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Cover page of the Journal of Health Sciences


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 14  |  Issue : 1  |  Page : 48-52

Cross-sectional study of awareness toward COVID-19 among medical students of Kumaun region of Uttarakhand


1 Department of Community Medicine, Government Medical College, Haldwani, Uttarakhand, India
2 Department of Community Medicine, Government Medical College, Orai, Uttar Pradesh, India
3 Department of Physiology, Government Medical College, Haldwani, Uttarakhand, India

Date of Submission04-Jul-2020
Date of Acceptance21-Sep-2020
Date of Web Publication09-Feb-2021

Correspondence Address:
Dr. Mohd. Maroof
Department of Community Medicine, Government Medical College, Haldwani, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_171_20

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  Abstract 

Background: COVID-19 pandemic has been declared as a public health emergency of international concern by the World Health Organization. Being highly contagious in nature, it has become a major concern for healthcare profession.
Aims and Objectives: The aim of the study is to assess the medical students' awareness regarding risk perception, disease transmission, and prevention of COVID-19 and to study their source of information and activities affected by lockdown.
Materials and Methods: We conducted an online, descriptive cross-sectional study in April–May 2020, using WhatsApp Messenger. Medical students of 1st-year and 3rd-year (posted in community medicine department) in Government Medical College, Haldwani, were approached through convenience sampling. Frequencies and proportions were computed for descriptive purposes. Chi-square test was utilized for statistical significance.
Results: A total 244 1st-year and 3rd-year medical students, consisting of 106 (43.4%) males and 138 (56.6%) females, have participated in the study with a mean age of 20.8 (standard deviation 1.66) years. Overall, more students from either batch and gender found the disease very dangerous. TV was the most frequent source of information for their awareness. Almost similar frequency of students felt their social activities/visits affected during the lockdown period. Majority of students were aware about the important clinical features of COVID-19. Most of them agreed upon various modes of transmission severe acute respiratory syndrome coronavirus 2. The most frequently reported source of transmission was going to crowded spaces and exposure to coughing and sneezing. All students agreed for hand washing and avoiding contact with an infected person as the prevention method for COVID-19. Only about one-fourth of the students reported correct distance to be maintained between people.
Conclusion: There is a need for regular educational interventions and training programs on infection control practices for COVID-19 to minimize the risk of transmission to healthcare students.

Keywords: Awareness, COVID-19, Google Form, prevention, transmission


How to cite this article:
Hemaben T, Singh S, Kumari P, Maroof M, Bhatt M. Cross-sectional study of awareness toward COVID-19 among medical students of Kumaun region of Uttarakhand. Indian J Health Sci Biomed Res 2021;14:48-52

How to cite this URL:
Hemaben T, Singh S, Kumari P, Maroof M, Bhatt M. Cross-sectional study of awareness toward COVID-19 among medical students of Kumaun region of Uttarakhand. Indian J Health Sci Biomed Res [serial online] 2021 [cited 2021 Apr 16];14:48-52. Available from: https://www.ijournalhs.org/text.asp?2021/14/1/48/308950




  Introduction Top


COVID-19 is a zoonotic disease which has currently affected nearly all parts of the globe; therefore, the World Health Organization declared coronavirus disease as a pandemic on March 11, 2020.[1] The virus that causes COVID-19 was initially called as 2019-novel coronavirus and was then termed as severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) by the International Committee on Taxonomy of Viruses.[2] Since it is a communicable disease and its mode of transmission from person to person is through droplet infection, the key factors for the prevention of its spread lie in social distancing, practicing hand hygiene, and following respiratory etiquettes during coughing, sneezing, etc., Since medical students are at high risk as they go to various parts of hospital for clinical learning, awareness regarding the mode of spread and preventive measures is must for them. As they belong to medical fraternity, their family and neighbors may expect them to clear their myths and queries regarding COVID-19, so they can also be a resource for information, education, and communication to them. Therefore, the study was designed:

  1. To assess the medical students' awareness regarding risk perception, disease transmission, and prevention for COVID-19
  2. To study their source of information and their activities affected by lockdown.



  Materials and Methods Top


It is an online, descriptive, cross-sectional study among 1st-year and 3rd-year medical students of Government Medical College, Haldwani, during the month of April–May 2020. A total of 244 out of 274 students (125 from 1st-year to 149 from 3rd-year) participated in the study with response rate being 89%. A self-designed questionnaire was prepared. For validation, a pilot study among 10 medical and paramedical staff of our department was conducted to check for completeness of the questionnaire before its dissemination through WhatsApp Messenger to the students. At the time of data collection, Uttarakhand was in a total lockdown; all schools, universities, and institutions were closed. Therefore, we opted to use WhatsApp Messenger for enrolling students. By employing a convenience sampling method, we identified the existing WhatsApp groups of medical students posted in our department and Google Form link to the questionnaire was sent to them. Students were free to participate or refuse in the study. We got 100% completion rate of filling the data in. Confidentiality of the participant was assured. Data were analyzed using MS Excel and IBM SPSS Statistics for Windows, version 20.0 (IBM Corp., Armonk, N.Y., USA). Frequencies and proportions were computed for descriptive purposes. Chi-square test was utilized to depict the statistical difference between groups.

The questionnaire intended to measure issues such as demographics of participants, their risk perception, knowledge of clinical presentation of the disease, methods of transmission of the disease, methods of prevention, their sources of information, and their activities affected by lockdown.

Ethical Clearance was obtained from Govt. Medical College, Haldwani Nainital (Uttarakhand) Institutional Ethical Committee with Ref no. 563/GMC/IEC/2020/Reg. No. 520/IEC/R-12-08-2020 dated 19.10.2020, the Informed Consent was obtained from the subjects.


  Results Top


[Table 1] shows that 106 (43.4%) students were male and 138 (56.6%) students were female who have participated in the study. Female participants were more as compared to males in both the classes. The mean age of these students was 20.8 (standard deviation 1.66) years. Majority of them belonged to nuclear family and Uttarakhand only with family size being <4.
Table 1: Sociodemographic profile of the medical students (n=244)

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[Table 2] details about disease and its perception status in students. More female students (69.5%) knew the full name of COVID-19 correctly than males. Difference was also statistically significant in two batches. Overall, more students from either batch and gender found the disease very dangerous. Girls (45.4%) were more afraid than boys (36.3%). None of them denied of the disease being dangerous. Difference was statistically significant among batches.
Table 2: Awareness of COVID-19 and risk perception

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Majority of medical students (94.6%, 92.8%, and 96.4% male students and 96.7% females from 1st year) identified fever, cough and shortness of breath as the main clinical features of COVID-19 respectively [Table 3]. As we compare these responses with those of 3rd year, almost similar percentage of awareness in males and females of 3rd year (94%, 92%, 94% for fever, cough, and shortness of breath and 97.4% for fever, cough and 94.8% for shortness of breath, respectively) is found.
Table 3: Awareness about clinical presentation of COVID-19

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Female students showed slightly better awareness as compared to male students. Percentage of students for awareness of other associated clinical features was lower either in male or female of any batch. However, statistically, extremely, significant difference was found in batches for diarrhea and myalgia only.

[Table 4] shows that most of the modes of transmission of SARS-CoV-2 were agreed upon by the students. On analysis, we found third year medical students had more sufficient knowledge than their first year counterparts about modes of transmission. The most frequently reported source of transmission was going to crowded spaces and exposure to coughing and sneezing droplets. Awareness of students was same (96.6% from first year and all from third year) for handshaking and touching surfaces like doorknobs and tables to act as mode of transmission.
Table 4: Awareness about transmission of COVID-19

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Analyzing [Table 5], we found that all students agreed for hand washing and avoiding contact with an infected person as the preventive method for COVID-19. Avoiding touching face for prevention was not agreed by only three students of junior batch. Only small proportion of students (1.7% and 4% from 1st to 3rd year, respectively) was disagreed upon the importance of wearing facemask as a protective method. 15.4% of the 1st-year and 4.7% of 3rd-year participants were confused about using tissues as a measure of prevention. This difference was found to be statistically significant.
Table 5: Awareness for prevention against COVID-19

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Majority of both year students (91%) [Table 6] correctly answered duration of hand washing. However, alcohol percentage was quite variable among their answers although 42.7% and 53.5% tried it correctly. Only about one-fourth of the students reported correct distance to be maintained between people. Although more senior batch students were correct as compared to juniors, statistically this difference was not significant.
Table 6: Practical awareness about prevention against COVID-19

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Source of information for their awareness has been depicted in [Figure 1] in order of most to least. Also illustrated in [Figure 2] is the frequency of students who feel their social activities/visits affected during lockdown period.
Figure 1: Sources of information regarding COVID-19

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Figure 2: Activities of students affected by lockdown

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  Discussion Top


During COVID-19 pandemic, the national-level spread and fatalities of disease in India may increase interest in understanding about COVID-19 and implement preventive measures at either individual or community level. Awareness regarding COVID-19 among students can be affected by disease distribution, the severity of disease, and information, education, and communication methods. Our study measures the awareness of medical students about COVID-19 during the pandemic 2020.[3] Risk perception among the students was COVID-19 as very dangerous disease, which is almost similar to a studyby Al-Hazmi et al.[4] conducted in Saudi Arab. Some students had wrong knowledge about transmission of COVID-19 via food like that in a study by Aker and Midik,[5] who reported that some students were agreed with the statement that “COVID-19 was spread by people eating bats in China.”

Source of information regarding COVID-19 among students as television was similar to the study by Al-Hazmi et al.[4] Our study revealed that medical students had an excellent level of awareness regarding the clinical presentation and transmission of COVID-19 disease, which is similar to the study by Al-Mohrej and Agha[6] and higher than Al-Hazmi et al.[4] Knowledge regarding hand hygiene practices to prevent COVID-19 infection was found among all the students, and it was more than the study conducted among medical students in Hong Kong after SARS epidemic.[7] A study conducted by Wehrwein et al.[8] depicted that the male and female students have different learning style preferences and our study also shows that females have higher knowledge regarding correct abbreviation and clinical presentation of COVID-19 disease than male, maybe due to different learning behavior regarding COVID-19 disease. To prevent the local transmission rate of COVID-19, Indian government had declared the nationwide lockdown in multiple phases.[9] In our study, family and friend visit of maximum students were affected by the lockdown however, Al Hazmi et al.[4] showed their subjects' family and friend visits least affected. This significant difference may be due to nationwide implementation of lockdown in India during the COVID-19 pandemic. All students knew about avoiding close contact with infected person. Very few students in both the batches knew the minimum distance to achieve social or physical distancing correctly which was defined (minimum 1 m) by the Ministry of Health and Family Welfare, Government of India.[10] Almost half of the students of both batches did not know that hand sanitizer must contain minimum 60% ethanol or 70% isopropanol as recommended by the Centers of Disease Control and Prevention.[11]


  Conclusion Top


Medical students from the Kumaun region of Uttarakhand showed adequate awareness of COVID-19. Global spread of COVID-19 and the number of fatalities associated with it might have increased public interest in understanding how to take correct preventive measures at community and individual level. More emphasis should be placed on Continuing Medical Education of the students about risk, transmission, and preventive measures, such as using tissues when sneezing and coughing and proper tissue disposal.

This is important in showing the role of medical students in communicating accurate health-related information to their families. Medical training may therefore be regarded as an opportunity to engage in social education during the pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO Director-General's Opening Remarks at the Media Briefing on COVID-19-11 March 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-generals-opening-remarks-at-the-media-briefing-on-covid-19; 11 March, 2020. [Last accessed on 2020 Sep 17].  Back to cited text no. 1
    
2.
Cascella M, Rajnik M, Cuomo A, Scott C, Dulebohn, Napoli RD. Features, Evaluation, and Treatment of Coronavirus (COVID-19).  Back to cited text no. 2
    
3.
Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Bio Med 2020;91:157-60.  Back to cited text no. 3
    
4.
Al-Hazmi A, Gosadi I, Somily A, Alsubaie S, Bin Saeed A. Knowledge, attitude and practice of secondary schools and university students toward Middle east respiratory syndrome epidemic in Saudi Arabia: A cross-sectional study. Saudi J Biol Sci 2018;25:572-7.  Back to cited text no. 4
    
5.
Aker S, Midik Ö. The views of medical faculty students in turkey concerning the COVID-19 pandemic. J Community Health 2020;45:684-8.  Back to cited text no. 5
    
6.
Al-Mohrej A, Agha S. Are Saudi medical students aware of Middle East respiratory syndrome coronavirus during an outbreak? J Infect Public Health 2017;10:388-95.  Back to cited text no. 6
    
7.
Wong TW, Tam WW. Handwashing practice and the use of personal protective equipment among medical students after the SARS epidemic in Hong Kong. Am J Infect Control 2005;33:580-6.  Back to cited text no. 7
    
8.
Wehrwein EA, Lujan HL, DiCarlo SE. Gender differences in learning style preferences among undergraduate physiology students. Adv Physiol Educ 2007;31:153-7.  Back to cited text no. 8
    
9.
COVID-19: Lockdown across India, in Line With WHO Guidance | | UN News. Available from: https://news.un.org/en/story/2020/03/1060132. [Last accessed on 2020 Sep 17].  Back to cited text no. 9
    
10.
High level Group of Ministers Reviews Current Status, and Actions for Prevention and Management of COVID-19. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=1606637. [Last accessed on 2020 Sep 17].  Back to cited text no. 10
    
11.
Hand Hygiene Recommendations | CDC. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html?. [Last accessed on 2020 Sep 17].  Back to cited text no. 11
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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