ISSN: 2456-8090 (online)

DOI: 10.26440/IHRJ/0502.05414

 

Knowledge, Attitude and Practice towards COVID-19 among Dental Practitioners in Bhutan

PRATAP SINGH TAMANG1, GYAN PRASAD BAJGAI1, DORJI PHURPA1, SONAM NGEDUP1, HARI PRASAD POKHREL*2

 

Cite this article as: Tamang PS, Bajgai GP, Phurpa D, Ngedup S, Pokhrel HP.  Knowledge, Attitude and Practice towards COVID-19 among Dental Practitioners in Bhutan. Int Healthc Res J. 2021;5(2)OR1-OR6. https://doi.org/10.26440/IHRJ/0502.05414

 

Author Affiliations:

  1. Jigme Dorji Wangchuck National Referral Hospital, Thimphu Bhutan.
  2. Gidakom Hospital, Ministry of Health, Thimphu Bhutan (https://orcid.org/0000-0003-4421-7378).

Contact Corresponding Author at: hari88pokhrel [at]gmail[dot]com

 

ABSTRACT

INTRODUCTION: Corona virus disease was first reported in Wuhan city of China in 2019. The disease is caused by a highly infectious virus which can be transmitted from human to human through physical contact, droplets, or touching surfaces contaminated with the virus.

AIM: The study aims to get an assessment of knowledge, attitude and practices towards COVID-19 disease among the dental practitioners in Bhutan.

MATERIAL AND METHODS: An online cross- sectional study was conducted among dental practitioners working in different hospitals across the country. All dental professionals who provided their email address were included in the study. Data were collecting using a structured questionnaire shared though email. A total of 157 dental professionals were invited through e-mail to participate in the study.

RESULTS: A total of 125 dental professionals participated in the study (response rate 79.6%). Over half of the participants (51.2%) were between the age group 20-30 years. Despite almost everyone (98.4%) knowing the causative agent and management of COVID-19 positive patients, only around a half of the participants (48%) had a good level of knowledge on COVID-19.

CONCLUSION: The study found that less than half of the participants have a good level of knowledge on COVID-19 while a majority of them feel that there is discrimination against COVID-19 positive patients and health professionals working for COVID-19 patients. The study highlights the need to conduct sensitization, trainings or CME on COVID-19 periodically to keep all health professionals updated with latest advancements to help maintain safety in clinical practice.

 

KEYWORDS: Bhutan, COVID-19, Dental practitioners, Knowledge, Practice

  

INTRODUCTION

Corona virus disease was first reported in Wuhan city of China in 2019.1 The virus came into limelight when atypical cases of patients suffering from pneumonia like illness was reported in Wuhan.2 One such patient who suffered pneumonia was admitted to one of the hospitals who was later confirmed to be affected by corona virus, specifically β-coronavirus 2019-nCov.3,4  The virus was identified and named as SARS-Cov-2 on 11th February 2020 and the disease as Corona Virus Disease (COVID-19) by the World Health Organization (WHO).3 A month later, on 11th March 2020 it was declared as a pandemic by WHO.5 

The most common symptoms of the disease are high fever, dry cough, sneezing, fatigue, loss of smell, difficulty in breathing, body aches and chest pain among others. The virus can be transmitted to humans from animals where it mutates and can be transmitted from humans to humans through physical contact, droplets, or touching surfaces contaminated with the virus.6,7 Its transmission is rapid and these modes have been established.6 Droplets can travel up to 6 feet and the virus remains active and contagious, suspended in the air for up to 4 hours.7 These droplets can settle on the surfaces which in turn can infect people who handle them. A person gets infected if they touch the surfaces contaminated by the virus and then touch eyes, nose, mouth or any other mucous membranes.7 Therefore, washing hands frequently with soap and water or alcohol based hand rubs have been recommended to prevent infection by health experts including the WHO.8 

In Bhutan first positive case of COVID-19 was detected on 5th March, 2020. The country experienced two national lockdowns; first lockdown from 11th August 2020 which lasted for 21 days and second lockdown from 20th December 2020 till 31st January 2021 for 43 days in a stretch due to sporadic community transmission. The lockdowns helped curb the community transmission which was controlled very effectively.  As of 1st March, 2021 the country recorded a total of 867 confirmed cases with 865 being declared recovered and one death taking the recovery rate to 99.8%.9 

It is important for health professionals to keep themselves abreast with the latest updates on COVID-19 in order to prevent and contain the disease. Assessment of knowledge, attitude and practices (KAP) on COVID-19 among dental practitioners is important due  to   nature  of   work   and   close   proximity  of the working environment. Therefore, such studies are being conducted to obtain accurate information about what is known, believed or practiced in a population or community to prevent and fight the disease.10-12 It is important to get accurate and timely information about this infectious disease so that people do not panic during the pandemic and are well prepared to overcome it. Sharing confusing or wrong information during pandemic can lead to unnecessary panic and distress.12 Therefore, KAP is crucial for the understanding of peoples’ level of knowledge and attitudes and practices towards COVID-19.13 This study aims to describe knowledge, attitude and practices regarding COVID-19 among the dental practitioners in Bhutan. 

MATERIAL AND METHOD

A cross-sectional online survey was conducted in February 2021 among dental practitioners working in different hospitals across the country to assess the knowledge, attitude and practices on COVID-19. Data were collecting using a structured questionnaire shared though email. There were a total of 191 dental practitioners in the country during the conduct of this study. Dental professionals not willing to share their email address and those without email address were excluded from the study. A total of 157 (82.2%) dental professionals working across the country provided their email address and were invited through e-mail to participate in the study. Informed consent form was included at the beginning of the online survey and those responding to questionnaire were assumed to have consented for the study. Data management was done using Microsoft Excel and analyzed using SPSS. The findings are presented as frequency and percent. Mean and standard deviations also have been presented wherever applicable. Knowledge is categorized as ‘good’, ‘moderate’ and ‘poor’ depending on the total score of the participant using Benjamin Bloom criteria. Ethical clearance was granted by the Research Ethics Board of Health (REBH), Ministry of Health, Bhutan (Approval No. REBH/Approval/2020/x06). 

RESULTS

A total of 125 dental professionals participated in the study (response rate 79.6%). Over half of the participants (51.2%) were between the age group 20-30 years. Around a half of the participants (49.6%) did not attend sensitization meeting/ CME on COVID-19 and over a half (52.8%) of them reported that COVID-19 financially affected them. Only around one-fifth (22.4%) of the participants followed Ministry of Health/Prime Minister’s Office for updates on COVID-19 (table 1). 

Correct responses to knowledge questions have been presented in table 2. Almost everyone (98.4%) the causative agent of COVID-19 and management of COVID-19 positive patients. However, only around one fourth  (26.4%)   had     an   idea   about    the    clinical symptoms and around one-third (35.2%) were aware of the life span of virus outside the body. Around 10% of the participants had a poor level of knowledge and less than a half of them (48%) had a good level of knowledge on COVID-19 (table3). 

Alternate link to tables/figures (copy/paste link in a new browser window): https://drive.google.com/file/d/1HbyrEwbMbPlAIeQOYL2D80yhPbpBYnbX/view?usp=sharing

Attitude of participants towards COVID-19 is presented in table 4. A majority of the participants (89.6%) reported that they are scared of human to human transmission of COVID-19 and discrimination against COVID-19 positive patients and health professionals working for COVID-19 patients (86.4%). All the participants agreed that avoiding crowded places would help to prevent COVID-19 infection. However less than half (48%) reported that COVID-19 will be successfully controlled in dental clinic or laboratory. 

Practices of dental professionals to prevent COVID-19 is presented in table 5. Almost everyone (97.6%) followed cough etiquettes and a majority (92.8%) of the participants’ practices hand hygiene. However, only around two-third (69.6%) of dental professionals used PPE during dental procedures and only around 60% of the participants disseminated information on COVID-19 prevention to patients visiting them.

Alternate link to tables/figures (copy/paste link in a new browser window): https://drive.google.com/file/d/1H0UplIn3tRZwVr1PlAE51pLWQHRA7P4j/view?usp=sharing

DISCUSSION

The study found that less than half of the participants had a good level of knowledge on COVID-19 disease. This corresponds to findings reported by studies conducted in other countries which have reported that dental professionals had insufficient knowledge on COVID-19 disease and disinfection processes.14,15 Contrary to this, a global study among dental professionals found that dentists had a good level knowledge to deal with COVID-19 disease.16  This study found that a majority of the dental professionals feel that there is discrimination against COVID-19 positive patients and health professionals working for COVID-19 patients. The working distance for dental personnel is very less with long contact duration which puts them at a higher risk of contracting COVID-19.11 Similar findings were reported among medical and dental professionals in Nepal.17 The COVID-19 pandemic has shown drastic effects on individuals’ social lives, since all sorts of gatherings, social events and even usual hospital cares are closed to reduce the transmission. It has also affected people financially and psychologically. Various preventive measures are put in place including occasional lockdowns to disrupt the transmission chains.18 

Although the dental professionals had intentions to practice appropriately, some did not have adequate knowledge to implement in practice against COVID 19 disease which was similar to the study by Acharya et al. where  80%  of   the   participants   did  not   have  good knowledge.17 Our study found that around 10% of participants had a poor level of knowledge on COVID-19.  This   is   in  consistence to the findings reported by many other studies on COVID-19.14,15,17 This could be because many participants did not attend the training on COVID-19 disease and/or do not follow media and other COVID-19 related developments. Thus, there is a need to implement activities such as online classes, workshops and trainings to upgrade their knowledge. 

Latest guidelines and protocols of Ministry of Health should be made available to all health professionals to stay safe and protect others from becoming infected (14, 18). Not being able to include dental professionals without email address and non-response rate of around 20% were limitations of the study. 

CONCLUSION

The study found that less than half of the participants had a good level of knowledge on COVID-19 while the majority of the participants felt there is discrimination against COVID-19 positive patients and health professionals working for COVID-19 patients. Only around two-third (69.6%) of the participants used PPE during dental procedures and 60% of the participants disseminated information on COVID-19 prevention to patients visiting them. The study highlights the need to conduct sensitization, trainings or CME on COVID-19 periodically to keep all health professionals updated with latest advancements and maintain safety in clinical practice. 

Acknowledgement: The authors extend their appreciation to all the participants who have contributed their valuable time to make this study successful.

 

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©  Pratap Singh Tamang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY-NC 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the use is not commercial and the original author(s) and source are cited.