KNOWLEDGE, PERCEPTION AND ATTITUDE TO CHOLERA OUTBREAK AMONG RESIDENTS IN IBADAN NORTH-WEST LOCAL GOVERNMENT AREA, NIGERIA

Abstract

Cholera outbreaks have profound impacts on the health and well-being of communities. Rapid containment of outbreaks largely depend on people's knowledge, perceptions and attitude to the disease. Studies have shown an increase of outbreaks in developing countries. Ibadan Northwest (IBNW) Local Government Area (LGA) experienced recurrent cholera outbreaks between June and November 2011 in spite of cholera control programmes in Oyo state. Furthermore several studies have been done on perception of emerging disease outbreak but few on cholera outbreaks. Information on knowledge, perception, attitude to cholera outbreaks are important for planning preventive health educational programmes and this study was conducted to assess knowledge, perception and attitude to cholera outbreak among residents of IBNW LGA. The cross-sectional design used a four-stage sampling technique to select 7 inner core, 4 transitory and 4 peripheral communities out of 28, 15 and 17 communities respectively. Household from each community was selected based on sample size proportionate to size and 427 respondents from IBNW LGA. Respondents were interviewed using a semi-structured questionnaire which included questions on socio-demographic characteristics, knowledge, perceived vulnerability (likelihood of being infected by a disease), perceived severity and attitude to cholera outbreak. Knowledge was scored on a 19-point (score of ≤10 rated poor), perceived vulnerability on 15-point (scores of :57 rated low) while perceived severity was scored on 25-point (:512 rated low) scales. A 24-point scale was used to score attitude to cholera outbreak (score of ≤12 rated negative). Data were analysed using descriptive statistics, Chi-square and logistic regression at p= 0.05. Respondents' age was 35.0±11.4 years, 70.7% were females, 69.1% were married and 93.4% were Yoruba. Most (95.3%) of the respondents had good knowledge of cholera. About 71.4% respondents knew the cause of cholera and most (97.2%) knew diarrhoea and (96.3%) vomiting as clinical symptoms of cholera. Many (69.8%) ate food prepared outside the house. The commonest source of information during an outbreak was the radio (38.6%). Majority respondents (62.3%) perceived their vulnerability to cholera to be low while 98.1 % perceived severity of cholera to be high. Significantly, more respondents residing in the inner core communities perceived themselves vulnerable to cholera (OR=23.7: CI 9.64-58.31). Majority (71.2%) of the respondents had positive attitude in the mitigating efforts during a cholera outbreak. Respondents aged 18 to 30 years were more likely to have positive attitude in the mitigating efforts during a cholera outbreak (OR=3.24: CI 1.30-8.09). Many (82.4%) had never reported cases while 69.3% were willing to report cases. About 70.0% reported they would submit to being investigated during an outbreak. Respondents' good knowledge of cholera, high perception of its severity and positive attitude in the mitigating efforts during an outbreak offered windows of opportunity in the control of cholera outbreak. However specific risks communication should be aimed at improving hygiene practices and focus on perceived vulnerability.