward 2019 novel coronavirus. J Infect Public Health 2020;13:1419-23.
Modi PD, Nair G, Uppe A, Modi J, Tuppekar B, Gharpure AS, et al
. COVID-19 awareness among healthcare students and professionals in mumbai metropolitan region: A questionnaire-based survey. Cureus 2020;12:e7514.
Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatr 2020;51:102083.
[Figure 1], [Figure 2]