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 Table of Contents  
Year : 2017  |  Volume : 12  |  Issue : 2  |  Page : 89-92

Evaluation of knowledge and awareness about the ebola virus disease among the medical undergraduate students: A cross-sectional study

Department of Anatomy, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka, India

Date of Web Publication8-Sep-2017

Correspondence Address:
Naveen Kumar
Department of Anatomy, Melaka Manipal Medical College, Manipal University, Manipal Campus, Udupi, Manipal - 576 104, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdmimsu.jdmimsu_48_17

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Introduction: Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, is a fatal illness and it can be transmitted to people from wild animals and spreads in the human population by human-to-human transmission. Proper awareness of viral infection is necessary for both general population and medical professionals in minimizing the rate of mortality of the infected individual. The current cross-sectional study has been undertaken to evaluate the level of awareness about EVD in medical undergraduate students at their early academic curriculum. Materials and Methods: A total of 282 MBBS students of Malaysian origin studying in India were included in the study. Faculty-validated close-ended questionnaire was designed which comprised the questions related to general and medical-related aspects of Ebola virus. Results: Overall knowledge on EVD was moderate (score 2) with a majority of students (59%) followed by 35% of students having a low level (score 1) of awareness and only minimal number (6%) of students having an adequate level of awareness (score of 3). Conclusion: Overall knowledge about EVD among the medical undergraduate students at their preliminary curricular stages was in a satisfactory range with a score of 2. Nevertheless, their awareness of medical perspectives of EVD is comparatively more than that of general aspects.

Keywords: Awareness, Ebola virus, Ebola virus disease, medical undergraduate

How to cite this article:
Abhinitha P, Yusof CP, Sinniah SS, Kumar N. Evaluation of knowledge and awareness about the ebola virus disease among the medical undergraduate students: A cross-sectional study. J Datta Meghe Inst Med Sci Univ 2017;12:89-92

How to cite this URL:
Abhinitha P, Yusof CP, Sinniah SS, Kumar N. Evaluation of knowledge and awareness about the ebola virus disease among the medical undergraduate students: A cross-sectional study. J Datta Meghe Inst Med Sci Univ [serial online] 2017 [cited 2021 Mar 7];12:89-92. Available from: http://www.journaldmims.com/text.asp?2017/12/2/89/214187

  Introduction Top

Ebola virus disease (EVD) was also known as Ebola hemorrhagic fever previously. It is a fatal illness if left untreated, can be transmitted to human beings from wild animals, and spreads in human population by human-to-human transmission. EVD first appeared in 1976 with the two simultaneous outbreaks: one in Nzara (Sudan) and the other was in Yambuku (Democratic Republic of Congo [DRC]). The latter occurred in the village situated near Ebola River, from which the virus and the disease got its name.[1] The most recent case of EVD was reported in 2014, in a private clinic of the DRC as an unknown cause initially. Due to improper aseptic precautions, several health-care workers believed to be exposed to Ebola virus.

The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are five species that have been identified: Zaire, Bundibugyo, Sudan, Reston, and Taï Forest. The Bundibugyo Ebola virus, Zaire Ebola virus, and Sudan Ebola virus have been associated with large outbreaks in Africa. The virus responsible for West African outbreak in 2014 belongs to the Zaire species.

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs, or other body fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines found ill or dead or in the rainforest.[2] Ebola also spreads through human-to-human transmission through direct contact (with broken skin or mucous membranes) with the blood, secretions, organs, or other bodily fluids of infected people and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. The incubation period for Ebola virus is estimated to be 2–21 days.

First symptoms of Ebola virus infection are the sudden onset of fever, fatigue, muscle pain, headache, and sore throat. These symptoms are followed by vomiting, diarrhea, skin rashes, symptoms of impaired kidney, and liver function and in some cases both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.[3] Supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improve survival. There is yet no proven treatment available for EVD. However, a range of potential treatments, including blood products, immune therapies, and drug therapies, are currently being evaluated.

In this context, it is better to have adequate knowledge about the various symptoms, mode of transmission, and aseptic precautions to be taken in Ebola infection among the general population. Such awareness is utmost important to the medical profession through them an effective campaign could be established. Therefore, the current cross-sectional study has been undertaken to evaluate the level of awareness on EVD in its both general and medical perspectives among medical undergraduate students during their early academic curriculum.

  Materials and Methods Top

The present cross-sectional study involved 282 medical undergraduate students studying in the pre- and para-clinical phase of MBBS course. Faculty-validated close-ended questionnaire with concealed point system was developed to test their awareness levels toward the EVD and associated facts. The questionnaire comprised both general and medical perspectives of EVD that could be answerable by the medical undergraduate students at their early curricular stages. The responses given by the students were coded as data.

Data analysis

All the responses were evaluated with regard to the choice of answer by students; this was then summated to provide an overall view of the basic understanding of students toward the objective of the study. Summated points were then used to tabulate various data inclusive of pie chart and bar diagrams. Unattended questions were awarded zero points which were also considered into an overall summation of the student's assessment by the questionnaire. The frequency table was prepared statistically using SPSS software (version 15.0).

  Results Top

The descriptive frequency statistics together with its percentage occurrence of both valid (corrected) and invalid responses for all the 15 questions comprising both general and medical related questions are depicted in [Table 1]. Accordingly, aspect number 2, 7, and 8 were in the least scored with the percentage of <25. Similarly, the question 4 representing medical knowledge question was also responded to be lowest valid.
Table 1: Statistical evaluation of data from the responses for questions of awareness with the frequency and percentage levels (n=282)

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The frequency profile as depicted in [Table 2] and [Figure 1] shows 6.4% (18) of medical undergraduate students with the frequency of 18 had an adequate level of awareness on Ebola virus infection, while 34.4% of students with the frequency of 97 had least aware of it. Nevertheless, a large majority of students (59.2%) had witnessed a moderate level of awareness about the fatal Ebola virus with the frequency of 167 out of 282.
Figure 1: Percentage incidence of categorized level of awareness of Ebola virus disease

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Table 2: Descriptive analysis of awareness pattern of medical undergraduate students about Ebola virus infection (1-least aware, 2-moderate, 3-adequate) awareness

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The awareness pattern of student participants' on EVD was categorized into two types; overall general knowledge and knowledge related to its medical perspectives.

Most of the students (61%) found to be lacking general aspects of EVD as only 39% of the participants correctly answered majority of these questions in the questionnaire [Figure 2]. On the other hand, 48% of students seem to know certain facts of EVD about its medical/clinical issues [Figure 3]. This shows that even though there is an overall lack of general knowledge on Ebola virus etiology, an adequate level of awareness on its clinical complications and pathogenicity is satisfactorily known among the medical undergraduate students.
Figure 2: General level knowledge profile about Ebola virus disease

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Figure 3: Medical perspective level of knowledge profile about the Ebola virus disease

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  Discussion Top

The recent outbreak of Ebola caused a lot of precautionary steps to be taken by the government and health officials which caused a lot of news and brochures on the symptoms of Ebola to be distributed in clinics, hospitals, and even advertisements on the media channels so that citizens can be well educated. These cause them to have more knowledge on this topic compared to general questions on Ebola. Besides that, as modern age students who are more prone to search the internet for answers are also curious as they encounter a new article as it stimulates them to read it. Hence, by this indirect learning method, they tend to gain more information rather than their book referring routine which is cumbersome to many as it is heavy and also not easily accessible. Rarity and lack of effective therapeutic and prophylactic measures of EVD cause public health significance in morbidity and mortality, particularly during its sudden outbreak.[4]

A cross-sectional study about awareness, knowledge, and misconceptions of EVD at a family practice setting in Nigeria by Shittu et al. reported the serious existence of misconceptions by 40% of participants with the belief that EVD is air borne.[5] A study conducted at Nigeria state also stated the suboptimal EVD-related knowledge, attitude, and perception among the schoolchildren. However, in the same study, a good number of students were able to respond positively to the questions stating three common modes of spread of EVD and top three signs of EVD involving abnormal bleeding from body parts, vomiting, and fever.[6]

In the current study, in an attempt of assessment of medical undergraduate student awareness level toward the EVD and its consequences, a majority of students (59.2%) were found having moderate awareness that could be regarded as “safe awareness category.” Of 282 participants, 97 of them (34.4%) admitted that they are “unaware” of the EVD. This is quite “risk factor” of being unaware about such life-threatening virus. Adequate awareness category toward Ebola virus was shown only by 18 students (6.4%) of the total number, and this category of students were very much aware of both contents of general knowledge questions as well as medical related questions. Therefore, they are regarded as “high awareness” category.

The lowest percentage of correct answers under the category of general awareness were identified for the questions such as the name from where the Ebola got its origin, its first discovery, and source of its outbreak. Among the medical perspective question, the lowest correct response was seen for the question related to the mode of Ebola viral transmission. Sufficient knowledge of its mode of transmission of any infections is utmost important, particularly to the medical professionals. The lack of such awareness could lead to problems to one's own health. This could lead to many fatalities if there is a sudden reemergence of this Ebola virus in the future.

The highest percentage of correctly answered questions were attributed to medical perspectives of EVD emphasizing mainly its mode of transmission and symptoms of the disease. The recent outbreak of Ebola virus probably made it popular through the social media where the Centers for Disease Control and Awareness together with WHO have frequently advertised the symptoms and dangers of disease to the public so that further spread can be controlled and least amount of people will be affected. In total, there was a higher percentage of students with the medical perspective level of awareness compared to the general level awareness.

An overall of 38.87% of medical undergraduate students had adequate awareness toward general aspects of EVD. The low level of awareness may be because students find it unnecessary to know the etiological data, history of its origin of Ebola, etc., in detail which is not going to help their curricular knowledge on EVD anyways. Therefore, students are not well versed regarding this issues.

A study on knowledge, attitude, and practices related to EVD done on a general population in Sierra Leone, a victim of Ebola outbreak, reported very interesting facts of awareness in different places. Authors have surveyed the general populations of different places and compared their level of awareness in different aspects such as information about the Ebola virus, the virus origin, various signs and symptoms of its diseases, and treatment or preventive measures.[7] Comprehensive knowledge on such fatal pathogen is a critical aspect in increasing the likelihood of individuals to accept the promoted prevention and medical-seeking behaviors.

  Conclusion Top

The current survey portrayed that medical undergraduate students have a moderate level of awareness toward Ebola virus. However, the students were more aware of medical aspects of the Ebola virus than its general background. This survey performed in their early curricular levels of medical study.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Richard VG, Hazel MD, Mark Z, Ivan MR, Peter LC. Marburg & Ebola hemorrhagic fevers. Mims' Medical Microbiology. Vol. 5. Philadelphia: Elsevier Saunders; 2013. p. 334-5.  Back to cited text no. 1
World Health Organization. Ebola Strategy, Ebola and Marburg Virus Disease Epidemics, Preparedness, Alert, Control, and Evaluation; 2014. Available from: http://www.mamaye.org.sl/sites/default/files/KAP%20Summary_Sept302014.pdf.  Back to cited text no. 2
Centers for Disease Control and Prevention. Ebola Homepage. Available from: http://www.cdc.gov/vhf/Ebola/. [Last accessed on 2014 Nov 14].  Back to cited text no. 3
Gupta N, Mehta N, Gupta P, Arora V, Setia P. Knowledge regarding Ebola hemorrhagic fever among private dental practitioners in Tricity, India: A cross-sectional questionnaire study. Niger Med J 2015;56:138-42.  Back to cited text no. 4
[PUBMED]  [Full text]  
Shittu RO, Sanni MA, Odeigah LO, Akanbi II AA, Sule AG, Isiaka-Lawal S, Aderibigbe SA. Awareness, knowledge and misconceptions about Ebola Virus Disease (EVD) in a family practice setting in Nigeria, West Africa. J Antivir Antiretrovir 2015;7:10-4.  Back to cited text no. 5
Ilesanmi O, Alele FO. Knowledge, attitude and perception of Ebola Virus Disease among secondary school students in Ondo State, Nigeria, October, 2014. PLoS Curr 2016;8. pii: Ecurrents.outbreaks.c04b88cd5cd03cccb99e125657eecd76.  Back to cited text no. 6
Catholic Relief Services. Study on Public Knowledge, Attitudes Practices Relating to Ebola Virus Disease (EVD) Prevention and Medical Care in Sierra Leone; 2014. Available from: http://www.mamaye.org.sl/sites/default/files/KAP%20Summary_Sept302014.pdf.  Back to cited text no. 7


  [Figure 1], [Figure 2], [Figure 3]

  [Table 1], [Table 2]


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