A STUDY OF THE AWARENESS AND PREVENTIVE MEASURES OF LASSA FEVER AMONG ADULTS IN BEKWARRA LOCAL GOVERNMENT, CROSS RIVER STATE

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CHAPTER ONE

 INTRODUCTION

1.1       Background of the Study

Lassa fever is an acute, virulent hemorrhagic disease with a very high rate of morbidity and mortality. It is a viral zoonotic disease endemic in West Africa, mostly in Nigeria. The virus is transmitted by the Multimammate rat (Mastomys natalensis) found in most sub-Saharan Africa (Enria, Mills, Bausch, Shieh, and Peters, 2011). Its awareness remains low in sub-urban or rural communities in Nigeria. It was discovered in 1969 in Lassa town in Borno State and first isolated the same year from a missionary who was working as a nurse at Jos mission hospital in Jos, Nigeria. (Gyoh, 2013).

According to Nigeria Center for Disease Control and Prevention (NCDC) (2015), there have been reported cases of suspected Lassa fever in Nasarrawa, Edo, Ondo, Gombe, Taraba, Bauchi, Ebonyi, Plateau and Lagos including Abuja. In 2015 alone, 350 suspected cases of Lassa fever, 46 lab confirmed, 101 deaths with CFR = 5.45% have been reported in Lagos, Abuja and 14 other states in Nigeria (NCDC, 2015). In early 2016, cases of Lassa fever were widely distributed within the country, as of January, 2016, Nigeria has reported one 172 confirmed and suspected cases of Lassa fever, including 83 deaths (CFR=48%) (NCDC, 2016). The Ministry of Health reported more than 1,700 cases with 112 deaths in 2012, with 36 deaths in 2013 and 989 cases during the dry season, typically from October- Novermber to February, but may vary according to the environmental conditions for the multimmate rats population.

The incubation period ranges from one to three weeks, usually around ten days (NCDC, 2016). About 80% of the infected people have mild or no symptoms and one in five infections results in severe diseases with multi-organ impairment. The onset of symptoms is non-specific in symptomatic cases with general weakness of the

body, sore throat and fever, nausea, vomiting, pharyngitis, dry cough, chest and abdominal pain in the first phase. In most severe cases, the intensity of the symptoms increases over a period of days and are characterized by hemorrhage (Pulmonary and intestinal, mucosal), facial swelling, respiratory distress, shock and symptoms of the central nervous system (WHO, 2016)^a, Proteinuria may be observed. Around 15-20% of hospitalized cases results in death. In pregnancy, Lassa fever is usually severe with spontaneous abortion during the third trimester (European Centre for Disease Control and Prevention (ECDC), 2015).

The dissemination of information on preventive measures of Lassa fever among rural dwellers cannot be over emphasized because these areas of extreme poverty, low socioeconomic status, overcrowding, poor housing facilities, inadequate or lack of health infrastructure and high level of illiteracy catalyze the outbreak and spread of Lassa fever both within and outside the community (Ilesanmi, Omotoso, Alele & Adewuyi, 2015).

1.2  Statement of the Problem

Statistics about Lassa feverare frightening and alarming. According to the world health organization (WHO), Lassa fever is endemic in West African countries such as Benin, Ghana, Liberia, Sierra Leone, Guinea and most especially Nigeria (WHO, 2015).

Studies have shown that up to half a million cases of Lassa fever with about five thousand death annually (WHO, 2011). It is estimated that 51 million Nigerian may be at risk of contracting the disease with the annual number of deaths at 58,330. Lassa fever kills in a thrail, it is not uncommon for it to wipe out a whole family (Ogundipe & Nanlong, 2016). The disease is highly contagious and usually result to death, also has a very high rate of mortality in hospitalized patients, those at risk include: rural dwellers, slum and overcrowded settlement, workers in the hospital as well as friends and relative of infected persons (Tobin, Asogun, Isah, Ugege & Ebhogagha, 2013).

Approximately 15% – 20% of patients hospitalized for Lassa fever die from the illness, however, over all 1% of infection with Lassa fever result in death. The death rates are particularly high for women in the third trimester of pregnancy and for fetuses about 95% of which die in the uterus of infected mothers, (Yun and Walker, 2012).The united state center for disease control and prevention report said symptoms of Lassa fever are mild and undetected in 80% and in 20%, the disease present serious symptoms, 15-20% of hospitalized patients die (US CDC, 2015).

Unfortunately, there is currently no vaccine that protects against Lassa fever, awareness and preventive measures seem to be the most effective tool for combating the dreaded disease which mostly occurs in the rural communities where the people are more exposed due to poor housing standard, poor food storage practice , inadequate or lack of health care infrastructure as well as poor environmental sanitation and personal hygiene and co-habitation with rodents (Ilesanmi, et al 2015; Oladeinde, Omergie and Odia, 2014).

 1.3       Objectives of the Study 

            General Objective

The general objective of this study is to determine the awareness and preventive measures of Lassa fever in Bekwarra Local Government Area of Cross River state, Nigeria.

Specific Objectives

The specific objectives of this study were:

1. To determine the awareness of Lassa fever in Bekwarra Local Government Area of Cross River state, Nigeria,
2. To determine the awareness of signs and symptoms ofLassa fever in Bekwarra Local Government Area of Cross River state, Nigeria.
3. To determine the risk factors of Lassa fever in Bekwarra Local Government Area of Cross River state, Nigeria.
4. To identify the methods of prevention ofLassa fever in Bekwarra Local Government Area ofCross River state, Nigeria.

1.4 Research Questions

1. What is the awareness of Lassa fever in Bekwarra Local Government area of Cross River state, Nigeria?
2. What is the awareness of the signs and symptoms of Lassa fever in Bekwarra Local Government Area of Cross River State, Nigeria?
3. What is the awareness of the risk factors of Lassa fever in Bekwarra Local Government Area of Cross River State, Nigeria?
4. What are the methods of preventing Lassa fever in Bekwarra Local Government Area of Cross River State, Nigeria?

1.5       Significance of the Study

The significance of this study is to highlight the awareness and preventive measures of Lassa fever among adults in Bekwarra Local Government; it will assist Non Governmental Organizations (NGOs), stakeholders and policy makers in evaluating, improving, and facilitating the implementation of evidence based strategies to prevent the outbreak of Lassa fever in Nigeria and Bekwarra local Government Area of Cross River State, Nigeria.

This study will also provide relevant information to stakeholders for Community Health Awareness Campaigns for Lassa fever. The findings of this study will serve as a baseline for future research.

 1.6 Limitations of the Study

There is paucity of research on the subject matter and by implication there is paucity of material, concerning the study area, so the researcher would have to work hard to get enough information on the study. Some households did not have an eligible respondent present, or refuse to give consent in the absence of the head of the household, the researcher arranged for a meeting with the eligible respondent whenever they felt convenient otherwise the next household was considered.

 1.7   Operational Definition of Terms

At risk: Being exposed to risk factors of Lassa fever, rats or causes of Lassa fever.

Awareness: The state of knowing that Lassa fever exists.

Endemic: Areas were Lassa fever is regularly found and is difficult to get rid of.

Fever: A condition of the body whereby the body temperature is higher than normal as a result of Lassa fever infection.

Lassa fever:  A Viral, Zoonotic disease transmitted by the Multimammate rat and characterized by severe fever and other symptoms.

Lassa fever: A Viral, Zoonotic disease transmitted by Multimammate rat and characterized by fever and severe bleeding.

Mortality: Death as a result of Lassa fever infection.

Preventive measures: actions or activities that stop or hinder the occurrence of Lassa fever infection.

Virus: A non cellular sub-microscope infectious organism that cause Lassa fever.

 Project Overview

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