KNOWLEDGE, AWARENESS AND PERCEPTIONS OF CORONAVIRUS IN NIGERIA
Abstract
This study was carried out on the knowledge, awareness and perceptions Covid 19 pandemic in Nigeria. Mass gatherings at sporting and religious events attract huge crowds, creating high-risk conditions for the rapid spread of infectious diseases. The study was carried out in Ibadan, Oyo state. During the first week of March, the surge of Coronavirus disease 2019 (COVID-19) cases has reached over 100 countries with more than 100,000 cases. Healthcare authorities already initiated awareness and preparedness activities beyond the borders. A poor understanding of the disease among healthcare workers (HCWs) may implicate in delayed treatment and the rapid spread of infection. The study aimed to investigate the knowledge and perceptions of HCWs about COVID-19. A descriptive research design was conducted among HCWs about COVID19 during the first week of March 2020. A 23-item survey instrument was developed and distributed randomly to HCWs using social media; it required 5 minutes to complete. Chisquare test was used to investigate the level of association among variables at the significance level of p<0.05.Of 529 participated,a total of 453 HCWs complete the survey (response rate: 85.6%); 51.6% are males, aged 25-34 years (32.1%), and most of them are doctors (30.2%) and medical students (29.6%). Regarding COVID-19, most of them used social media to obtain the information (61%), a significant proportion of HCWs had poor knowledge of its transmission (61%), and symptoms onset (63.6%) and showed a positive perception of COVID-19 prevention and control. Factors such as age and profession are associated with inadequate knowledge and poor perception of COVID-19. As the global threat of COVID-19 continues to emerge, it is critical to improving knowledge and perceptions among HCWs. Educational interventions are urgently needed to reach HCWs beyond the borders, and further studies are warranted. The study recommended that social gatherings should be avoided to prevent the spread of coronavirus.
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
The coronavirus disease 2019 (COVID-19), initially taken as “pneumonia of unknown etiology”, emerged in December 2019, Wuhan, Hubei Province, China. The causative pathogen was announced by the Chinese Center for Disease Control and Prevention (China CDC) on Jan 08, 2020, to be a novel coronavirus (Al-Tawfiq et al., 2020), lately named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 broke out in Wuhan in January 2020, and spread to the whole Hubei Province, the rest of China and abroad with astonishing speed. On Jan. 31, 2020, the World Health Organization (WHO) announced that COVID-19 constitutes a "public health emergency of international concern". As of Feb 28, there were 7,8961 cases confirmed in China, and 4,691 cases confirmed in 51 other countries. On that day, WHO increased the assessment of the risk of spread and risk of impact of COVID-19 to very high at the global level.
Mass gatherings at sporting and religious events attract huge crowds, creating high-risk conditions for the rapid spread of infectious diseases. The 2000–2001 meningococcal meningitis outbreak after the Hajj pilgrimage illustrated this threat of infectious diseases on global health security. The International Health Regulations Emergency Committee of the World Health Organization (WHO) declared Zika virus (ZKV) a Public Health Emergency of International Concern on 1 February 2016 (Simon, 2019). The media hype on ZKV transmission at the 2016 Rio Olympic Games diverted the attention of global public health authorities from other lethal infectious diseases with epidemic potential. Attention and resources must now be refocused on the continuing epidemic threat of the highly lethal Middle East respiratory syndrome coronavirus (MERS-CoV).
Previous studies have shown the effects of social mixing patterns and distancing measures (such as school closures and travel restrictions) on the spread of infectious diseases and epidemics (Fred, 2016; Briese et al., 2020; Gautret et al., 2020). A recent study showed how viral mutation can lead to an additional epidemic peak (Reusken, 2020). However, few studies have explored the potential negative impact of public gatherings and Holiday travel during an epidemic.
There have been intermittent MERS-CoV community cases and hospital outbreaks (WHO, 2019), but no sustained epidemic. Hospital case clusters of MERS-CoV represent the primary location where rapid human-to-human transmission of MERS-CoV have occurred; although limited spread among family members has been observed. SARS-CoV was also predominantly spread through nosocomial transmission, but the epidemiological features of MERS-CoV remain less clear. While 90 % of reported MERS-CoV cases have been from KSA, MERS-CoV has spread to 27 countries in Europe, North Africa, Asia, USA, and the Middle East. All cases had travel links with KSA or other countries in the Arabian Peninsula. As of 26 August 2016, 1,800 confirmed MERS-CoV cases have been reported to WHO from over 21 countries, including 640 deaths (35 % case fatality rate). MERS-CoV-related mortality is significantly increased in patients with comorbidities such as diabetes, renal disease, cardiac disease, lung and liver disease, or other immunosuppressive conditions. There are no known effective treatments or preventive vaccines for MERS-CoV (Adebayo, 2020).
1.2 Statement of the problem
Once again, the world is currently experiencing a global viral COVID-19 pandemic. As of March 26, 2020 confirmed cases of coronavirus disease (COVID-19) has been reported to be 478,446 and 21,524 deaths had been reported in more than 30 countries of the world.
Apart from the intrinsic infectivity of the virus, population mobility and epidemic prevention and control measures could affect the prevalence scale. Unfortunately, the prevalence of COVID-19 encountered the Spring Festival Migration of China, the world’s largest annual human migration as hundreds of millions of people rush home for family reunions. In addition, the epicenter Wuhan is the capital of Hubei Province of China. It has a population of more than 15 million, including resident and floating population, and it situates at the transportation hub in the central China area. As of Jan 23, 2020, more than 5 million people were migrating out of Wuhan according to official accounts. Emergency monitoring and close contact management in Wuhan was carried out since Jan 03, 2020; China CDC Level 2 emergency response activated on Jan 06, and Level 1 emergency response activated on Jan 15. On Jan 20, 2020, COVID-19 was included in the statutory report of Class B infectious diseases, managed as Class A infectious diseases by the National Health Commission of China. The Chinese government locked down the Wuhan city on Jan 23, and then locked down other cities of Hubei Province immediately after. By Jan 25, 30 provincial governments in China activated first-level public health emergency response. Hence, In addition to strict quarantine management, substantial social distancing measures to limit population mobility and to reduce within-population contact rates were executed almost in the whole country. For example, public activities were canceled; communities adopted enclosed management; the national holiday of Spring Festival and the winter vacation were extended so that work resumption and school re-opening could be extensively postponed. In addition, people were required to wear facemasks in public. However, with all those efforts, the prevalence of COVID-19 was escalating.
1.3 Objectives of the study
The main objective of the study was to examine the impact of infectious epidemic on social gathering, using corona virus disease as case study.
1. To understand the attitude, knowledge and perception of Corona virus.
2. To examine the perception of social distancing on the spread of infectious epidemic diseases.
3. To establish the symptoms of COVID-19 and the steps to take when these symptoms occur.
1.4 Research questions
1. What is the attitude, knowledge and perception of Corona virus?
2. What is the perception of social distancing on the spread of infectious epidemic diseases?
3. What are the symptoms of COVID-19 and the steps to take when these symptoms occur?
1.5 Significance of the study
Epidemic prevention and control strategies need to be re-examined. Vaccine and antiviral drug development is the ultimate way to defeat a virus, but it is time-consuming. Non-pharmaceutical interventions to interrupt transmission could be implemented immediately, gaining time for pharmaceutical development. Briefly, there were three steps of non-pharmaceutical interventions for reducing contact rates between susceptible individuals and infected individuals. First, quarantine management, i.e. quarantining the infected, the suspicious and their close contacts; second, social distancing to confine within-population contact; third, locking down the epicenter to prevent further exportation of infected and latently infected individuals to other regions.
Quarantine management is a fundamental measure ought to be taken once the human-human transmission is confirmed. Theoretically, if substantial social distancing and/or epicenter lockdown were implemented early enough, there would be no prevalence or no spreading. But realistically, it takes time for preliminary investigation. Besides, rigorous measures would bring about deep social influences and economic consequences. So, it is challenging to choose the right response at the right scale in the right area at the right time, especially when the transmission pattern and clinical characteristics were not fully understood.
The importance of non-pharmaceutical control measures requires further research to quantify their impact. Mathematical models are useful to evaluate the possible effects on epidemic dynamics of preventive measures, and to improve decision-making in global health.
Theoretically, this study stands to provide additional knowledge to the body of existing literature on the spread this pandemic disease to the world and of particular reference to Nigeria. The result of this study will serve as good base or guide for future reference and it will also encourage further research on the importance of staying healthy. Furthermore, this study will provide relevant information on the reasons for the spread of this disease from China to the rest of the world.
This study will also be of benefit to researchers, academics and scholars in carrying out research and academic works related to this study.
1.6 Scope of the Study
This study focuses mainly on the impact of infectious epidemic on social gathering. The study focused on corona virus disease. The study was also limited to health workers in the outpatient department of University College hospital Ibadan and students in the University of Ibadan. It will therefore, be carried out among the students and health workers in the outpatient department of University College hospital Ibadan.
1.7 Limitations of the Study
The time frame was not enough for the researcher to delve into the issue as comprehensively as would have been desired. This also informed the decision to focus on one department so the time would be invested in identifying and evaluating all possible aspects of the subject matter so as to make the study as comprehensive as possible. The use of a case study arguably has many limitations, however it allows for a level of research that was commensurate with the nature of results expected.
CHAPTER TWO
LITERATURE REVIEW
2.1 Overview of Coronavirus
Coronavirus disease 2019 (abbreviated “COVID-19”) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The disease is highly infectious, and its main clinical symptoms include fever, dry cough, fatigue, myalgia, and dyspnea. In China, 18.5% of the patients with COVID-19 develop to the severe stage, which is characterized by acute respiratory distress syndrome, septic shock, difficult-to-tackle metabolic acidosis, and bleeding and coagulation dysfunction (Utibe, 2019).
The first infected patient who had clinical manifestations such as fever, cough, and dyspnea was reported on 12 December 2019 in Wuhan, China. Since then, 2019-nCoV has spread rapidly to other countries via different ways such as airline traveling and now, COVID-19 is the world’s pandemic problem (Felix, 2020).
Coronaviruses (CoV) infections are emerging respiratory viruses and known to cause illness ranging from the common cold to severe acute respiratory syndrome (SARS) (Yin et al., 2019). CoV is zoonotic pathogens that can be transmitted via animal-to-human and human-to-human. Multiple epidemic outbreaks occurred during 2002 (SARS) with ~800 deaths and 2012 (Middle East Respiratory Syndrome: MERS-CoV) with 860 deaths (Lee, 2020). Approximately eight years after the MERS-CoV epidemic, the current outbreak of novel coronavirus (COVID-19) in Wuhan City, Hubei Province of China, has emerged as a global outbreak and significant public health issue. On 30 January 2020, the World Health Organization (WHO) declared COVID-19 as a public health emergency of international concern (PHEIC). Astonishingly, in the first week of March, a devastating number of new cases have been reported globally, emerging as a pandemic. As of 9 March 2020, more than 110,000 confirmed cases across 105 countries and more than 3800 deaths have been reported (Philemon et al., 2020).
The COVID-19 is spread by human-to-human through droplets, feco-oral, and direct contact, with an incubation period of 2-14 days. So far, no antiviral treatment or vaccine has been recommended explicitly for COVID-19. Therefore, applying the preventive measure to control COVID-19 infection is the utmost critical intervention. Healthcare workers (HCWs) are the primary section in contact with patients and are an important source of exposure to the infected cases in the healthcare settings, thus, expected to be at a high risk of infections. By the end of January, the WHO and CDC (Centers for Disease Control and Prevention) have published recommendations for the prevention and control of COVID-19 for HCWs. Indeed, the WHO also initiated several online training sessions and materials on COVID-19 in various languages to strengthen the preventive strategies, including raising awareness, and training HCWs preparedness activities (Wan, 2019). In several instances, misunderstandings of HCWs delayed controlling efforts to provide necessary treatment, implicate rapid spread of infection in hospitals, and also may put the patients' lives at risk. In this regard, the COVID-19 epidemic offers a unique opportunity to investigate the level of knowledge, and perceptions of HCWs during this global health crisis. Besides, we also explored the role of different information sources in shaping HCWs knowledge and perceptions on COVID-19 during this peak period.
It seems that the current widespread outbreak has been partly associated with a delay in diagnosis and poor infection control procedures. As transmission within hospitals and protection of healthcare workers are important steps in the epidemic, the understanding or having enough information regarding sources, clinical manifestations, transmission routes, and prevention ways among healthcare workers can play roles for this gal assessment. Since nurses are in close contact with infected people, they are the main part of the infection transmission chain and their knowledge of 2019-nCoV prevention and protection procedures can help prevent the transmission chain. Iran is one of the most epidemic countries for COVID-19 and there is no information regarding the awareness and attitude of Iranian nurses about this infectious disease.
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