ABSTRACT
Background: A successful pandemic response in populated geographies and resource-limited settings like India relies on informed decision making. Knowledge, attitudes, and practices (KAP) studies performed during these times are crucial to illustrate how well a community adopts prevention strategies. Objective: The present study, conducted during the peak months of the first wave of the COVID-19 pandemic, aimed at assessing the KAP levels of internet-savvy Indians. Methods: This observational cross-sectional study was conducted between 20 May and 10 October 2020. We employed a self-reported questionnaire using Google Forms, containing two parts-demographics and KAP evaluation-with the latter having three subsections of 10, 5, and 5 questions each. Data from completed questionnaires were extracted and exported from Google Forms and coded. Descriptive statistics and first-order analysis were conducted. Binary logistic regression was performed with a 95% confidence interval to determine significant associations between categorical dependent and independent variables. Results: We received responses from 1154 participants (58.84% male). Most respondents had good knowledge of the disease transmission course (92.55%), showed seriousness towards the emerging illness (91.07%), had a good attitude towards personal hygiene and physical distancing (93.76%), and had followed good safety/hygienic practices (93.76%). Good attitudes differed significantly between Karnataka and Tamil Nadu provinces (OR 1.053; 95% CI 0.588-1.886; p = 0.0439). The survey participants did not show any significant gender differences in any question types (p > 0.05). Conclusions: The results obtained add significant value to the existing KAP literature on COVID-19 in India and may help policymakers achieve public compliance with preventive measures.
ABSTRACT
Coronavirus Disease 2019 (COVID-19), during the second wave in early 2021, has caused devastating chaos in India. As daily infection rates rise alarmingly, the number of severe cases has increased dramatically. The country has encountered health infrastructure inadequacy and excessive demand for hospital beds, drugs, vaccines, and oxygen. Adding more burden to such a challenging situation, mucormycosis, an invasive fungal infection, has seen a sudden surge in patients with COVID-19. The rhino-orbital-cerebral form is the most common type observed. In particular, approximately three-fourths of them had diabetes as predisposing comorbidity and received corticosteroids to treat COVID-19. Possible mechanisms may involve immune and inflammatory processes. Diabetes, when coupled with COVID-19-induced systemic immune change, tends to cause decreased immunity and an increased risk of secondary infections. Since comprehensive data on this fatal opportunistic infection are evolving against the backdrop of a major pandemic, prevention strategies primarily involve managing comorbid conditions in high-risk groups. The recommended treatment strategies primarily included surgical debridement and antifungal therapy using Amphotericin B and selected azoles. Several India-centric clinical guidelines have emerged to rightly diagnose the infection, characterise the clinical presentation, understand the pathogenesis involved, and track the disease course. Code Mucor is the most comprehensive one, which proposes a simple but reliable staging system for the rhino-orbital-cerebral form. A staging system has recently been proposed, and a dedicated registry has been started. In this critical review, we extensively analyse recent evidence and guidance on COVID-19-associated mucormycosis in India.