INTRODUCTION

The coronavirus disease 2019, also known as COVID-19, is a highly communicable viral respiratory infectious disease with potential life-threatening capabilities.^1-3 The causative organism of COVID-19 is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).⁴ SARS-CoV-2 is a single-stranded RNA virus that belongs to the family of coronaviridae and it is commonly transmitted through contact with infected respiratory droplets.^1,3,5,6 The incubation period of COVID-19 is 1 – 14 days while its common symptoms include fever, cough, dyspnoea, myalgia, headache, and diarrhoea.^1,4,5 Also, severe COVID-19 can lead to serious complications such as encephalitis, acute myocardial infection, renal failure, and multi-organ failure.^1,2,8,9

Historically, the first case of the disease was first reported in a wet market in the city of Wuhan, Hubei Province, China.¹⁰ From China, the viral infection had spread to other countries.¹⁰ As at May 13, 2020, a total of 4, 170,424 confirmed cases and 287,399 death cases of COVID-19 had been recorded globally, respectively.¹¹ Also, in Nigeria, a total of 4,787 people had been confirmed to have COVID-19 disease, of which 3.3% (n=158) of them died as a result of the disease, as at May 13, 2020.¹²

As earlier mentioned, COVID-19 is a communicable disease that is contracted via mucosal contact with COVID-19-infected respiratory droplet(s).^1,5,7 This implies that any activity that increases one’s exposure to other persons’ respiratory droplets increases one’s likelihood of contracting the disease. However, some professional practice involves very close physical contact with clients; examples of such professions include nursing, barbing, medicine, and dentistry.

Just like a wild fire, the rate at which the disease is spreading in Nigeria is very alarming and worrisome.¹² Focusing on the dental profession in Nigeria, the dentists are a very high-risk group when it comes to COVID-19 transmission.¹³ This is so because they commonly operate on the mouth, and sometimes the nose – the two body outlets for respiratory droplets. A way of preventing patient-to-dentist transmission of the disease is by the use of personal protective equipment (PPE),¹³ including head gears, face masks, face shields, goggles, N95 respirator, protective gowns, and hand gloves. However, despite the high virulence rate of coronavirus, no published Nigerian study, to the best of the authors’ knowledge, had been conducted to explore the knowledge, risk perception, and attitudes of Nigerian dentists toward COVID-19.

Furthermore, there are global concerns about the attitudes and behaviours exhibited by the lay public towards people suspected or confirmed to have COVID-19.¹⁴ Of these attitudes and behaviours, one of the most worrisome of them is that related to stigmatization.¹⁴ Recently, there had been reports of stigmatization associated with COVID-19 among the lay public in some parts of the world.^14,15

Aims

This study aims to explore the knowledge, risk perception, and attitudes of Nigerian dentists toward COVID-19.

MATERIAL AND METHODS

This study was a descriptive cross-sectional pilot study surveying a random sample of 69 dentists in Nigeria, online.

The study tool was a piloted anonymous e-questionnaire (Google Form) which was developed from literatures written on: (i) knowledge, attitudes, and practices of health professionals and other population groups on COVID-19 and other viral infections affecting humans;^16-22 and (ii) origin, transmission, and pathophysiology of COVID-19.^1-15 The e-questionnaire had 4 sections. The first section obtained information on the socio-demographic characteristics (such as age, sex, duration of practice, and place of practice) of the participants while the second, third, and fourth sections obtained information about the participants’ (as shown in Table 1); knowledge of COVID-19; risk perceptions of COVID-19; and attitudes toward COVID-19, respectively.

Being a pilot study, a convenient sample size of 69 dentists in Nigeria was used. Simple random sampling technique was used to select the study participants.

Only those participants that were identified as dentists and who were also willing to participate in the study were considered eligible to participate in the study.

From April 28, 2020, to May 12, 2020, the hyperlink of the study tool (e-questionnaire) was circulated to a total of 100 dentists via WhatsApp social media. Only 69 dentists responded to the e-questionnaire. Data collected was analysed using the SPSS version 22 software. The descriptive statistics of all variables was determined. A p-value of <0.05 was used to determine the level of statistical significance.

Ethical Considerations

Approval to conduct the study was obtained from the Department of Community Health, Aminu Musa Habib College of Health Science and Technology, Yauri, Nigeria. Prior to participation, all participants were informed about the aims and objectives of the study, their freedom of participating, and the anonymity of their participation. Only those participants that gave electronic informed consent to partake in the study were allowed to proceed to fill the e-questionnaire; those that declined participation were automatically disabled from participating. To ensure anonymity, the e-questionnaire did not obtain information about the means of identity from any of the participant. No participant was harmed in the course of the study.

RESULTS

Response Rate

The response rate for the study was 69% (69/100).

Socio-demographic Characteristics

The majority (62.3%) of the respondents were within the age range of 20 – 29 years, 50.7% were males, 75.4% had been practicing for about 1 – 5 years, and 58.0% were practicing as a dentist in a public institution (Table 1).

Table 1. Background Characteristics of Respondents

 Knowledge of COVID-19

All respondents had heard of COVID-19 and the most common source of information on the disease was the social media. Also, more than half (56.5%) of the respondents had never received any lecture/seminar on COVID-19 (Table 2).

Table 2. Respondents’ awareness and sources of information about COVID-19

All respondents knew about the cause of COVID-19 and also that the virus can be transmitted through respiratory droplets. However, only 95.7% knew the family that the causative coronavirus belongs to. Furthermore, although not all the respondents knew about the incubation period, symptoms, and safety measures to be adopted in curbing COVID-19 transmission; however, the majority (≥76%) of them had this knowledge (Table 3).

Table 3. Respondents’ knowledge of COVID-19

Risk Perception of COVID-19

All the respondents perceived COVID-19 to be highly contagious and a potential cause of respiratory failure. Furthermore, all of them felt that it is not safe to see a COVID-19 patient without personal protective gears (Table 4).

Only 81.2% of the respondents perceived COVID-19 to be a severe infection. Virtually all (98.6%) of them identified that it is not safe to examine a COVID-19 patient without personal protective equipment (PPE) or partial use of PPE. Also, virtually all (98.6%) of them believed that physical distancing and good respiratory hygiene practices help to limit spread of the infection (Table 4).

  Table 4. Respondents risk perception on COVID-19

Attitudes towards COVID-19

Four (5.8%) respondents agreed that HIV/AIDS is better than COVID-19 by far. None of the respondents agreed that those infected with COVID-19 were immoral; similarly, none of them agreed that people living with COVID-19 should be thrown out of the community. However, more than half ([29+16]/69, 65.2%) of them indicated that they would like to help people that are infected with COVID-19 (Figure 1).