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LASSA FEVER AMONG HEALTH CARE WORKERS

Project Topic: KNOWLEDGE, ATTITUDE AND PREVENTION OF LASSA FEVER INFECTION AMONG HEALTH CARE WORKERS IN FEDERAL TEACHING HOSPITAL ABAKALIKI


ABSTRACT

 This is a descriptive cross sectional study of the population of healthcare workers in FETHA to ascertain their knowledge, attitude and preventive measures against Lassa Fever infection. The study population was 300 respondents out of (1175) healthcare workers in FETHA. The study population comprised the medical doctors, the nurses, the medical laboratory scientists, pharmacists, health attendants, community health extension workers (CHEWS) and physiotherapists. The study also cut across the entire departments in the teaching hospital. The data collected are displayed in tables, and analyzed with the analyzing software (epi info 2005 version). Amongst 300 respondents, % have heard of lassa fever while % knew that lassa fever infection is caused by lassa virus. % have no idea of the causative agent while few said that it is caused by bacteria, fungi and others. % respondent knew that lassa fever is transmitted through contact whereas % said it is through aerosol. Among the 300 respondents, 197(65.89%) admitted to have seen lassa fever patients, while 103(33.1%) said they have not seen lassa fever patient. Among the 197 respondents who admitted to have seen lassa fever patients, 140 (71%) have been involved in the management of the patients.  (%) of the respondents said that lassa fever can be prevented, they stated that lassa fever can be prevented by the following ways, use of nose mask  (%), use of gloves  (%), use of apron   (%), careful handling of body fluid  (%), while about (%) said that the patient should be avoided in order to prevent lassa fever. The findings from this study show that a high percentage of the health care workers of federal teaching hospital, Abakaliki have a good knowledge of lassa fever infection, as 96% know about the causative organism, 99% know about the vector, 88.7% know the modes of transmission, and 93% know the common presenting symptoms, and they also know that it has a very high infectious rate.

CHAPTER ONE

1.0       Introduction

Lassa Fever is an acute viral haemorrhagic and febrile illness caused by Lassa virus, a member of the arenavirus family of viruses7. It is transmitted to human from contacts with food or households items contaminated with rodent excreta.

The disease is endemic in the rodent population in parts of West Africa. Person to person infection and laboratory transmission can also occur, particularly in the hospital environment in the absence of adequate active control measures.

Diagnosis and prompt treatment are essential.

Background Information

History of Lassa Fever

Lassa Fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa virus1. The disease was first described in the 1950s, while the virus was first identified in 1969 when two missionary nurses died in the town of Lassa in Borno state, Nigeria, in the YedSer Ram river valley at the south end of Lake Chad. It was later named after the town in Borno state called, Lassa North eastern Nigeria, from where the first case of the disease described originated.

Lassa Fever is endemic in Nigeria, Sierra Leone. Guinea and Liberia. The disease carrying rats are however found throughout West Africa and the acute geographic range of the disease may be more extensive. The evidence of human infection has also been found in the Central Africa Republic, Congo, Mali and Senegal.

The infection has also been transported outside by travellers from endemic regions or visitors from outside. Thus, cases have been reported in Europe and the United States of America from patients with a history of travel to West African countries. The infection causes up to 300-500,000 cases with 5000 deaths annually.

In Nigeria, epidemics of the disease have been reported in:

Ebonyi State                           –           2005,2008, 2011,2012

Imo State                                            –           1989

Anambra State                                    –           1970,2012

Plateau State                           –           1969 and 1970

Nassarawa State                      –           2001

Ogun State (Abeokuta)           –           2005

Taraba State                            –           2007

Federal Capital Territory         –           2007 and 2008 etc.

Lassa Fever is also endemic in Edo State with yearly incidence of cases in Ekpoma and its environs. Other states includes: Kogi, Adamawa, Enugu and Benue State. Cases have been managed in Lagos State and Abuja.

Spread

Animal host and reservoir of Lassa virus is a multimammate rat, mastomysnatalensis, a frequent breeder, which generally readily colonizes human homes. These factors contribute to the relatively effective spread of Lassa Virus from infected rats to human.

1.2       Symptoms of Lassa Fever

They occur often about 3-21 days after the patient come into contact with the virus. They include fever, pain behind the sternum, sore throat, back pain, cough abdominal pain, vomiting, diarrhoea, conjunctivitis, facial swelling, protein in urine and mucosal bleeding.

1.3       Diagnosis of Lassa Fever

Lassa Fever can be diagnosed by these several methods: Enzyme-linked immunosorbent serologic assay (ELISA), Immunochemistry, culture and Reverse transcription polymerase chain Reaction (RT-PCR).

Facilities for confirmation of chemical diagnosis of Lassa fever are available at the institute of Lassa fever research and control (ILFRC), Irrua Specialist Teaching Hospital, Irrua, Edo State and also at the College of Medicine, University of Lagos, Nigeria.

1.4       Complications and Treatment

Deafness is the most common complication of Lassa fever.

Ribavirin9 is the specific antiviral drug for Lassa Fever, mostly effective when given earlier, i.e. within 6 days of the onset of fever, in the course of the illness. Patient should also be given supportive therapy.

Barrier Nursing is Important.

1.5       Importance of the Study

It will help to find out the attitude of health care workers in Federal Teaching Hospital Abakaliki, towards Lassa Fever.

It will help government and health authorities at various levels to create awareness on the preventive measure of Lassa fever where necessary.

This study is imperative in this era that efforts are geared towards meeting the millennium development goals (MDG’s) by 2015, particularly MDG 1,4 and 6 because Lassa Fever is a common cause of ill health, particularly in rural areas and sub-urban areas. Accordingly, it has a large impact on productivity and therefore, poverty reduction programs. It is a major cause of maternal death and foetal loss in endemic areas.

1.6       Objectives of the Study

The National Lassa Fever stake Holder’s Forum of Nigeria held a conference in Abuja in December, 2007 with the theme “Challenge of Lassa Fever epidemic in the sub-region: The way forward” hence the objective of the study are:

GENERAL OBJECTIVE

To determine the knowledge, attitude and prevention of Lassa Fever among health care workers in FETHA.

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KNOWLEDGE, ATTITUDE AND PREVENTION OF LASSA FEVER INFECTION AMONG HEALTH CARE WORKERS IN FEDERAL TEACHING HOSPITAL ABAKALIKI

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