POTENTIAL BARRIERS TOWARDS REPORTING OF SUSPECTED LASSA FEVER CASES BY HEALTHCARE WORKERS IN IBADAN

Abstract

Without knowledge of disease occurrence, health officials are limited in their ability to identify sources of illness and prevent further disease in the community. There is need for healthcare workers to remain alert to endemic infectious diseases of this nature and to institute appropriate measures to promptly identify cases and report them, protect themselves and care-givers. Effective prevention and control will depend on accurate and prompt diagnosis with urgent reporting to appropriate authorities and institution of appropriate control guidelines to abort this trend. This study is designed to assess the potential barriers towards reporting of suspected Lassa fever cases by doctors and nurses in public health facilities in Ibadan. A descriptive cross-sectional study design was employed. Stratified simple random sampling was used to select a total of 238 doctors and nurses who work at the public primary (70), secondary (36) and tertiary (132) levels of public health facilities in Ibadan. A self-administered, structured questionnaire and an observational checklist which contained items on socio demographic details, knowledge of Lassa fever and it's reporting through the integrated disease surveillance and response strategy, attitude to Lassa fever reporting, factors associated with reporting practice and availability of infrastructures for reporting of the suspected cases was used to collect the data. Knowledge of Lassa fever and its' reporting was scored based on 25 and 22 questions respectively from the knowledge sections. Participants with scores ≥12 and ≥9 respectively were categorized as having good knowledge of Lassa fever and its' reporting respectively. A total of 255 questionnaires were distributed and 238 were returned completed giving a response rate of 93.0%. The mean age of the respondents was 36.5 ± 9.3years. Only 28.2% of the respondents reported an awareness of the integrated disease surveillance and response (IDSR) diagnostic criteria for Lassa lever. A little proportion (28.4% and 21.6%) of the participants had good knowledge of the disease and it's reporting through the lDSR strategy respectively. The potential barriers towards reporting of suspected Lassa fever cases identified in this study were knowledge of the disease(AOR 2.3,95% CI 1.1-4.8) , knowledge of its' reporting through the integrated disease surveillance and response (IDSR) strategy (AOR 2.2, 95% 1.0-4.8), involvement in outbreak investigations(AOR 0.2, ) 95% CI 0.1-0.5), availability of posters (AOR 3.3,95% C.I 1.4-7.9) and manuals in clinics (AOR 0.1, 95% Cl 0.1-0.3). Lack of knowledge of reporting requirement was identified as a major barrier affecting disease reporting among doctors and nurses at the three levels of health care facilities in Ibadan. The training and retraining of health workers responsible for data generation, collection and forwarding in health facilities on notifiable diseases, availability of posters and manual on these notifiable diseases in the facilities are recommended in order to improve the disease surveillance system.