Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
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Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : June | Volume : 16 | Issue : 6 | Page : DC06 - DC08 Full Version

Knowledge, Attitude and Practices Regarding Utility of CBNAAT in the Diagnosis of SARS-CoV-2 Disease among Medical Interns: A Cross-sectional Study


Published: June 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/55666.16528
Anindita Ballav, Susmita Bhattacharya, Parthasarathi Chakrabarty, Debalina Das

1. Senior Resident, Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India. 2. Professor, Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India. 3. Associate Professor, Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India. 4. Assistant Professor, Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.

Correspondence Address :
Dr. Debalina Das,
8 B.L Ganguly Lane, Kolkata, West Bengal, India.
E-mail: drdebalinadas63885@gmail.com

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) causes respiratory tract infections in human beings ranging from mild illnesses like common cold to severe disease like pneumonia. Currently, nucleic acid amplification tests Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and Truenat) and rapid antigen detection tests are approved for diagnostic purpose by Indian Council of Medical Research (ICMR). Medical Interns, the primary contact health-care personnel, need to be sensitised regarding proper utilisation of CBNAAT, so that rapid and accurate diagnosis of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) can be made in comparison to the more commonly used RT-PCR technique.

Aim: To evaluate the Knowledge, Attitude and Practices (KAP) of Bachelor of Medicine and a Bachelor of Surgery (MBBS) interns towards accessibility of CBNAAT in SARS-CoV-2 infection in a tertiary care hospital.

Materials and Methods: A cross-sectional study was performed through questionnaire shared via online platform amongst 102 Medical interns working at College of Medicine and Sagore Dutta Hospital from 22nd August 2021 to 21st September 2021. Based on their response, KAP was assessed by using a three-point Likert Scale. The collected data was entered in Microsoft excel, and reported as frequencies and percentages.

Results: Among 102 internees, 84 interns responded. Among 84 medical interns 31% had good, 50% had average whereas 19% had poor level of knowledge. About 58 (69%) agreed that CBNAAT can be used as a method for rapid diagnosis of SARS-CoV-2. About 75 (89.3%) answered that they are sending samples for COVID-19 testing. Only 56 (66.7%) agreed that CBNAAT should be recommended.

Conclusion: This study revealed that majority of the MBBS interns had positive attitude towards different aspects of CBNAAT utility but most of them had gaps in their KAP. This demands extra efforts to sensitise and train them adequately.

Keywords

Attitude and practice study, Coronavirus Disease-2019, Cartridge based nucleic acid amplification test

Coronaviruses (CoV) represent a major group of viruses causing respiratory tract infections in human beings. The illnesses may vary from mild common cold to severe disease like pneumonia. After SARS in 2003 and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, emergence of SARS-CoV-2 has been arousing profound global health concern (1),(2). This began as an outbreak in December 2019 and had spread to more than 200 countries within five months. This has started in Wuhan, China in December 2019, probably due to cross-species transmission (3). World Health Organisation (WHO) has declared it as pandemic on 11th March, 2020 (4). This deadly virus is the causative agent of COVID-19. It can proliferate through respiratory droplets and via close contact with infected person (1),(2). About 80% of individuals who are infected didn’t show any noticeable symptoms and however capable to transfer the infection rapidly (2). Due to its unique transmission potentials and lack of definitive antiviral therapy, SARS-CoV-2 caused wide spread infection throughout the world. Evidence shows that Healthcare Workers (HCWs) are particularly at high risk of acquiring SARS-CoV-2 infection from hospitalised patients, resulting in loss of precious man-power, panic and even shutting down of hospitals because of limited staff (5).

As of now there is no particular treatment against COVID-19, social distancing, face masks and frequent hand washing with soap or alcohol based hand rubs are still the major prevention measures in the population (6). Besides all those preventive measures, timely diagnosis of cases is one of the most important tools in breaking the chain of COVID-19.

Currently nucleic acid amplification tests RT-PCR, CBNAAT Truenat) and rapid antigen detection tests are approved for diagnostic purpose by ICMR. Among these, nucleic acid testing modalities are confirmatory but require dedicated infrastructure and trained technicians. However, in hospitals with large number of patients RT-PCR is one of the most acceptable diagnostic modality as more than 90 samples can undergo testing in one time. But it has its disadvantage i.e. long turn-around-time. In contrast, turn-around-time in CBNAAT and Truenat is very less i.e. an hour and even single sample can be tested. More over CBNAAT and Truenat do not require huge infrastructure. Lastly rapid antigen detection test can be used as point-of-care test but a negative result need to be confirmed by nucleic acid detection method (7).

ICMR has approved Cepheid Xpert Xpress SARS-CoV2 (CBNAAT) use from the beginning of pandemic. CBNAAT test should be run under Bio Safety Level-2 (BSL-2) conditions and with appropriate biosafety precautions. This test detects Envelope (E) gene and also the SARS-CoV-2 specific N2 region of the Nucleocapsid (N) gene (7),(8). CBNAAT/Xpert Xpress being rapid and considerably reliable test for COVID-19 confirmation will greatly reduce the turnaround time, which is a key factor in emergency case detection (9),(10). Also, the workload of testing centres can be reduced to a large extent by using high throughput CBNAAT/ Xpert Xpress machines. However, the limiting factor behind the mass use of high-throughput machines and cartridges is their high cost (11).

The KAP assessment of HCWs and medical students toward such outbreaks is essential due to the large amount of misconceptions and false information that are circulating on social media (12). Previous viral epidemics like SARS, MERS and Ebola have shown that the assessment of KAP among HCWs is actually considerably useful in raising awareness about best practices and educating them (13),(14),(15).

Medical Interns, being the 1st contact health personnel in hospitals need to be sensitised towards proper utilisation of CBNAAT, so that rapid and considerably accurate diagnosis of SARS-CoV-2 can be made in comparison to the more commonly used RT-PCR technique. Also, there is no particular study published with regard to KAP study towards CBNAAT in COVID-19 era in medical students. Hence, this KAP study was conducted to assess the existing KAP among MBBS interns regarding CBNAAT COVID-19 diagnosis and justify the need for conducting further training.

Material and Methods

A hospital-based descriptive type of cross-sectional study was conducted on MBBS interns, who were posted at College of Medicine Sagore Dutta Hospital, Kolkata, a tertiary care teaching hospital in West Bengal, India, from 22nd August 2021 to 21st September 2021 after getting permission from Institutional Ethics Committee (IEC) (Memo No: CMSDH/ IEC/ 241/08/ 2021 dated on 21/08/2021). A departmental core committee was formed comprising of the members of this study to design it appropriately and prepare a questionnaire also based on experience of members in the department. The questionnaire form was posted and circulated using various social media platforms (Google form was circulated through E-mail or Whatsapp) among the participants. The study participants were informed about the details of the study objectives for filling the questionnaire at the beginning of the study.

Inclusion criteria: All MBBS interns (total 102) of the current batch who expressed willingness to participate (total 84) in the study and signed an informed consent form were included in the study. Identity of all the study subjects was kept confidential.

Exclusion criteria: Those interns who were unwilling to participate in the study (total 18 interns did not participate).

A self-designed questionnaire was prepared by authors and sent to experts for their valuable opinions regarding the validity of the questionnaire. No pre-questionnaire training was imparted to the participating interns in this department. The questionnaire had three parts. First part included socio-demographic data (age and sex). The second part of the questionnaire was about knowledge and consisted of eight close ended questions. One mark was allotted to each question. In case of no answer from the participant, the response was considered and marked as incorrect and thus the total correct response was calculated. Knowledge score was calculated out of a total score of 8 (eight). Knowledge level was categorised as good, average and poor on the basis of their knowledge score. Those interns who scored <3 were classified as poor, score between 4-6 were considered as average and score >7 were marked as good. Third part of the questionnaire contained five close ended questions which included attitude and forth part contained two close ended question included practices of the interns towards CBNAAT for COVID-19 diagnosis. Attitude and practice was assessed by using a three-point Likert Scale. All the study participants who agreed were marked as positive attitude practice and those, who disagreed, or were neutral; were considered to have negative attitude and practice. After the completion of the questionnaire session, the core committee conducted a training session for those participating MBBS interns. The objective of the session was to train them on the utility of CBNAAT COVID-19 testing on the following points - sample collection and transportation, sensitivity and duration of CBNAAT testing and comparison of CBNAAT testing with RT-PCR.

Statistical Anaylsis

Data was entered in Microsoft excel. Descriptive data was reported as frequencies and percentages.

Results

Among 102 internees 84 responded. Rest of the participants (18) did not responded. Most of them were in the age group of 22-26 years, 52.4% were male and 47.6% were female. Subjects’ knowledge level was classified into three categories i.e having poor, average or good. Among 84 medical interns 31% had good, 50% had average whereas 19% had poor level (Table/Fig 1).

Among 84 interns, 58 (69%) thought that CBNAAT can be used as a part of rapid diagnosis in SARS-CoV-2 infection. Of them, 50 (59.5%) agreed that CBNAAT is helpful in diagnosis of SARS-CoV-2 infection in hospitals with limited settings. Only 44 (52.4%) accepted that a single CBNAAT positive test is to be considered confirmatory, without any repeat testing. 54 (64.3%) agreed that CBNAAT significantly reduce the time to detect SARS-CoV-2. 76 (90.5%) agreed that specimen collection and transfer of sample for CBNAAT must be performed using appropriate Personal Protective Equipment (PPE) (Table/Fig 2).

Among 84 interns, 75 (89.3%) were sending samples for CBNAAT testing for SARS-COV-2 detection being the primary patient contact health-care personnel and 56 (66.67%) thought that CBNAAT should be recommended to others than for tuberculosis (Table/Fig 3).

Discussion

The clinical and epidemiological management of the COVID-19 pandemic is dependent on molecular assays with short turn-around time. Goldenberger D et al., validated the novel Xpert Xpress SARS-CoV-2 assay and found an excellent concordance over a range of SARS-CoV-2 loads and across established human coronaviruses (16). The current study was done among MBBS interns to assess their KAP concerning the application of CBNAAT test with regard to SARS-CoV-2 infection. To the best of authors knowledge, this was a pioneering systematic KAP study conducted on junior doctors regarding utilisation of CBNAAT for diagnosis of microbial agents other than for tuberculosis. Yadav S et al., conducted a similar study among the junior and senior residents regarding the utility of CBNAAT testing in diagnosis of pulmonary, extrapulmonary and drug resistant tuberculosis. As present study is a novel study, however, authors could only compare present study with the study conducted by Yadav S et al. They showed that knowledge level is on an average of 58.3% in residents without training which is almost similar to present study observation (17). Similar to this study, majority of the interns showed positive attitude and practices regarding CBNAAT testing in diagnosis of SARS-CoV-2 infection (17). Medical Interns are the first contact health personnel in the hospitals. So, they need to be present study about a method which can accurately detect SARS-COV-2 infection and is rapid too. The CBNAAT method, though used mostly for rapid and accurate diagnosis of tuberculosis, can be utilised for this purpose with a different cartridge but utilising the same machine. Thus, diagnosis of SARS-COV-2 can be done very rapidly compared to the more commonly used RT-PCR technique. In case of emergency situations like urgent need to undertake operations or to conduct maternal delivery, the role of CBNAAT for diagnosis of COVID-19 infection is very helpful (18). The junior doctors should be aware of these facts, though they have not been trained about it. Another KAP study by Gahlot A et al from UP in 2020 regarding SARS-CoV-2 infection and its control amongst medical students showed positive results in students like present study. They also focused on constant need of updating knowledge of the HCW’s concepts about COVID-19. They further stated that periodic educational interventions, training programs and conducting webinars on infection control practices for COVID-19 for all HCWs and students can be pivotal for improvement (19). Authors regularly conduct training and feedback programs for all categories of HCWs including medical interns. This study highlighted the importance of training on CBNAAT COVID-19 testing under emergency situations for medical professionals.

Limitation(s)

One of the major drawbacks of the study was the sample size, which was limited to the medical interns of College of Medicine and Sagore Dutta Hospital. So, it could not be generalised. Another limitation was inherent biases of self-reported questionnaire.

Conclusion

ICMR recommends CBNAAT testing for diagnosis of SARS-CoV-2 infection from the beginning of this pandemic. However, knowledge response remained average as reflected in the present study. This demands extra efforts for training and retraining of junior doctors because they act as primary contact of the patients in most cases. This point of care test is needed for quick and precise diagnosis to contain the spread of infection the soonest. The turn over time of CBNAAT COVID-19 testing is very short (an hour) compared to the more common RT- PCR test which takes about 24 hours detection time.

References

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Chatterjee P, Nagi N, Agarwal A, Das B, Banerjee S, Sarkar S, et al. The 2019 novel coronavirus disease (COVID-19) pandemic: A review of the current evidence. Indian J Med Res. 2020;151(2-3):147. [crossref] [PubMed]
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Huang L, Zhang X, Zhang X, Wei Z, Zhang L, Xu J, et al. Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study. J Infect. 2020;80(6):e1-3. [crossref] [PubMed]
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Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. The Lancet Public Health. 2020;5(9):e475-83.
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DOI and Others

DOI: 10.7860/JCDR/2022/55666.16528

Date of Submission: Feb 15, 2022
Date of Peer Review: Mar 12, 2022
Date of Acceptance: May 03, 2022
Date of Publishing: Jun 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 18, 2022
• Manual Googling: Apr 30, 2022
• iThenticate Software: May 02, 2022 (22%)

ETYMOLOGY: Author Origin

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