Abstrak
Introduction: Cholera outbreaks in Nigeria have been characterized by unusually high mortality (CFR>1%), indicating that systems presently in place for prevention, detection and management of
cholera are weak. Given that inadequate health worker performance has been a problem in resourcelimited settings and poor health worker knowledge has been implicated in poor health status in developing nations, it is imperative that the knowledge of primary health care (PHC) workers on cholera prevention and management procedures be assessed from time to time.
Methods: Using a cross-sectional study design, data collected from 286 PHC workers across four local government areas of Oyo State. Data were collected using a pre-tested self-administered questionnaire with sections eliciting responses to questions on general knowledge of cholera, prevention methods, knowledge and practice of safety procedures among health workers. Descriptive statistics and Chi-square tests were used to present the data and test for statistical associations between categorical variables at 5% level of significance respectively.
Results: Nurses (35.05%) constitute the highest proportion of health workers compared to doctors (8.7%). The mean age of respondents was 38.02 ± 9.48 years with the majority of respondents between 30-49 years. Majority (83.6%) do not know the cholera alert threshold. Overall, 45.1% of respondents demonstrated good knowledge of cholera prevention and management measures. Very few (28.0%) of the respondents had undergone any form of training on cholera outbreak in the past year. More workers aged 40 - 49years knew the cholera alert threshold compared to other age groups (p=0.033).
Conclusion: Results from this study show that health workers at the primary level in Oyo State still lack adequate knowledge of general cholera prevention and management procedures. More training and retraining of health workers with regards to management of cholera is desirable to reduce the mortality rates within the selected areas.
Keywords: Cholera, health workers, primary health care, epidemic, fatality rates, personal protective equipment
Abstrait
Introduction : Les épidémies de choléra au Nigeria ont été caractérisées par une mortalité inhabituellement élevée (PFC> 1%), ce qui indique que les systèmes actuellement en place pour la
prévention, la détection et la gestion du choléra au Nigeria sont faibles. Étant donné que les performances insuffisantes des agents de santé ont été un problème dans les pays à ressources limitées et que les mauvaises connaissances des agents de santé ont été impliquées dans l’état de santé médiocre des pays en développement, il est impératif que la connaissance des agents de soins de santé primaires (SSP) sur les procédures de prévention et de gestion du choléra soient évaluées de temps en temps.
Méthodes : En utilisant une conception d’étude transversale, les données ont été recueillies auprès de 286 agents de SSP dans quatre communes de l’État d’Oyo. Les données ont été recueillies à l’aide d’un questionnaire autoadministré prétesté avec des sections permettant de recueillir des réponses aux questions sur les connaissances générales sur le choléra, les méthodes de prévention, les connaissances et la pratique des procédures de sécurité des agents de santé. Des statistiques descriptives et des tests du chicarré ont été utilisés pour présenter les données et pour tester les associations statistiques entre les variables qualitatives à un niveau de signification de 5%.
Résultats : Les infirmiers (35,0%) étaient les cadres les plus populaires alors que les médecins (8,7%) étaient les moins populaires. L’âge moyen des répondants était de 38,02 ± 9,48 ans, la majorité d’entre eux ayant entre 30 et 49 ans. La majorité (83,6%) ne connaît pas le seuil d’alerte du choléra. Au total, 45,1% des répondants ont démontré une bonne connaissance des mesures de prévention et de gestion du choléra. Très peu de répondants (28,0%) avaient suivi une formation sur l’épidémie de choléra au cours de l’année écoulée. Un plus grand nombre de travailleurs âgés de 40 à 49 ans connaissaient le seuil d’alerte du choléra par rapport aux autres groupes d’âge (p = 0,033).
Conclusion : Les résultats de cette étude montrent que les agents de santé primaire dans l’État d’Oyo n’ont toujours pas une connaissance suffisante des procédures générales de prévention et de gestion du choléra. La formation et recyclage davantage des agents de santé en matière de gestion du choléra est souhaitable pour réduire les taux de mortalité dans les zones sélectionnées.
Mots-clés : choléra, agents de santé, soins de santé primaires, épidémie, taux de mortalité, équipement de protection individuelle
Correspondence: Dr. T.A. Obembe, Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: tobems@yahoo.com
Referensi
WHO. Guidelines for cholera control. Geneva; 1993.
Bhattacharya S, Black R, Bourgeois L, et al. The Cholera Crisis in Africa. Public Heal. cholera Cris. Africa. Sci. 2009;324.
Zuckerman J, Rombo L and Fisch A. The true burden and risk of cholera: implications for prevention and control. Lancet Infect. Dis. Elsevier; 2007;7:521–530.
WHO. Prevention and control of cholera outbreaks: WHO policy and recommendations. WHO. World Health Organization; 2011;
Shikanga OT, Mutonga D, Abade M, et al. High Mortality in a Cholera Outbreak in Western Kenya after Post-Election Violence in 2008. Am. J. Trop. Med. Hyg. 2009;81:1085–1090.
Oladele DA, Oyediji KS, Niemogha MT, et al. An assessment of the emergency response among health workers involved in the 2010 cholera outbreak in northern Nigeria. J. Infect. Public Health. Elsevier; 2012;5:346–353.
Tambo E, Ugwu E and Ngogang J. Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries. Infect. Dis. Poverty. 2014;3:29.
Ajoke O, Adesida SA, Nwaokorie FO, Niemogha M-T and Coker AO. Cholera Epidemiology in Nigeria: an overview. Pan Afr. Med. J. African Field Epidemiology Network; 2012;12.
Hutin Y, Luby S and Paquet C. A large cholera outbreak in Kano City, Nigeria: the importance of hand washing with soap and the danger of street-vended water.
Global Workforce Alliance. List of 57 countries facing Human Resources for Health crisis. 2008.
Uwakwe O. CBU. Systematized HIV/AIDS education for student nurses at the University of Ibadan, Nigeria: impact on knowledge, attitudes and compliance with universal precautions. J. Adv. Nurs. 2000;32:416–424.
Umeh CN, Essien EJ, Ezedinachi EN and Ross MW. Knowledge, beliefs and attitudes about HIV/AIDS-related issues, and the sources of knowledge among health care professionals in southern Nigeria. J. R. Soc. Promot. Health. 2008;128:233–239.
Lawoyin TO, Ogunbodede NA, Olumide EAA and Onadeko MO. Outbreak of cholera in Ibadan, Nigeria. Eur. J. Epidemiol. Kluwer Academic Publishers; 1999;15:365–368.
OYSG. Oyo State Government – Official Website of Oyo State Government. 2017.
Latunji OO. Driving Contraceptive Uptake In Nigeria: Current Issues And Trends. HealthThink. 2017.
Nigeria. Nigeria Demographic and Health Survey 2013. 2014;
NDHS. Nigeria 2008 Demographic and Health Survey. 2008;
Rowe A, de Saigny D, Lanata C and Victora C. How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet. Elsevier; 2005;366:1026–35.
Abdulraheem I, Amodu M, Saka M, Bolarinwa O and Uthman M. Knowledge, Awareness and Compliance with Standard Precautions among Health Workers in North Eastearn Nigeria. Community Med. Heal. Educ. Abdulraheem J Community Med Heal. Edu J Community Med Heal. Edu. 2012;2.
Aisien AO and Shobowale M. Health care workers’ knowledge on HIV and aids: universal precautions and attitude towards PLWHA in Benin-City, Nigeria. Niger. J. Clin. Pract. Medical and Dental Consultants’ Association of Nigeria; 2005;8:74–82.
Blacklock A, Sesay A, Kamara A, Kamara M and Blacklock C. Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone. Glob. Health Action. 2015;8:1–6.
Ohene-Adjei K, Kenu E, Bandoh DA, et al. Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014. BMC Public Health. BMC Public Health; 2017;17:1–10.
Lau JTF, Fung KS, Wong TW, et al. SARS transmission among hospital workers in Hong Kong. Emerg. Infect. Dis. Centers for Disease Control and Prevention; 2004;10:280–286.
Langmuir AD. The Surveillance of Communicable Diseases of National Importance. N. Engl. J. Med. 1963;268:182–92.
Bawa SB and Olumide EA. The effect of training on the reporting of notifiable diseases among health workers in Yobe State, Nigeria. Niger. Postgrad. Med. J. 2005;12:1–5.
Awalime DK, Davies-Teye BBK, Vanotoo LA, Owoo NS and Nketiah-Amponsah E. Economic evaluation of 2014 cholera outbreak in Ghana: a household cost analysis. Health Econ. Rev. Health Economics Review; 2017;7.
Abdulraheem IS, Olapipo AR and Amodu MO. Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. J. Public Heal. Epidemiol. 2012;4:5–13.