Knowledge Attitude and Practices of COVID-19 Associated Mucormycosis amongst Dental Practitioners in India – A Cross Sectional Study

Background: The SARS COV-2 virus outbreak led to a pandemic last year wreaking havoc all over the world. With the next wave waiting to strike India, a steep increase in the incidence of Covid-19 associated Mucormycosis cases in recent times amongst the Indian population showing a mortality rate of 30-70% has been noted. Most patients show signs and symptoms pertaining to the oral cavity and peri-oral structures. Therefore, the need for the dental fraternity to be aware about its clinical presentation and pathophysiology plays a crucial role in early diagnosis of Mucorales infection.

Materials and Methods: A cross sectional study was conducted amongst dental practitioners across India. 703 responders responded to a questionnaire that consisted of 15 questions, which were divided into subheadings of Knowledge, Attitude and Practices having 5 questions each.

Results: On statistical analysis of question-wise data received, out of a total of 15 questions, majority of the questions showed highly statistical significance between BDS and MDS responders. Knowledge Attitude and Practices amongst BDS and MDS respondents showed statistical significance (p>0.05) and with increase in number of years into dental practice there was no statistical difference seen amongst the sub groups.

KEYWORDS: covid-19 associated mucormycosis, mucormycosis, mucormycosis questionnaire

With the rise in Covid-19 claiming more than a million lives worldwide, India faces yet another disastrously emergent condition. India, after being deemed the World's capital of Diabetes, continues to remain on the horns of dilemma in battling the paramount issues related to it, moreover the arrival of covid-19 and administration of corticosteroids only made this a perfect recipe for another cataclysmic outcome.

Mucormycotina or Mucormycosis is a potentially infectious saprophytic fungal infection, resulting in a fatal triad of angioinvasion, mycotic thrombosis and ischemic necrosis of the tissues which could also be vision-threatening. Incidence of mucormycosis varies from 0.005 to 1.7 per million population and the global case fatality rate is as high as 46%. It shows six different clinical forms namely: rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous, and other rare forms.

Information and awareness regarding CAM has been provided to the population via various channels like social media, tele information and the internet. However, the assessment of knowledge and awareness amongst Indian dental practitioners is still of great importance. With the steep increase in number of reported cases all over India the need for the dental fraternity to be aware about the clinical presentation and pathophysiology, plays a crucial role in early diagnosis and prompt treatment of CAM.

A total of 703 dental practitioners from across India responded to the survey. A majority of the responders were from the age group of 20-30 years (n=397). Approximately 59.6% of the responders were females, 59.3% dental practitioners were MDS (n=417). Majority of the responders were from the state of Maharashtra.

Out of a total of 703 responses, 57.2% responses were from dental practitioners practicing for less than 5 years, 17.5% were practicing since 6-10 years, 11.7% from 11-15 years, and 13.7% were practicing since 16 years or above.

The questionnaire was divided into three categories Knowledge(K), Attitude(A) and Practices(P). When the sum of K, A and P was taken individually and a sum of all the categories was combined, there was a highly statistical significance obtained under all the four categories, when BDS and MDS responses were compared.

The rising incidence of Covid 19, has been challenging, and as we continue to achieve stability over the current situation, the new imminent threat of Mucormycosis has shown an increased level of distress amidst the lashing fourth wave. With the possibility of a new wave right around the corner, the need for vigilance in early diagnosis and management of these life threatening conditions is indispensible. This study primarily focuses on critical and timely management of the deadly disease, however, knowledge about current consensus, pathophysiology, occurrence and incidence can further help the medical fraternity through the challenging times of this epidemic and pandemic.

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