HEALTH WORKERS’ KNOWLEDGE, PERCEPTIONS AND PRACTICES RELATING TO AVIAN INFLUENZA INFECTION IN PERI-URBAN LOCAL GOVERNMENT AREAS OF IBADAN, NIGERIA

Abstract

Avian Influenza (AI) is a serious public health problem in Nigeria and Primary Health Care (PHC) workers have important roles to play in its control. However, their knowledge and practices relating to AI have not been fully investigated. This study was designed to determine the knowledge, perceptions and practices of PHC workers relating to AI prevention and control in Akinyele, Egbeda, Lagelu, Ido and Oluyole areas of Ibadan. A total population study was planned. However, only 515 of the 718 PHC workers in the LGAs consented to participate. A semi-structured questionnaire which included a 61- point knowledge scale and questions on perceptions and practices was used for data collection. Knowledge scores of 0-30, 31-45 and 46-61 were rated as poor, fair and good respectively. Data were analyzed using descriptive statistics, Chi-square, t-test, ANOVA and logistic regression with level of significance set at 0.05. The respondents comprised 32.6% Health Assistants (HAs), 30.7% Senior Community Health Extension Workers (SCHEWs), 12.2% Junior Community Health Extension Workers (JCHEWs), 11.8% Community Health Officers (CHOs), 10.7% nurses/midwives, 1.0% doctors and 1.0% pharmacists. Their mean age was 38.4 ± 8.7 years and 81.9% were females. All respondents had heard about AI, 49.5% were aware that its spread is facilitated by birds and 7.6% were aware that it could easily spread in health care centres. Sources of information about AI included radio (68.3%), television (66.8%) and professional peers (56.5%). Overall mean knowledge score was 37.2 ± 9.4. Mean knowledge scores for males and females were 39.8 ± 8.4 and 36.6 ± 9.6 respectively with a significant difference. Significant differences were also observed in the knowledge scores for different cadres: doctors 54.5 ± 2.1, pharmacists 41.2 ± 6.1, nurses/midwives 39.7 ± 6.9, CHOs 39.5 ± 7.7, SCHEWs 38.0 ± 7.9, JCHEWs 35.8 ± 11.8 and HAs 34.2 ± 11.4. Respondents with poor, fair and good knowledge scores of AI were 21.4%, 60.6% and 18.1% respectively. Consumption of infected birds/fowls (82.1%) was a major mode of transmission of AI to human populations mentioned by respondents. The correctly identified symptoms of AI included coughing (68.9%), shortness of breath (66.8%) and body temperature greater than 38ºC (63.3%). The correctly mentioned medications for managing AI were Tamiflu (11.1%) and Relenza (2.1%). Only 13.2% perceived themselves to be vulnerable to AI and 56.7% rightly perceived all age groups to be susceptible to it. Respondents with tertiary education were 6.0 times more likely to perceive AI to be serious than those with non-tertiary education (95% CI, 0.5-4.9). Preventive practices adopted by respondents against AI included wearing of gloves (92.2%), equipment sterilization (82.9%) and hand washing using water, soap and disinfectants (70.9%). Gaps in knowledge and misconceptions relating to vulnerability to avian influenza infection existed among the health workers. However, many of them adopted effective preventive measures. There is need for training to bridge the identified gaps.