ANNALS OF IBADAN POSTGRADUATE MEDICINE
The Annals of Ibadan Postgraduate Medicine (Journal of the Association of Resident Doctors, U.C.H. Chapter) is published bi-annually.
O.S. Ilesanmi1,2, A.O Kareem3 , A.A. Afolabi1 , A.J. Kareem4 and V. Ukwenya5
Background: Infection Prevention and Control practices are required to manage COVID-19 and Lassa fever (LF). We aimed to assess COVID-19 and LF risk perception and knowledge, attitude, and practices (KAP) towards prevention among doctors and nurses in a treatment centre in Ondo State, Nigeria.
Methods: We conducted a comparative cross-sectional study using semi-structured interviewer-administered questionnaires. We computed KAP scores with ‘‘+1’’ for correct response and ‘‘0’’ for incorrect response. Cumulative scores >80% implied good KAP of LF and COVID-19. Chi-square test was used to assess associations between sociodemographic characteristics and COVID-19 and LF KAP. P-values<0.05 were statistically significant.
Result: The mean age of respondents was 37.81±8.46 years. Risk perception scores were 2.82±0.53 for LF and 2.76±0.58 for COVID-19 (p=0.002). Mean overall knowledge scores towards prevention were 18.48±2.08 for LF and 15.59±3.22 for COVID-19 (p<0.001). Practices towards prevention scores were 18.18±2.27 for LF and 15.89±1.47 for COVID-19 (p<0.001). Concerning LF, 72.8% of doctors had good knowledge of prevention compared to 42.9% nurses (p<0.001), 18.3% of doctors had good attitude to LF prevention compared to 27.2% nurses (p=0.039). Also, 84.8% nurses had good LF preventive practices compared to doctors (64.5%) (p<0.001). A strong positive correlation (r=0.72) existed between COVID-19 and LF risk perception (p<0.001).
Conclusion: Continuous on-the- job trainings are needed among doctors and nurses in LF and COVID-19 treatment centres.
Keywords: Coronavirus, Lassa fever, COVID-19 knowledge, Lassa fever knowledge, COVID-19 attitude and practices, Lassa fever attitude and practices.
Dr. O.S. Ilesanmi
Dept. of Community Medicine,
College of Medicine,
University of Ibadan,
The outbreak of the novel Coronavirus (COVID-19) has reiterated the vulnerability of the entire globe to pandemics, and has had a huge impact across many systems and sectors.1,2 The health sector has also not been spared from the COVID-19 experience.2,3 This is evident in the overwhelming of COVID-19 treatment centres, the need for more bed units for patients’ care, and increased pressure and workload on healthcare workers (HCWs), especially doctors and nurses.4 These characteristic features of the pandemic are likely to cause COVID-19 transmission in healthcare settings. In this regard, infection, and prevention control (IPC) measures have been recommended to be practiced at the treatment centres for protection against COVID-19.4 These practices are required among all HCWs especially doctors and nurses who are directly involved in providing care to COVID-19 and Lassa fever positive patients. Adequacy of knowledge is however required to influence the attitude and practices of these cadres of HCWs regarding the recommended IPC measures.3,5
Globally, nearly 87 million cases of COVID-19 have been recorded between 31st December, 2019 and 6th January, 2021.6 The COVID-19 infection toll in Africa has risen to 2,879,193 laboratory confirmed cases. 6 In Nigeria, 77,299 laboratory-confirmed COVID-19 cases have been recorded, out of which more than 800 cases have been recorded among HCWs.6 The increasing rate of COVID-19 infection among HCWs has been attributed to poor IPC measures in health facilities, especially the COVID-19 treatment centres.7 The reported shortages of personal protective equipment (PPE) have equally contributed to increased risk for COVID-19 infection among HCWs.7 These reasons therefore imply that HCWs bear multiple risks while dispelling their duties during the COVID-19 pandemic. Firstly, HCWs provide frontline care to COVID-19 patients who could expose them to COVID-19 infection.7 Secondly, they bear the risk of onward transmission of COVID-19 to families, friends, and colleagues.7 To reduce the vulnerability of HCWs to increased risk of COVID-19 infection, compliance with safety guidelines need to be accentuated during this period as noted in previous epidemics.
The Nigerian population and health system have been faced with several epidemics prior to the emergence of COVID-19.8 The Lassa fever (LF) outbreak is especially notable due to its rapid transmission rates, potential fatalities, and a significant overwhelming of the health system. HCWs in resource-poor settings are particularly vulnerable to LF outbreaks due to the unavailability of IPC materials and defaulting from IPC compliance.9 Non-adherence to recommended IPC measures in healthcare settings have however been reported as potential factors for LF outbreaks.9 High levels of LF transmission have been documented from studies conducted in healthcare facilities where IPC measures such as regular handwashing and use of face masks and hand gloves have not been frequently practiced.10 Poor IPC practices have been described as an outplay of the poor knowledge of both LASV disease and IPC measures among HCWs, including nurses and doctors. The possession of adequate knowledge regarding LF and its preventive measures is needful to address all potential sources of its infection and reduce the potential for sporadic outbreaks of LF both within and outside healthcare facilities.11
Given the high attack rate associated with COVID-19 and fatalities associated with viral haemorrhagic fevers including LF, appraisal of the risk perception and KAP among HCWs is not only necessary but also expedient. Therefore, it is needful to assess the attitudes and practices of HCWs especially doctors and nurses who provide frontline care to patients. A study of this nature is timely and imperative considering the need for good IPC practices, improved health service delivery and enhanced workplace safety regarding the management of COVID-19 and LF. This study therefore aimed to assess COVID-19 and LF risk perception and knowledge, attitude, and practices (KAP) towards prevention among doctors and nurses in a treatment centre in Nigeria.