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BACKGROUND Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements of infection control. . OBJECTIVE This study aimed to assess the level of awareness, perception, and attitude regarding COVID-19 and infection control among Jordanian dentists METHODS The study population consisted of dentists who work in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire comprised a series of questions about dentists’ demographic characteristics, their awareness of incubation period, the symptoms of the disease, mode of transmission of the COVID-19, and infection control measures for preventing COVID-19, and their attitude toward treating patients with COVID-19. Results RESULTS This study included a total of 368 dentists aged from 22 to 73 year with a mean (SD) of 32.9 (10.6) year. A total of 112 (30.4%) had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or received lectures regarding COVID-19. A total of 162 (44.0%) dentists reported that the incubation period is 7-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of how to identify patients at risk of having COVID-19, were able to correctly report known modes of transmission and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it is necessary to ask patients to set far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission. Conclusion CONCLUSIONS Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, infection control and measures in dental clinic. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during crisis, including this COVID -19 pandemic, to make sure that dentists are well informed and aware of the best practices and recommended disease management approaches.
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JMIR Preprints Khader et al
Dentists’ awareness, perception, and attitude
regarding COVID-19 and infection control: A cross-
sectional study among Jordanian dentists
Yousef Khader, Mohannad Al Nsour, Ola Barakat Al-Batayneh, Rami Saadeh,
Haitham Bashier, Mahmoud Alfaqih, Sayer Al-Azzam, Bara’ Abdallah AlShurman
Submitted to: JMIR Public Health and Surveillance
on: March 19, 2020
Disclaimer: © The authors. All rights reserved. This is a privileged document currently under peer-review/community
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stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Table of Contents
Original Manuscript ....................................................................................................................................................................... 5
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Dentists’ awareness, perception, and attitude regarding COVID-19 and
infection control: A cross-sectional study among Jordanian dentists
Yousef KhaderSCD, ; Mohannad Al NsourPhD, ; Ola Barakat Al-BataynehFRACDS, ; Rami SaadehPhD, ; Haitham
Bashier; Mahmoud AlfaqihPhD, ; Sayer Al-AzzamPhD, ; Bara’ Abdallah AlShurmanMSc,
Corresponding Author:
Yousef KhaderSCD,
Phone: +962796802040
Email: yskhader@just.edu.jo
Abstract
Background: Despite the availability of prevention guidelines and recommendations on infection control, many dental practices
lack the minimum requirements of infection control. .
Objective: This study aimed to assess the level of awareness, perception, and attitude regarding COVID-19 and infection control
among Jordanian dentists
Methods: The study population consisted of dentists who work in private clinics, hospitals, and health centers in Jordan. An
online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire comprised a series of questions
about dentists’ demographic characteristics, their awareness of incubation period, the symptoms of the disease, mode of
transmission of the COVID-19, and infection control measures for preventing COVID-19, and their attitude toward treating
patients with COVID-19.
Results: This study included a total of 368 dentists aged from 22 to 73 year with a mean (SD) of 32.9 (10.6) year. A total of 112
(30.4%) had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in
dentistry, and 28 (7.6%) had attended training or received lectures regarding COVID-19. A total of 162 (44.0%) dentists reported
that the incubation period is 7-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of how to
identify patients at risk of having COVID-19, were able to correctly report known modes of transmission and were aware of
measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it is necessary to ask
patients to set far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to
decrease disease transmission.
Conclusion: Conclusions: Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, infection control and
measures in dental clinic. However, dentists had limited comprehension of the extra precautionary measures that protect the
dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national
dental associations to all registered dentists during crisis, including this COVID -19 pandemic, to make sure that dentists are well
informed and aware of the best practices and recommended disease management approaches.
Conclusions: Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, infection control and measures in
dental clinic. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and
other patients from COVID-19. National and international guidelines should be sent by the regional and national dental
associations to all registered dentists during crisis, including this COVID -19 pandemic, to make sure that dentists are well
informed and aware of the best practices and recommended disease management approaches.
(JMIR Preprints 19/03/2020:18798)
DOI: https://doi.org/10.2196/preprints.18798
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JMIR Preprints Khader et al
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https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Original Manuscript
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Dentists’ awareness, perception, and attitude regarding COVID-19 and infection control: A
cross-sectional study among Jordanian dentists
Abstract
Introduction
   

        !"#    
$
Methods

$ %$ &'('(
              )      
 !
"#        !"#     
 !"#
Results
*+,''-*./0*'#."(+0
%""'.*(120"#3.3*(20
                  ',  .-+20        
 !"#%"+'.11(20
-!"14 !"#
        !"#      
 !"#%
'-3.-1-20 
       

Conclusion
$ !"#
56
 !"#7
  
 !"#

https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Keywords:  !"#
Introduction
Background
 !"#8

  /%9/!    &:9/!# ;"<  %       !!    
&
6
=5 >% /55?
  
 !"#;'<
COVID-19 and dental treatment
%
;*<6


;1<% !"#

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!
    B  6   !"#     
    !"#
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B.850  !"# ;,!"(<D
                  
!
            
                         
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
)=
=;",<
Objectives
         
                        
6

;"""'<$
A
            

          5                 
 !"#$
Methods
Study population
  $   
&'('(%
 E 
 @      $
 %              $              
$%
     3    A $  
    $      $            $
)   8        3      -((          
@5     
>$
                      
: 
9?$F/
Study Instrument
G      
;",!"(<:
!
 !"#  !
      H  )         
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
)
 !"# !"#)
 !"#
Data analysis
/C//./C//0
&

Results
Participants’ characteristics
*+,.'13"'*0
3'+2.*,+-((0''-*
./0*'#."(+0I"*(./0
#1.,#0""'.*(120"11.*#"20
1,.'',20',.-+20)
    "%   ""'.*(120         
"#3 .3*(20     ', .-+20 
 !"#
"*+,
Variable n %
E
@ '13 +++
& "'* **1
%.0
J*( "## 31"
K*( "+# 13#
I
J3 ",3 3(*
3!"( 3# "+(
L"( "'1 **-
9
& "#( 3"+
7 "1, 1('
/ *( ,'
5
F ""' *(1
& ', -+
C "11 *#"
C ,1 '',
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
Awareness about incubation period, symptoms, and mode of transmission of the COVID-19
infection
8   "+'.11(20 -!"1"**
.*+"20  '!"1  +" ."++20  -!'"   "' .**20   
'!- !
"#'4.M*+*#,+20.M**3
#"(20$
    - ."#20  %  "'- .*1320   
  !"#   8   
         !"# *"+.,3#20
*1-.#1*20
   6    !"#  *13 .#*,20   
 
.'0
')
 !"#
Variable n %
 N N
'!"1 "** *+"
'!- "' **
-!"1 "+' 11(
-!'" +" "++
/ !"#
@ *+* #,+
 **3 #"(
/ *"+ ,3#
 "1- *##
 ""# *'*
9 "** *+"
/ "(3 ',3
9 ', -+
/9 '" 3-
$> - "#
&
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
B *** #(3
5 *"3 ,3+
 *1* #*'
Awareness of measures for preventing COVID-19 transmission in dental clinics
4!
.*31#+'20
.*1-#1*20.*1'#'#20
         !"#    
*%.*3##-+20


*)  !"#   

Measures for prevention COVID-19 transmission n %
@          !  

*31 #+'
9

*1- #1*
C   

*1' #'#
C *'3 ,,*
 %          

*"( ,1'
% *(1 ,'+
C            

',1 --'
Perception of COVID-19
% +3 ."--20   !"#   '+1.-"-20  
*3.#320%."*3*+-20
   !"#     4.*+( #-,20
 !"#
Attitude toward treatment of patients with COVID-19
&.'(*33'20 !"#
   9 )  
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
'-3.-1-20

,(.'"-20
5 *(1.,'+20
 !"#
             B          A  "+"
.1*,20      >"-
.1+20>",'
.1#320>
&%""#.*'*20
   ='"1.3,'20  
                        6        
 !"#'-#.-3,20
 !"#
@'1#.+--20
 !"##1.'3320

Discussion
$
 !"#'('(
$@
6$
$%;"*<
 !"#3+"1;+-<8
     
 
;"1<5)
)
       ;"3<    ;"+< 
6     ;1< 7 $   
 !"#B
 ;"1<
     ;"<       
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
>

        6                    

;#<
= !"# !
"# ;,< !"#
A                        A  
                   ;"-<      
A
!=
 !"#.-"-20
  !"#   %
=6
OP$ )
.'"-20)
 
54.,'+20
 !"#
;"<
B
 A 1*,2     > 1+2
  1#32      /
.*'*20!
 !"#   
  C  
;,<
C
"1
"1  !"#!
;",< 
.3,'206
 !"#-3,2
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
      !"# ?       
      !"#  ?   
B
;",<%1!
 4           ;" #< 
    4 .#-,20         
 !"#
    %%                     

                            
=6=B
I
B &              


B
Conclusion
$ !"#
56
     !"# E

       !"#        

References
" & D 5 @ ? Q   '("# . !"#0H :  @
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'  7R % 5% / /  %R % ?& ! 
HR
R%BBF5$/%$ C5
'("-'("->(->(">A"(.10H1*,!13HH>>>"("("+>44'("+(+(('
* ?7*1(("*
'('(;&1'('(<
https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
JMIR Preprints Khader et al
1 Q/58D4%%!
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 '("# . !"#0@C 9 H:
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.0H '('(;"*
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!!!!!!!.0!!!
#  C.0 E9
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https://preprints.jmir.org/preprint/18798 [unpublished, non-peer-reviewed preprint]
... Ensuring a proper level of knowledge regarding the characteristics of COVID-19 and how to protect health workers and patients; is important to enhance the practice of medical services and to reduce the transmission of COVID-19. Several studies have investigated healthcare workers' knowledge and attitudes towards COVID-19 pandemic (Giao et al. 2020;Khader, Al-Batayneh, and Saadeh 2020;Bhagavathula et al. 2020). The level of knowledge regarding symptoms and incubation period, varied among participants. ...
... The majority of dentists (94.3%) regularly clean and disinfect objects and surfaces that have been exposed to patients confirmed or suspected of COVID-19, and (92.9%) considered wearing personal protective equipment such gloves and facemasks during practice. Moreover, 77.2% would isolate confirmed or suspected cases in suitably aerated separate rooms (Khader, Al-Batayneh, and Saadeh 2020). ...
... The second section focussed on their knowledge of the COVID-19 characteristics, such as its signs and symptoms, modes of transmission, incubation period, and prevention methods. A search in the literature was conducted and questions in this section were adapted from studies that investigated the knowledge of healthcare workers on COVID-19 (Khader, Al-Batayneh, and Saadeh 2020;Giao et al. 2020). ...
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Objective This study investigated audiologists’ knowledge of COVID-19 characteristics and infection control measures they followed during the COVID-19 pandemic. Moreover, it examined the impact of COVID-19 on audiology practice, and audiologist’s knowledge of telehealth as an alternative. Design A web-based cross-sectional study using a questionnaire consisting of four sections. Study sample This study engaged 164 audiologists practicing in Jordan and Arab countries. Results Fever, cough, difficulty in breathing, and fatigue were identified as COVID-19 characteristics by over 80% of the audiologists. Other symptoms were identified by less than half of the audiologists. The audiologists showed limited knowledge regarding measures against COVID-19 transmission. This study revealed the limited availability of infection control measures in many audiologists’ workplace. The majority of audiologists stopped working due to the COVID-19 crisis and only 61.6% of the audiologists were familiar with the concepts of tele-audiology and its related aspects. However, most participants were keen to learn more. Conclusions This study revealed limited knowledge among audiologists regarding some of the COVID-19 characteristics, and limited compliance with the infection control policies. Limited knowledge in the application of telehealth in audiology practice was also shown.
... A good awareness and knowledge of the mode of transmission of COVID-19 among dental professionals is essential to implement these guidelines. Although a number of reports are available on the dentists' awareness of the pandemic and attitudes towards the implementation of clinical guidelines [9,10] no such data are available from Sri Lanka. Hence, we ...
... Prevention of COVID-19 is mainly achieved by proper hand washing, social distancing and by respiratory protective measures such as the use of face masks/face shields [13]. In contrast to the findings of other similar surveys [10,12], almost a fifth of our respondents incorrectly mentioned that hand hygiene is not important in preventing infection and pet animals are a major source of infection. Personal protective equipment (PPE) is an essential prerequisite for the safe delivery of dental care, as well as for the protection of the dental surgeon and the dental team. ...
... Sri Lankan dental professionals' knowledge of the COVID-19 10. Are you aware that loss of taste and loss of smell are early symptoms of COVID-19: a) Will you insert an immediate travel history question (2 weeks before dental attendance): Yes No b) Will you question the patient on recent loss of taste or smell? ...
Article
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Background Dental practitioners are some of the most vulnerable professionals exposed to the risk of contracting the Corona Virus Disease-19 (COVID-19), by virtue of the aerosol generating procedures (AGPs). Hence, an evidence based and detailed knowledge of the disease is important in order to mitigate the effects of the COVID-19 transmission. Aim To identify the perspective, knowledge, and attitudes of Sri Lankan dental surgeons on the COVID-19 pandemic. Methods An online web-based, self-administered questionnaire survey (Google) was conducted among Sri Lankan dental surgeons. All questions, in the pre-tested questionnaire were close-ended, and formulated to elicit data on the views, knowledge, attitudes, and infection control practices related to the COVID-19 pandemic. Results One quarter of the cohort responded and the majority (44.7%) were 30-40 years old with a marginal female preponderance (52.3%). In general, females were significantly more knowledgeable than males on COVID-19, and the post-pandemic preparedness for dental practice (p<0.05). One sixth (18.2 %) incorrectly surmised that, i) pet animals were a source of infection, ii) COVID-19 is not transmitted via surface contact and iii) hand hygiene is not important in preventing infection transmission. All respondents correctly identified AGPs as a high-risk procedure for infection transmission, but approximately two thirds failed to identify specific AGPs in dentistry. Conclusion Taken together, the knowledge, attitudes and practices of Sri Lankan dental surgeons on the COVID-19 pandemic appear satisfactory, but there are knowledge gaps that need to be fulfilled through further continuous education courses.
... The respondents demonstrated good knowledge of the common symptoms of COVID-19 which include fever, dry cough, chest pain, dyspnoea, fatigue and myalgia. this is similar to the ndings of Arora et al [16] and Khader et al [17] who reported good knowledge of COVID-19 among ...
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Background: The impact of the COVID-19 pandemic on the world is unprecedented, posing greater threats to vulnerable healthcare systems, especially in developing countries. This study aimed to assess the knowledge of dental healthcare providers in Nigeria about the disease and evaluate their responses to the preventive measures necessitated by the disease. Methods: This was an online self-administered questionnaire-based study conducted among Dentists practicing in Nigeria. A message containing the link to the survey was sent widely via social medial platforms and electronic mails to dentists practicing in Nigeria. The data collection was done between the 2nd of June and 3rd of July, 2020. Results: A total of 314 responses was recorded. Fever was the most commonly specified generalized symptom (97.5%), while the use of masks (100%), hand hygiene (99.7%), social distancing (97.7%) and surface cleaning (99.4%) were the most commonly employed general preventive methods. The main identified risk of transmission in the clinic was aerosol generating procedures (98.7%). Conclusion: The general knowledge of dental personnel in our study population appears to be adequate on the common features of COVID-19 but less adequate regarding the less common features. The COVID-19 pandemic has also modified some aspects of dental service delivery but more needs to be done in this regard. Preventive measures against the transmission of COVID-19 in dental practice settings include proper utilization of teledentistry, clinical triage, preprocedural 1% hydrogen peroxide oral rinses, and the use of appropriate PPEs which should always be encouraged.
... Katılımcılarımızın çoğunluğu entübasyon ve ekstübasyon ile ilgili bilgi sorularına doğru cevap vermiştir. Yaptığımız literatür taramasında anestezi teknisyen/teknikerleri için COVID-19 enfeksiyonunda özellikle entübasyon ile ilgili bilgi düzeylerine yönelik bir anket çalışmasına rastlanmazken diş hekimleri, eğitim ve sağlık çalışanlarına COVID-19 enfeksiyonunun tanısı, kontrolü ve önlenmesine yönelik anket çalışmalarına rastlandı (9,10) . ...
... Katılımcılarımızın çoğunluğu entübasyon ve ekstübasyon ile ilgili bilgi sorularına doğru cevap vermiştir. Yaptığımız literatür taramasında anestezi teknisyen/teknikerleri için COVID-19 enfeksiyonunda özellikle entübasyon ile ilgili bilgi düzeylerine yönelik bir anket çalışmasına rastlanmazken diş hekimleri, eğitim ve sağlık çalışanlarına COVID-19 enfeksiyonunun tanısı, kontrolü ve önlenmesine yönelik anket çalışmalarına rastlandı (9,10) . ...
... The distribution showed a significant association between professional affiliation and knowledge. In a similar study in Jordan which conducted among practicing dentists, it was found that 71.7% were aware of mode of transmission of COVID-19, and infection controls measures in dental clinics, and has the perspective that COVID-19 is a dangerous disease (9). ...
Article
Full-text available
Background: The COVID-19 pandemic caused by SARS-CoV-2 has claimed thousands of lives worldwide. To enhance knowledge and awareness of COVID-19, considerable online resources have been made available, including aspects related to the dental profession. The study aim was to examine the knowledge, perception, and attitude of dental professionals in Indonesia toward COVID-19. We conducted a survey via a questionnaire created using Google docs and distributed to 632 members of the Indonesian Dental Association in the context of a webinar hosted by the Indonesian Oral Biology Association on first June, 2020. Materials and Methods: The questionnaire consisted of 17 items pertaining to demographic data, knowledge and virus identification, awareness regarding drugs commonly used in dentistry during pandemic and research opportunities. Participants were asked to complete the questionnaire after the webinar by choosing one answer to each question. For the analysis, participants were divided into three groups according to their professional background i.e., employment at national hospital, private hospital, or academic faculty. Data were analyzed using descriptive statistics and expressed as frequencies and percentages. The chi-square test was used to investigate the association between professional activity and the level of knowledge, perceptions, and attitudes about COVID-19. Results: Sixty percent of the participants correctly identified the pathogenesis of the disease. This knowledge was not associated with their professional affiliation (p = 0.95). Sixty-seven percentage had comprehensive knowledge about virus detection methods. This knowledge was not associated with their affiliation either (p = 0.54). Questions regarding drugs of choice, prevention, and the spread of COVID-19 were correctly answered by 89, 96, and 82% of the participants, respectively. Knowledge of these aspects were significantly associated with the professional affiliation (p < 0.05). All respondents were optimistic regarding research opportunities (p < 0.01). Respondents from academics were more interested in joining COVID-19-related research projects with governmental institutions (p < 0.01). Conclusion: Knowledge and awareness of COVID-19 among Indonesian dentists are reasonably good. However, further improvement would be beneficial to manage patients during this pandemic. As the number of COVID-19 cases continue to rise in Indonesia, it is important that dentists keep abreast of the updated knowledge on this moving field. Dentist knowledge on infection control should be strengthened through continuous educational programs.
... Katılımcılarımızın çoğunluğu entübasyon ve ekstübasyon ile ilgili bilgi sorularına doğru cevap vermiştir. Yaptığımız literatür taramasında anestezi teknisyen/teknikerleri için COVID-19 enfeksiyonunda özellikle entübasyon ile ilgili bilgi düzeylerine yönelik bir anket çalışmasına rastlanmazken diş hekimleri, eğitim ve sağlık çalışanlarına COVID-19 enfeksiyonunun tanısı, kontrolü ve önlenmesine yönelik anket çalışmalarına rastlandı (9,10) . ...
... El período de incubación del COVID-19 es de 5 a 6 días en promedio, llegando en algunos casos a los 14 días 21,22 , que son los días recomendados para la observación médica y cuarentena de potenciales infectados. Este periodo de incubación relativamente largo, con ausencia de cualquier sintomatología, representa un desafío para el personal de salud en la lucha por controlar la propagación del COVID-19. ...
Article
Full-text available
A fines del 2019 se presentaron 27 casos de neumonía atípica de etiología desconocida en la ciudad de Wuhan, China. Los síntomas de los pacientes que padecían la nueva neumonía viral fueron fiebre, tos seca, disnea y fatiga. El virus causante fue nombrado coronavirus de tipo 2 causante del síndrome respiratorio agudo severo (SARS-CoV-2) y la enfermedad fue nombrada en febrero de 2020 por la Organización Mundial de la Salud como enfermedad por coronavirus COVID-19. Las rutas de contagio de persona a persona incluyen transmisión directa por inhalación de gotitas de tos, estornudos, y transmisión indirecta, por medio de fómites que hagan contacto con las membranas mucosas orales, nasales u oculares. Los odontólogos debido a la naturaleza única de los procedimientos que realizan, tienen un alto riesgo de infección cruzada del COVID-19, ya que al trabajar en la boca del paciente está expuestos a una gran cantidad de gotas de saliva y aerosoles producidos durante la atención dental. La pandemia del COVID-19 requiere que el odontólogo tenga una preparación especial para la prevención del contagio en la consulta dental. El odontólogo también debe actualizarse sobre cómo el COVID-19 se relaciona con la profesión para estar bien preparado y ser miembro activo en las medidas sanitarias para controlar la pandemia. El objetivo de esta revisión es presentar información actualizada sobre el COVID-19, y dar soporte científico para el uso de las diferentes estrategias para minimizar el riesgo de contaminación cruzada en la práctica dental durante la pandemia de COVID-19.
... [5][6][7] COVID-19 is reported to manifest clinically with one or more mild symptoms of fever, cough, headache, body aches, dyspnea and fatigue, with symptomatic recovery within a few weeks. 1 While severely affected individuals show manifestation of progressive respiratory distress syndrome due to the lung substance damage and edematous changes caused by the virus in leading to shock and death in some cases. 8 The mortality rate range is 0.8 to 4.3% based on the early data from different regions. 9 A majority of middle to elderly patients with comorbidities including, tumor, cirrhosis, hypertension, coronary heart disease and diabetes are reported dead as a result of COVID-19 infections. ...
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Background Coronavirus Disease (COVID-19) epidemic is a public health emergency of international concern. Dentists are exposed to the enormous risk of COVID-19 infection during this epidemic. This study aims to assess the knowledge and practice of dentists toward the COVID-19 epidemic in Lebanon. Methods We conducted an online survey using the snowball-sampling technique. Information on socio-demographic data, knowledge, practice, and additional information required concerning COVID-19 were collected. Results Our results showed that the majority of the Lebanese dentists had good knowledge (91.3%), and nearly half of the respondents had a good practice (58.7%) regarding COVID-19. The most common information source was the World Health Organization (73.7%). Multiple linear regression showed that specialist dentists who completed training on COVID-19 with a high level of knowledge had better practice. Conclusions Lebanese dentists revealed good knowledge regarding COVID-19. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and patients from this virus. Our findings have important implications for the development of strategies suitable for improving the level of practice among dentists and enhance prevention programs.
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Importance In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures Documented NCIP. Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 10⁹/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0). Conclusions and Relevance In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.
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A novel coronavirus (2019-nCoV) is causing an outbreak of viral pneumonia that started in Wuhan, China. Using the travel history and symptom onset of 88 confirmed cases that were detected outside Wuhan in the early outbreak phase, we estimate the mean incubation period to be 6.4 days (95% credible interval: 5.6 7.7), ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). These values should help inform 2019-nCoV case definitions and appropriate quarantine durations. © 2020 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
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Objectives: To assess virus knowledge among dentists in Saudi Arabia and to identify factors associated with recommended management practices of patients. Method: A structured questionnaire was distributed to dentists in major Saudi cities between September 2016 and December 2017. The questionnaire investigated participants’ knowledge about Middle East Respiratory Syndrome Coronavirus (MERS-CoV) transmission, consequences, patient identification and history taking practices. Data was collected using paper-based questionnaires or an online link sent to dentists registered with Saudi Dental Society nationwide. The analysis was carried using Statistical Package for Social Sciences for Windows, version 22.0 (IBM Corp., Armonk, NY, USA) logistic regression, odds ratio and confidence intervals to identify the relationship between variables. Results: A total of 423 dentists responded the paper-based questionnaire. Overall the knowledge was good with gaps in history taking practices. Best management practices of MERS-CoV patients were significantly higher among dentists with better knowledge of virus transmission (odd ration [OR]=1.16, p less than 0.0001), patients’ identification (OR=1.40, p less than 0.0001) and those knowing that corona infection can be fatal (OR= 2.44, p=0.02). Conclusion: Best management practices depends on correct patient identification. Educational campaigns should target dentists, given the unique nature of dental practice.
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Abstract Background Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available. Objectives This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1) What are the sources that generate bio-aerosols?; 2) What is the microbial load and composition of bio-aerosols and how were they measured?; and 3) What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission? Methods Systematic scoping review design. Searched in PubMed and EMBASE from inception to 09-03-2016. References were screened and selected based on abstract and full text according to eligibility criteria. Full text articles were assessed for inclusion and summarized. The results are presented in three separate objectives and summarized for an overview of evidence. Results The search yielded 5,823 studies, of which 62 were included. Dental hand pieces were found to generate aerosols in the dental settings. Another 30 sources from human activities, interventions and daily cleaning performances in the hospital also generate aerosols. Fifty-five bacterial species, 45 fungi genera and ten viruses were identified in a hospital setting and 16 bacterial and 23 fungal species in the dental environment. Patients with certain risk factors had a higher chance to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies found that bio-aerosol generating procedures resulted in transmission of infectious diseases or allergic reactions.
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Background Middle East Respiratory Syndrome (MERS) is caused by MERS coronavirus (MERS-CoV). More than 80% of reported cases have occurred in Saudi Arabia, with a mortality exceeding 50%. Health-care workers (HCWs) are at risk of acquiring and transmitting this virus, so the concerns of HCWs in Saudi Arabia regarding MERS were evaluated. Methods An anonymous, self-administered, previously validated questionnaire was given to 1031 HCWs at three tertiary hospitals in Saudi Arabia from October to December, 2014. Concerns regarding the disease, its severity and governmental efforts to contain it, as well as disease outcomes were assessed using 31 concern statements in five distinct domains. A total concern score was calculated for each HCW. Multiple regression analyses were used to identify predictors of high concern scores. Results The average age of participants was 37.1 ± 9.0 years, 65.8% were married and 59.1% were nurses. The majority of respondents (70.4%) felt at risk of contracting a MERS-CoV infection at work, 69.1% felt threatened if a colleague contracted MERS-CoV, 60.9% felt obliged to care for patients infected with MERS-CoV and 87.8% did not feel safe at work using standard precautions. In addition, 87.7% believed that the government should isolate patients with MERS in specialized hospitals, 73.7% agreed with travel restriction to and from areas affected by MERS and 65.3% agreed with avoiding inviting expatriates from such areas. After adjustment for covariates, high concern scores were significantly associated with being a Saudi national (p < 0.001), a non-physician (p < 0.001) and working in the central region (p < 0.001). Conclusions The majority of respondents reported concern regarding MERS-CoV infection from exposure at work. The overall level of concern may be influenced by previous experience of MERS outbreaks and related cultural issues. The concerns of HCWs may affect their overall effectiveness in an outbreak and should be addressed by incorporating management strategies in outbreak planning.
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OBJECTIVE: The goal of this study was to evaluate the infection control measures actually implemented by dental surgeons during dental practice, as patients and professionals are exposed to high biological risk in dental care environments. METHOD: 614 questionnaires (90.69%) were answered by professionals registered in updating or in post-graduate courses in the Municipality of São Paulo. RESULTS: Out of surveyed professionals 30.62% admitted that surface protection barriers were not used, whereas 34.17% were using non ideal or outdated pre-disinfection practices. The autoclave was used by 69.38% of participants, although 33.80% were not monitoring control of the sterilization cycles. Chemical and biological indicators were not used simultaneously by 83.21% of respondents and were not employed on a daily or weekly basis by at least 81.75%. Dubious methods of sterilization were cited by 44.77%. Occupational accidents caused by cutting and piercing objects were reported by 47.88%; however, the biologic risk was underestimated by 74.15% of the professionals who suffered the accidents. Irritant solutions were used as an antiseptic agent by 18.55%. CONCLUSIONS: Infection control measures reported by dental surgeons during their practices are deficient. It is necessary to educate, raise awareness of professionals, and promote constant updating courses on procedures which aim at improving safety of dental care.
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The objective of the study was to determine the level of Knowledge, Attitude and Practice (KAP) of patients attended dental clinics at King Abdulaziz University Hospital (KAUH) regarding cross infections and infection control in dentistry. A cross-sectional study was conducted among 225 patients who attended the dental clinics of KAUH, Jeddah, Saudi Arabia, 2014. A standardized, confidential, anonymous, interviewing questionnaire was used. Knowledge about dental infections was assessed by 12 MCQs. The attitudes were assessed through answering seven statements on a three- point Likert scale. Patients' self reported practices were also evaluated. Descriptive and inferential statistics were done. Results of the study revealed that 39.5%, 38.7% and 21.8% of the participants obtained poor, fair and satisfactory level of knowledge about infections and infection control in dentistry, respectively. Social media was the commonest source of information about dental infection. Participant's educational level was significantly associated with the level of knowledge about dental infection. Patients had positive attitudes towards infection control in dentistry. Regarding self-reported practice, only few participants would ask dentists about sterilization of dental instruments (9.3%), wearing face mask (13.3%) and gloves (16.4%) if they don't do so. In conclusion, our participants had good attitudes towards infection control in dentistry. However, their knowledge and practice need improvements. Conduction of educational programs is needed through social media, mass media, schools and public places. These programs involve both patients and providers.
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Background: This study aimed to determine knowledge, attitude and practice of airborne and droplet isolation precautions among Dental Health Professionals (DHPs) (dental students, interns, practitioners and auxiliaries) during the outbreak of MERS (Middle East Respiratory Syndrome), corona virus infection in Riyadh city, Saudi Arabia. Material and Methods: A cross-sectional survey was conducted among 406 dental health professionals (DHPs) working in selected dental facilities in Riyadh city, Saudi Arabia during the outbreak of MERS (April-June 2013). A structured, close-ended, self-administered questionnaire explored the knowledge, attitude, and practice towards droplet and isolation precautions. Collected data was subjected to descriptive statistics to express demographic information, mean knowledge score, mean attitude score and practice score of DHPs. Inferential statistics (Mann– Whitney U test and Kruskal Wallis tests, p < 0.05) were used to examine differences between study variables. Spearman’s rho correlation was used to identify the association between the knowledge-attitude, knowledge-practice, and attitude-practice. Results: A response rate of rate of 90.22% (406 out of 452) was obtained. The mean scores of knowledge, attitude and practice were 10.61 ± 1.19, 50.54 ± 7.53 and 8.50 ± 2.14 respectively. Spearman’s correlation test revealed a significant linear positive correlation between knowledge and attitude(r-0.501, P- 0.01), knowledge and practice (r-0.185, P-0.01) and attitude and practice (r-0.351, P- 0.01) of DHPs about airborne isolation precautions. Conclusions: Dental health professionals considered in the present study showed good knowledge, positive attitude and good practice towards droplet and airborne isolation precautions during outbreak of MERS.
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The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.
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Background: A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Objective: To estimate the length of the incubation period of COVID-19 and describe its public health implications. Design: Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020. Setting: News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. Participants: Persons with confirmed SARS-CoV-2 infection outside Hubei province, China. Measurements: Patient demographic characteristics and dates and times of possible exposure, symptom onset, fever onset, and hospitalization. Results: There were 181 confirmed cases with identifiable exposure and symptom onset windows to estimate the incubation period of COVID-19. The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. Limitation: Publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases. Conclusion: This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS. Our results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases. Primary funding source: U.S. Centers for Disease Control and Prevention, National Institute of Allergy and Infectious Diseases, National Institute of General Medical Sciences, and Alexander von Humboldt Foundation.