Assessment Of Knowledge And Prevention Of Lassa Fever Among People Attending Primary Health Care

Abstract

This study was on assessment of knowledge and prevention of lassa fever among people attending primary health care. The total population for the study is 200 staff of selected health centers. The researcher used questionnaires as the instrument for the data collection. Descriptive Survey research design was adopted for this study. A total of 133 respondents made doctors, nurses, lab technicians and junior staffs were used for the study. The data collected were presented in tables and analyzed using simple percentages and frequencies.

 Chapter one

Introduction

1.1Background of the study

Lassa fever  is  an acute  viral  hemorrhagic  illness  caused by  Lassa  virus,  a  member  of  the  virus  family Arenaviridae.  The  disease  is endemic  in    Sierra  Leone, Guinea,  Liberia,  and  Nigeria  (Bowen  et  al.  2000)  where The  number  of  Lassa  Fever  virus  infections  per  year    is estimated  at  100,000  to  300,000  with  approximately 5,000  deaths  (Bowen  et al.,  2000;  Gunther  et  al.,  2000; World   Health  Organisation (WHO),  2005,  WHO,   2000). Outbreaks    have    been    reported    in    Ghana,  and  serological  evidence  of  human  infection  has  been  found in  Ivory    coast  ,  Senegal  and    Mali.  (Richmond  and Baglole,  2003).  The  virus  has  also  been  imported  into countries  where  it  is  not  endemic,  for  example,  by returning  travelers  (Gunther  et  al.,  2000).  The  virus exhibits  persistent,  asymptomatic  infection,  with  profuse urinary  virus  excretion  in  Mastomys  natalensis,  the ubiquitous  and  highly  commensal  rodent  host Keenlyside et al., 1983; Monath  et  al., 1974). The virus is  shed  in their  excreta  (urine  and feces),  which  can  be aerosolized and inhaled by  humans (Viral  haemorraghic fever consortium, 2011). Primary mode of spread is from rodent  to  man  through  contact  with  rodent  excreta  or urine in food or during hunting and processing of  rats  for consumption.  The  virus    has  the  capacity  for  person-to-person spread, either  within households  during  care  for  sick  relatives  or  in  health care  settings (Fischer-Hoch, 2005).  Percutaneous  or  per-mucosal  exposure  to  blood and  other  infected  body  fluids,  especially  if  the  fluids contain  blood,  can  result  in  secondary  human  spread. This  type  of  transmission  is  the  most    likely    route    in  health  care    settings  (Aranoff  et  al.,  1997).  This nosocomial  hazard  can  be  minimized  by  proper  and timely infection-control measures, careful management of infected patients, and, in some  cases,  administration  of prophylactic  therapy  to  health  care  workers  after exposure  (Weber    and  Rutala    2001;    Morbidity    and  Mortality  Weekly  Review  (MMWR)  1988).  Lassa  fever presents at  it’s      early  stage    with  symptoms and signs indistinguishable  from  those  of    other  viral,  bacterial  or parasitic  infections  common    in  the  tropics    such  as malaria,  typhoid    and  other  viral  haemorrhagic  fevers (Richmond    and    Baglole,  2003).  Laboratory  testing  is  required   for   confirmation.   Untreated,  Initial  flu-like and gastrointestinal symptoms  give  way  to  bleeding, organ failure  and  neurological  complications  (Bausch  et  al., 2001). The  drug ribavirin is effective if administered early following  infection  (McCormick  et  al.,  1986).   When  the disease  is  in  an  advanced  stage,  even  state-of-the-art intensive care cannot prevent a fatal outcome.  A suspect must  be  rapidly  excluded  or  verified  to  facilitate appropriate  case  management,  including  treatment,  the implementation  of  isolation  measures,  or the  tracking  of contact persons   (Haas et al., 2003) Late diagnosis   and  treatment    also  increases    the  likelihood  of  secondary transmission,  including    nosocomial    transmission.  It  is  therefore    imperative    that    health  care    workers  in endemic  communities    are  adequately  sensitized  on  the disease, it’s clinical  features  and  diagnosis.

Lassa fever is commonly found in  rural  communities,  where  the  over  70%  of  the  population  resides (Kelly et al., 2003).  The  focus  of  research into  awareness  of  Lassa  fever  has  been  till  date  population  based,  and  shown    varying    degrees    of    knowledge.    There    has  been   no  published  study   on  the  level  of  knowledge  among  health  workers,   and   particularly,  primary  care   providers.    This    has    much    implications    for    limiting  mortality  from  Lassa fever,  as  the greater  proportion of  people   live    in   the   rural   communities,  where    poverty  prevails    and    standards    of    living  are  low.  In  those communities, assess  to orthodox  medicine is  commonly through  the  Private   practitioner’s  clinic  or  the    Primary  health    centre.    These   are    more  likely  to    be    few   in  number,    ill-equipped   and    under    staffed. When   these  health  providers    are    themselves    ignorant    of  the disease,    the  tendency    to    misdiagnose    and      treat  wrongly  not   only  puts  the  health  worker   at  risk,  but  also  endangers  the  lives  of  the  close  family  contacts  and    community   at  large. Till  date,  there  has  been   no  published  study  to   assess the knowledge primary  care givers  in  these  rural communities  have of Lassa  fever. Moreso, the emergence of highly virulent and  contagious Lassa virus  in many more districts and states in  endemic countries  of  the  West  African  sub-region  and  the increasing  sporadic  cases  of  Lassa  fever  outside  the endemic  regions  within  and  outside  Africa  as  a  result of huge  inter-border  traffic  and  international  travels, necessitates  that  health  care  providers  should  have comprehensive  information  about  the  virus  and  the disease  it  causes Furthermore,  Lassa  virus  has  been associated with nosocomial outbreaks with high mortality, hence,  early  identification  of  infected  individuals  is important  for  prompt  implementation  of  appropriate barrier  nursing  guidelines  (Fischer-Hoch  et  al.,  1995; Mertens et al., 1973; White, 1972)

Statement of the problem

Since  Lassa  fever  was  first  described,  medical practice  in  much  of  rural  and  urban  Africa,  including Nigeria,  has  grown  substantially,  with  proliferation  of small  hospitals  and  clinics  run  often  with  emphasis  on profit,  and  which employ staff with little formal education or professional training outside of the meagre experience gained  at  their  workplace.  In  Nigeria  these  shoulder  a large  burden  of  the  medical  care  of  the  most  populous country in Africa (Fischer-Hoch, 1995). Based on this background the researcher wants to investigate Assessment of knowledge and prevention of lassa fever among people attending primary health care

Objective of the study

The objectives of the study are;

1. To ascertain the causes of Lassa fever
2. To ascertain about primary health care workers knowledge about Lassa fever
3. To investigate about the health care workers knowledge about prevention measure of Lassa fever

 

Research hypotheses

HO: There are no the causes of lassa fever

HI:   There are the causes of lassa fever

Hypothesis Two

HO:   health care workers  have no knowledge about prevention measure of Lassa fever.

HI:   health care workers have knowledge about prevention measure of Lassa fever

Significance of the study

The study will be very significant to students and ministry of health, the study will give a clear insight on the Assessment of knowledge and prevention of lassa fever among people attending primary health care. The study will also serve as a reference to other researcher that will embark on the related topic

Scope and limitation of the study

The scope of the study covers assessment of knowledge and prevention of lassa fever among people attending primary health care. The researcher encounters some constrain which limited the scope of the study;

1. a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study
2. b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.

1.7 DEFINITION OF TERMS

Attitude: attitude is a psychological construct, a mental and emotional entity that inheres in, or characterizes a person. They are complex and are an acquired state through experiences

Perception: the ability to see, hear, or become aware of something through the senses.

Lassa fever: Lassa fever, also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, headaches, vomiting, and muscle pains

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