a questionnaire-based survey on covid-19 knowledge

www.wjpps.com Vol 9, Issue 12, 2020. ISO 9001:2015 Certified Journal
1016
Ganapathy et al. World Journal of Pharmacy and Pharmaceutical Sciences
A QUESTIONNAIRE-BASED SURVEY ON COVID-19 KNOWLEDGE
& AWARENESS AMONG ALLIED HEALTH SCIENCES (AHS)
STUDENTS IN CHENNAI
1 and Deepa Rajendiran
M.G.R. Educational and Research Institute, Maduravoyal, Chennai, Tamilnadu.
1 Lecturer, Department of Pharmacology, Meenakshi Ammal Dental College & Hospital,
Maduravoyal, Chennai, Tamilnadu.
Kundrathur, Chennai, Tamilnadu.
ABSTRACT
Aim: This study aims to assess the knowledge and awareness of
COVID-19 among Allied Health Science (AHS) students in Chennai.
Materials and Methods: A total of 510 responders from various
college students in Chennai completed a questionnaire-based survey on
the awareness and knowledge, related to COVID-19. Descriptive
statistics were performed for all groups based on the percentage of
correct responses. The overall awareness for all the groups was
sufficient with 80% and the highest percentages of correct responses
were from I and II years students. 70.2% were highly informative
about plasma therapy but only 36% were aware of BNT162.
Conclusion: Students were aware of the SARS-CoV-2 and still, there
is a need for regular educational interventions and training programs
on the infection.
INTRODUCTION
Coronavirus diseases 2019 (Covid-19) is an emerging pandemic disease which is caused by a
novel coronavirus. Coronavirus is a large family of viruses that belongs to the β-virus
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES
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Volume 9, Issue 12, 1016-1028 Review Article ISSN 2278 – 4357
*Corresponding Author
DOI: 10.20959/wjpps202012-17930
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family. [1]
The word “corona” means “crown-like spikes” which is seen on the outer surface of
the virus structure. [2]
The novel coronavirus is a new strain which is previously called 2019-
nCov, later the name was changed into SARS-CoV 2 by the International Committee of
Virus. [3]
It is one of the largest RNA viruses which causes severe respiratory syndrome and
its genome size is approximately 26-32 kilo base. [4]
Previously Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) has been reported
in China in 2002. [5]
H1N1 Influenza disease turned out to be a pandemic reported first in
Mexico in 2009 [6]
and the Middle East Respiratory Syndrome coronavirus (MERS-CoV) was
emerged first in Saudi Arabia in 2012. The emerging of viruses over the last several decades
of challenges to public health. [7]
Recently Covid-19 disease reported in 2019 in Wuhan city
of Central Hubei Province of China. WHO (World Health Organization) declared the
coronavirus outbreak 2019-2020 as a public health emergency of international concern
(PHEIC) on 30 January 2020 and a pandemic on 11 March 2020. The WHO has currently
also prepared guidelines to fight Coronavirus by introducing eight pillars of support. [8]
1) Country level coordination, planning and monitoring
2) Risk communication and community engagement
3) Surveillance, rapid response teams and case investigations
4) Points of entry
7) Case management
8) Operational support and logistics
As the pandemic disease is exponentially increasing day by day, the information related to
the virus gets rolling updated with enhanced uncertainty and invariably. The mode of
transmission is through human to human contact via droplets by talking, coughing, and
sneezing from the infected person, contaminated fomites. This virus can survive on surfaces
for about 72 hours. From the time of exposure to onset, the symptoms show between 2-14
days, with an average of 5 days. [8]
This disease causes severe acute respiratory syndrome
(SARS CoV-2), which presents with symptoms like fever, headache, chills, dry cough,
respiratory distress, muscle pain, bone or joint pain, sputum production, sore throat, diarrhea,
abdominal pain, loss of smell or taste, and in severe conditions leading to viral pneumonia
and multi-organ failure. [9, 10,11]
This virus affects the lungs majorly as it attacks the host cells
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via the enzyme ACE2, which is most abundant in type 2 alveolar cells of the lungs. This virus
has a surface glycoprotein called a "SPIKE" which connects to ACE2 and enters the host
cells. This virus abundantly also affects the gastrointestinal organs as ACE2 is also expressed
in cells of the gastric, duodenal and rectal epithelium and small intestine. The standard
diagnostic test for detecting the virus is a real-time reverse transcription-polymerase chain
reaction (rRT-PCR) from a nasopharyngeal swab. [12]
The other diagnostic methods can also
be through chest X-rays by looking for pneumonia-like features. Elderly peoples, immune-
compromised individuals, and those with underlying diseases like cardiovascular disorder,
diabetes, and cancer are at high risk of contracting coronavirus. There is currently no vaccine
available for this virus but some of the drugs such as hydroxychloroquine, remdisivir, help to
get cure from the disease. Dexamethasone, a corticosteroid used for the reduction of the
mortality rate of the patient. Other supportive measures such as isolation, social distancing,
and wearing mask can protect from COVID 19.
Faculty of Allied Health Sciences (AHS) is one of the important emerging and supporting the
health care profession with many specializations. In recent years, they are identified as
“Health associate professionals” because of diverse growth and support. It includes
professions such as anesthesia technology, perfusion technology, cardiac pulmonary
technology, physician assistant, medical lab technology, radiology, renal dialysis technology,
operation theatre technology, and optometry, and so on. This study was focused mainly to
assess the knowledge of AHS students. As Allied health sciences, students are also the future
helping and supporting pillars of the medical society technically, its mandatory to create
more knowledge and awareness among them so that they get the expertise to prevent disease
transmission, diagnose, treat and rehabilitate people of all ages and all specialties. Together
with a range of technical and support staff, they may deliver direct patient care, rehabilitation,
treatment, diagnostics, and health improvement interventions to restore and maintain optimal
physical, sensory, psychological, cognitive, and social functions. [13]
OBJECTIVES
-To assess the knowledge of recent pandemic disease COVID 19.
-To educate and create awareness about the disease to the AHS students.
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METHODOLOGY
Study Participants: The target population selected was full-time undergraduate Allied
Health Sciences (AHS) students in Chennai. Around 15 colleges were offering this course;
both preclinical and clinical Students of all the specialties in Chennai were included in the
study.
Data collection: A questionnaire-based survey was conducted during the second week of
June 2020 through online mode (Table 1). The permission was obtained from the Institutional
Ethics committee. An online data collection tool was designed and executed using Google
Forms (via docs.google.com/forms). [14]
The questionnaire having both open & close-ended
questions were pre-designed and pre-validated by professionals in the field. Due to pandemic
lockdown, WhatsApp Messenger (Facebook, Inc., California, USA) was chosen to circulate
the questionnaire among students. Different specialties of the allied health sciences students
from all over the Chennai were assessed using Google forms. It contains socio-demographic
details such as name, age, gender, year and specialty of the study, informed consent in one
part, and next section contains twenty questions to check the awareness and knowledge of the
students on coronavirus. The questions were focused on the basics of coronavirus such as
mode of transmission, risk factors, quarantine period, drug, and possible complications. In
informed consent, it is mentioned that the students identity not revealed and kept
confidential. They were asked to click the appropriate option. Completed data collected,
entered in excel sheet and the results were analyzed with the proper statistical method.
Table 1: Survey Questionnaire.
MERS-CoV
SARS-CoV-2
SARS-CoV
NIPAH
Thorn Projections
EXCEPT
4. Corona virus transmits primarily through Aerosols
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Fomites
Mosquito-bite
……. China, Dec 31 2019
Japan, Dec 29 th
6 Spread of the corona virus can be prevented
by
Maintain social distancing.
Frequent hand wash
within a community
area, or environment
affecting an exceptionally high
proportion of the population
None of the above
ICMR
WHO
USFDA
CDC
20, called as...
corona virus EXCEPT …
heart diseases
11. One of the following acts as a shell for virus,
consisting of promoters and genetic material
Envelope
Membrane
Lipids
Capsid
Hydroxychloroquine &
chloroquine
Remdesivir
Acyclovir
COVID 19
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14-Days
10-Days
15 As soon as, corona virus enters in to the lungs
it adheres to
recommended peoples to take
D and zinc
Pfizer , an US pharma jointly developed a
vaccine which is at a clinical trial phase
BNT162
PICOVACC
BNT132
transfused from recovered corona virus
patient to a COVID 19 patient who is in
critical condition
Plasma therapy
Antigen therapy
A survey on COVID 19 awareness was conducted among the Allied Health Science students
of I, II, III year, and intern students in Chennai. Around 500 students from various colleges
responded to the survey, in which 72% of female members were actively showed their
participation than the male members.
Among the four years, 80% of the responders were a first-year and second year. Almost
76.7% of the students were aware of the causative organism as SARS-CoV-2 and 84.3% of
them were able to define the term „corona as crown-like spikes.
The main mode of transmission by aerosols and fomites was identified by 77.3% of students
and they were able to recognize the symptoms of infection. 97.4% responders were correct
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that the infection was reported in china 31st 2019 later on COVID 19 was officially named by
WHO, the students were highly informative about the spread of disease.
Only 46.5% of the students were aware of community spread. 65.2% of the responders were
able to identify the deadly influenza pandemic outbreak in 1919-1920 as Spanish flu. More
than 67.4% of the students were aware that young adults are less prone to the infection rather
than older groups with medical complaints like diabetes, heart disease, and weakened
immune system.
Only 44.9% of the total responders were able to recognize that the capsid acts as a shell for
the virus. Still, now there is no specific treatment for this viral infection that made only
39.2% of the responders to give out the correct response in an emergency, at present
Remdesivir, hydroxychloroquine and chloroquine are preferred.
Figure 1: Response showing the knowledge on emergency drug treatment for COVID
19.
76.1% of the students were able to give the correct response that RT-PCR is the method used to
diagnose Covid-19 infection and almost 86.1% were aware of the quarantine period is 14 days.
Around 78.1% of the responders were clear about the meaning for PPE as personal protective
equipment but only 36.4% of the responders were able to identify that the N95 mask is preferred
as a surgical mask, particulate respirator, and self-contained breathing apparatus. 36% responders
were aware of the infection about its mechanism were the organism adheres to ACE2 in the lungs
when it enters.
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Figure 2: Response showing the knowledge on pathological conditions of COVID 19.
Figure 3: Response showing the awareness regarding protective measure for COVID 19.
Most of the students were aware to take health supplements like Vitamin-C, D, and zinc as
recommended by health authorities. 70.4% is highly informative about plasma therapy but only
38.8% were known about BNT 162.
Figure 4: Response showing the knowledge on vaccine and drug development for
COVID 19.
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Figure 5: Response showing the knowledge on plasma therapy.
DISCUSSION
There was a sudden outbreak at the beginning of Dec 2019 in Wuhan City, due to an
infection with the severe acute respiratory syndrome; many patients were admitted to
hospitals with an initial diagnosis of pneumonia of an unknown etiology, later on, identified
as Coronavirus 2(SARS-CoV-2). World Health Organization (WHO) raised its pandemic
alert on March 11, 2020. [15]
It is an emerging communicable disease; even the experts have
inadequate knowledge about the virus in terms of its source, precise duration of incubation,
severity, and what makes it quite easily transmissible. Many researchers are finding a way to
get rid of this SARS-CoV2 by sharing the entire genome of the organism.
A questionnaire-based study was carried out among the students of the Faculty of Allied
Health Sciences in Chennai, an upcoming course in India with Health care professionals in
various specialties. The questionnaire was divided into three categories with basic
knowledge, structure, pathological role, and treatment of Covid-19. All most 89%
respondents were able to identify the causative organism as SARS-CoV-2, which includes the
symptoms of fever, cough, and shortness of breath, in milder cases it resembles like common
flu or a bad cold. Every day the infection rate increases, older people are at higher risk and
patients with comorbidities are likely to be affected at the earliest.
The students were also aware of its family as Coronaviridae, including the four genera within
the subfamily Orthocoronavirinae, namely Alphacoronavirus (α-CoV), Betacoronavirus (β-
CoV), Gammacoronavirus (γ -CoV) and Deltacoronavirus (δ-CoV), SARS-CoV-2 virus
belongs to the B lineage of the β-CoVs. (18). Most of them were able to recognize its
structure, the important structural proteins consist of the spike (S) surface glycoprotein, the
membrane (M) protein, the envelope (E) protein, and the nucleocapsid (N) protein, which is
essential for SARS-CoV-2 assembly and infection. Around 80% of the participants were able
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to know the causes of different infection sites are likely related to the presence of dipeptidyl
peptidase 4 (DPP4) and angiotensin-converting enzyme 2 (ACE2) in the lower respiratory
tract, which is the major human receptors for the surface spike (S) glycoprotein of MERS-
CoV and SARS-CoV-2, respectively. SARS-CoV-2 spike binds to human ACE2 with
approximately 10– 20-fold higher affinity than the SARS-CoV spike, making it easier to
spread from human to human. [16]
Awareness among students towards the use of personal protective equipment (PPE) for
suspected/confirmed Covid-19 patients was high in all years of Allied health science
students. An N95 respirator is a respiratory protective device designed to achieve a very close
facial fit and very efficient filtration of airborne particles. Surgical N95 Respirators are
commonly used in healthcare settings and are a subset of N95 Filtering Facepiece Respirators
(FFRs), often referred to as N95s. [17]
Students were aware of Covid-19 symptoms and the mean incubation period of SARS-CoV-
2, which was estimated to be 5.2 days. The period from the onset of Covid-19 symptoms to
death ranged from 6 to 14 days with a median of 14 days. It has also been reported that
asymptomatic COVID-19 patients during their incubation periods can effectively transmit the
infection, WHO recommends for 14 days. It has been identified that the SARS-CoV-2 can be
transmitted between humans via respiratory droplets apart from that close contact is also a
source of transmission, there is also a possibility of aerosol transmission in a relatively closed
environment with continuous exposure to high concentrations of aerosol. Moreover, it has
been noted in most of the infected patients with some gastrointestinal symptoms, including
diarrhea, nausea and vomiting have been reported. [18]
In this situation, it is essential to control the outbreak of COVID-19 by using any assay
method to know the accuracy of its detection. Students of III rd
yr and interns showed a higher
response towards the awareness in the detection and treatment of Covid-19 than I st and II
yr .
The major method in laboratory diagnosis would be nucleic acid detection particularly
reverse transcription-quantitative PCR (RT-qPCR) is a molecular biological diagnosis
technology based on nucleic acid sequences. The genome sequences available in GenBank
for SARS-CoV-2 helps to detect the nucleic acid by RT-qPCR or by viral gene sequencing of
nasopharyngeal and oropharyngeal swabs, stool, sputum or blood samples. [19]
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So far we dont have a specific treatment for Covid-19, but still, certain drugs are under trial
and show to be beneficial. The first case of SARS-CoV-2 infection in the USA was treated
with intravenous remdesivir when the patients condition deteriorated. The nucleoside analog
remdesivir (GS-5734) was reported to inhibit SARS-CoV-2 and MERS-CoV in vivo.
Chloroquine is a widely used antimalarial, antiamoebic, and autoimmune disease drug. Wang
et al. found that chloroquine effectively suppresses the recently emerged novel CoV (SARS-
CoV-2) in vitro.
Antiviral antibodies (IgG, IgA, IgM, IgE, and IgD) found in convalescent plasma from
recovered patients can effectively treat patients with viral infections. Convalescent plasma
therapy has been widely used in infectious diseases such as poliomyelitis, influenza A
(H5N1), and Ebola. [20]
Convalescent plasma therapy would be a promising option for the
treatment and prevention of SARS-CoV-2 infection in the future. BNT 162 is the vaccine
developed by Biopharmaceutical New Technologies to prevent the SARS-CoV-2 from
causing COVID-19 disease in humans. [21]
CONCLUSION
The new SARS-CoV-2pandemic is an ongoing crisis that is causing global uncertainty on an
unparalleled scale. Till now there is no specific anti-SARS-CoV-2 drug or treatment is available
for COVID-19. In severe cases, the main body of treatment is optimized to support treatment to
reduce symptoms. Thus the knowledge and awareness among health care students should be
strongly implemented through periodic educational interventions such as webinars, training
programs, group discussion, and role-plays which acts and built a safe tool to create more
awareness.
ACKNOWLEDGEMENTS
We thank all the students who participated in the study.
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a questionnaire-based survey on covid-19 knowledge

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