Perceived Emotional Effect of Lassa Fever Among Nurses and Midwives Working in General Hospital
CHAPTER ONE
Objectives General objective
To assess emotional effect of lassa fever among nurses and mid wives working in general hospitals in 5 general hospitals of Lagos state in western Nigeria and determine whether emotions differ by place of work (Rural vs Urban or Regional vs Health Centres)
The specific objectives of study are
- To determine the proportion of nurses and mid wives having good knowledge about LF.
- To determine the proportion of nurses and midwives having good attitudes and good practices in dealing with a suspected case of L.F.
- To identify socio-demographic factors that could influence the emotions of HCWs working in these 5 general hospitals on
- To assess whether emotions of HCWs vary by type of facility (General Hospital vs Health centres) and place of work ( Rural vs Urban)
CHAPTER TWO
LITERATURE REVIEW
HCWs are potentially exposed to blood-borne pathogens through contact with infected body parts, blood and body fluids in the course of their work. It has been estimated that each year, as many as 3 million HCWs all over the world experience percutaneous exposure to blood-borne viruses Hepatitis C and B and HIV viruses. Apart from these pathogens, The public health impact of LASV in the West African sub region as an emerging nosocomial transmitted pathogen requires significant response (Ekaete Alice et al., 2013).
Definition
Infection with LASV, a member of the Arenaviridae, results in a spectrum of illness from unapparent infection to Lassa fever, a severe multisystem disease that often has haemorrhagic manifestations (Robinson et al., 2016). Its initial clinical manifestations are difficult to differentiate from those of other common febrile illnesses, such as malaria, and a high index of clinical suspicion is required in the diagnosis (Akhuemokhan et al., 2017).
Historical Account of Lassa Fever
Lassa fever was first described in Sierra Leone in the 1950s but the virus responsible for the disease was not identified until 1969 when two missionary nurses died in Nigeria, West Africa, and the cause of their illness was found to be LASV, named after the town in Nigeria where the first cases were isolated (Mccormick et al., 2017). Although LASV was identified in 1969, records of haemorrhagic fever (HF) since the 1920s indicate this virus had been circulating for at least 50 years (Zapata & Salvato, 2015). The nurse presumably acquired infection from an obstetrical patient residing in Lassa. She died approximately one week after the onset of symptoms. Subsequently, two more nurses that attended the first patient contracted the disease, which was later named Lassa fever and caused the death of one of them. Infectious virus (LASV) was isolated from all three cases (Yunusa & Egenti, 2015).
CHAPTER THREE
METHODOLOGY
Study Design
The study design was a descriptive cross-sectional survey among nurses and midwives in 5 general hospitals of Lagos state from May –June, 2018.
Study Population
The study population included in 5 general hospitals in Lagos state. The cadre of HCWs required for the study were doctors, nurses (trained and auxiliary), midwives, as they were directly involved in clinical patient care or specimen collection.
Sampling Technique
All of the health care providers working in these 5 public general hospitals within our period of data collection were recruited
CHAPTER FOUR
RESULTS
Socio-demographic characteristics of respondents
The results in table 4.1 below shows the socio-demographic characteristics of respondents. The mean age of health workers was 30.4 years ± 7.7SD. The mean number of working years of the health professional was 4.9 years ± 5.2 SD. Females were in the majority 57.4% (112/195). Most of the health workers were married making up 64.6% (126/195) of respondents. Muslims were the majority 80.5% (157/195). There were seventeen doctors (8.7%), thirty-two nurses (16.4%), fifteen midwives (7.7%) and twelve midwives (6.2%) thirty eight student professionals and other health professionals including pharmacists, physician’s assistants, and nurse assistants constituted 41.5% of respondents (81/195).
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
Conclusion
The mean age of health workers was 30.4 years. The mean number of working years of the health professional was 4.9 years. Females were in the majority. Most of the health workers were married. Muslims formed the majority of health professionals. There were 17 doctors 32 nurses, 15 midwives, 12 midwives, 32 student professionals and 81 other health professionals including pharmacists, physician’s assistants, and nurse assistants and auxiliary workers.
Sixty three out of the one hundred and ninety five respondents (32.3%) had no idea what Lassa fever was. Of the remaining one hundred and thirty two, 67.7% (132/195) who had heard about Lassa fever, their knowledge was assessed with a sixteen item questionnaire on knowledge according to case definition. 48.5 % had good knowledge (scored ≥8 out of 16) about Lassa fever (p = 50%; 95% CI = 40% – 60%).
Ninety five out of 100 health professionals were found to have good attitude towards a suspected case of Lassa fever (p = 95%; 95% CI = 91% – 97%).
With regards to practice, all health professionals (100%) had good practices in Prevention and control of infections.
Socio-demographic factors found to be associated with knowledge on LF were age, marital status, occupation, number of working years
The mean age of health professionals who had good knowledge was significantly higher than those with poor knowledge. In that, a unit increase in age significantly increased the odds of having good knowledge Marital status was significantly associated with knowledge of Lassa fever amongst health professionals. Married health professionals had 3.6 times the odds of good knowledge on Lassa fever compared to health professionals who were single. This association was still significant after adjusting for other variables. A unit increase in number of working years significantly increased the odds of good knowledge on LF by 20%. Type of facility, whether general hospital or health centre were significantly associated with knowledge on LF. Health professionals who were in health centres had significantly 70% reduction of their odds of having good knowledge on LF as compared to health professionals in general hospital.
None of the socio-demographic factors were found to be significantly associated with health professionals’ attitude on Lassa fever.
However, health workers in rural facilities were found to be 80% significant reduction in their odds of having good attitude towards a suspected case of LF as compared to health workers in urban facility Non availability of PPE’s sometimes in facilities significantly reduced the odds of health professionals having good attitude towards a suspected case of LF.
Recommendations
- Ministryof Health (MOH), Nigeria should plan more training on LF with emphasis on other professionals as much as medical
- The MOH should provide adequate supply of PPE for both urban and rural general hospitals to assure there are no shortages at thefacilities
- The district health management team should provide health promotion strategies programs on LF in rural areas with emphasis on the strategy of strengthening community action to ensure positive EMOTIONS towards LF not only in the facility nit also within the communities
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