CHAPTER ONE

INTRODUCTION

1.1 Background of The Study

Lassa fever, also known as Lassa haemorrhagic fever (LHF), is an acute viral

haemorrhagic fever caused by the Lassa virus. It was first discovered in 1969

in a town called Lassa in Borno State, Nigeria (Frame et al., 2007). The

primary host of Lassa virus is the natal multimammate rat (many breasted

rat called Mastomys natalensis) found in and around homes in most sub-

Sahara African countries, scavenging on food remains or poorly stored food

(Werner, 2004). Lassa virus is transmitted by contact with the faeces or urine

of animals accessing grains stores in residences. Infected rodents excrete

the virus in urine, saliva, respiratory secretion and blood (Keenlyside et al.,

2003). Humans presumably become infected with the virus through contact

with infected rodents’ excreta, urine, tissues or blood (Monath et al., 2007).

Transmission to man can also be through feaco-oral route, inhalation of

contaminated air containing the virus, contact with infected blood, or

through sexual intercourse (Ogbu et al., 2007). Lassa fever outbreak has

1
been observed in the West African region like Nigeria, Liberia, Sierra Leone,

and Guinea (Monath et al., 2007; Carey et al., 2007).

In Nigeria, the recent outbreak in Bauchi State which occurred in 2015 was

unprecedented. It began in mid-November and by January 2016, the virus

had already spread to other states like Nasarawa, Niger, Taraba, Kano,

Rivers, Edo, Plateau, Gombe and Oyo. A total of 81 cases and 35 deaths

were reported, with a mortality rate of 43.2% (Federal Ministry of Health,

2016). Adequate information and knowledge of the disease is hence

imperative and cannot be over emphasised.

A study conducted recently in and around Lafia, North Central Nigeria among

200 respondents revealed that 87% of the respondents have heard about

Lassa fever previously even though there was a misconception on the mode

of transmission, while 39% of the respondents identified bleeding as the

major clinical manifestation (Reuben & Gyar, 2016). In another related study

conducted in Odeda Local Government Area of Ogun State, South West

Nigeria, result showed that, knowledge of Lassa fever among respondents

was fair with (68.3%) out of the 300 respondents involved in the study have

not heard of Lassa fever before, while rural dwellers have the poorest

knowledge of the disease (Lawal, 2014).Unfortunately, accurate figures on

2
outbreaks and subsequent responses to arrest the outbreak in Nigeria have

not been properly documented (Ajayi, et al., 2009). A number of figures

available have only focused on outbreaks that occurred in the past or in

recent years, on laboratory diagnosis of suspected cases (Fisher Hoch et al.,

2009; Omilabu et al., 2005; Ehichioya et al., 2010).

1.2 Statement of the Problem

Lassa fever is one of the viral haemorrhagic fevers. It is extremely virulent

and highly infectious (Anyanwu & Nwaopara 2005; Federal Ministry of

Health, 2008). Its incubation period has been reported to be between 1 to

24 days (Mertens et al., 2007; McCormick et al., 2008). The clinical

manifestation of the disease includes fever, general weakness, headache,

sore throat, muscle pain, cough, chest pain, nausea, vomiting, diarrhoea,

and abdominal pain with or without bleeding (Reuben & Gyar, 2016). It is

an emerging disease that causes high morbidity and mortality and has the

capacity to devastate and threaten lives if adequate measures are not put in

place to avert its occurrence.

Lassa fever is prevalent in the West African region with about 300,000 to

500,000 cases reported annually and causing about 5,000 deaths each year

3
(Ogbu et al., 2007). In Nigeria Lassa fever outbreaks occur almost every

year in different parts of the country, with yearly peaks observed between

December and February (WHO, 2016). Studies conducted in places around

the country have shown that knowledge of the disease is lacking among

many and inadequate amongst quite a large proportion thereby making it

difficult for people to avert the occurrence of the outbreak (Aigbiremolen et

al., 2012; Lawal, 2014; Reuben & Gyar, 2016).

Outbreaks of Lassa fever have however been reported in Edo, Ebonyi, Ondo,

Taraba, Plateau, Anambra, Nasarawa, Yobe and Rivers States (Ogbu et al.,

2007; Nigerian Centre for Disease Control, 2012). A previous study

conducted in the country has shown that the seroprevalence of the disease

in Nigeria is about 21 % (Tomori et al., 2008). This invariably means that

the prevalence of the disease is presently high in the country, thus the need

for mass enlightenment on how to prevent future occurrence of the disease

by ensuring that the people of Nigeria are adequately informed of the

disease.

4
1.3 Aim and Objectives of the Study

1.3.1 Aim of the study

The main aim of the study is to assess the knowledge and perception of

lassa fever among dwellers in Ihiagwa, Owerri West Local Government Area

of Imo State.

1.3.2 Objectives of the Study

The specific objectives of the study are;

i. To assess the level Knowledge of Lassa fever among Respondents.

ii. To determine the level of perception of lassa fever among the

respondents.

iii. To determine the relationship between the socio-demographic

variable of the respondents and Knowledge of Lassa fever.

1.4 RESEARCH QUESTIONS

RQ1: What is the level of knowledge of lassa fever among the respondents?

RQ2: What is the level of awareness of lassa fever among the respondents

RQ3: What is the Relationship between socio-demographic variables and

knowledge of lassa fever.

5
1.5 RESEARCH HYPOTHESIS

H0: Ihiagwa dwellers have no knowledge of lassa fever.

H1: Ihiagwa dwellers have knowledge of lassa fever.

H0: Ihiagwa dwellers are not aware of lassa fever.

H1: Ihiagwa dwellers are aware of lassa fever.

H0: There is no relationship between socio-demographic variables and

knowledge of lassa fever.

H1: There is relationship between socio-demographic variables and

knowledge of lassa fever.

1.6 SIGNIFICANCE OF THE STUDY

This research work will be of immense contribution in the following ways

i. This study would as well include suitable recommendations to

appropriate authorities on ways to prevent subsequent Lassa fever

outbreak hence evading death

ii. This study therefore will also provide basic information that would help

educate the community on the disease and its vector control measures.

6
iii. This study will also help to institute preventive measures that would

reduce the financial burden for treatment.

iv. This study will also help future researchers in providing them with

crucial information on lassa fever.

1.7 JUSTIFICATION OF THE STUDY

Information on prevention and control is rarely available in rural tropical

areas where rodent problems are more severe as compared to that in

developed countries and temperate regions but with fewer number of cases.

This study therefore will provide basic information that would help educate

the community on the disease and its vector control measures. This will go

a long way in helping to institute preventive measures that would reduce the

financial burden for treatment.

This study therefore will assess the level of awareness of the Lassa vector

and its control measures among dwellers who are likely to be infected. This

would provide information for ascertaining the most vulnerable means of

Lassa transmissions and thereby helping to institute a better strategized

campaign.

7
Information on rodent control provided by this study will also go a long way

in curbing transmission via Matomys natalensis. This would help prevent the

numerous unpleasant complications associated with Lassa fever, notably

foetal death and deafness. This study would as well include suitable

recommendations to appropriate authorities on ways to prevent subsequent

Lassa fever outbreak hence evading death.

1.8 LIMITATION OF THE STUDY

Inadequacy of relevant materials, articles and journal, poor finance, limited

time and the problem of self-reporting whereby the dwellers may not say

what they actually know and may say what they think the researcher would

be pleased to hear were the major problems encountered in the course of

this work.

8
1.9 DEFINITION OF TERMS

Knowledge: Facts, information, and skills acquired through experience or

education; the theoretical or practical understanding of a subject.

Perception: The way in which something is regarded, understood, or

interpreted

Lassa Fever: An acute and often fatal viral disease, with fever, occurring

chiefly in West Africa. It is usually acquired from infected rats.

Virus: An infective agent that typically consists of a nucleic acid molecule in

a protein coat, is too small to be seen by light microscopy, and is able to

multiply only within the living cells of a host.

Infection: The process of infecting or the state of being infected.

Rodent: A gnawing mammal of an order that includes rats, mice, squirrels,

hamsters, porcupines, and their relatives, distinguished by strong constantly

growing incisors and no canine teeth.

Haemorrhagic Fever: Viral hemorrhagic fevers (VHFs) are a group of

illnesses caused by four families of viruses. These include the Ebola and

Marburg, Lassa fever, and yellow fever viruses.

9
Seroprevalence: The level of a pathogen in a population, as measured in

blood serum.

Faeces: Waste matter remaining after food has been digested, discharged

from the bowels; excrement.

Feaco-Oral Route: This describes a particular route of transmission of a

disease.

10
 CHAPTER TWO

LITERATURE REVIEW

2.1 CONCEPTUAL FRAMEWORK

Lassa virus (LASV) is a member of the Arenaviridae family, which contains a

single Arenavirus genus, comprised of 23 virus species (Table 1)

(International Committee on Taxonomy of Viruses (ICTV) 2010). However,

several putative new arenaviruses from Africa and North America have been

discovered in recent years and are not yet included in the ICTV list, such as

Lujo virus, Catarina virus, Kodoko virus and Merino Walk virus (Briese et al.

2009; Cajimat et al. 2007; Cajimat et al. 2008; Charrel, de, X, and Emonet

2008; Coulibaly-N'golo et al. 2011; Gunther et al. 2009; Lecompte et al.

2007; Milazzo et al. 2008; Palacios et al. 2008; Palacios et al. 2010).

Lymphocytic choriomeningitis virus (LCMV), the prototypical arenavirus, was

the first arenavirus to be discovered in 1933 during a St. Louis encephalitis

epidemic (Armstrong and Lillie 2003), and thereafter became a popular tool

in the field of viral immunology, particularly for studying the mechanisms of

persisting viral infection and immunopathology (Oldstone 2002; Oldstone

2007; Zinkernagel R.M. 2002). Arenaviruses are zoonotic, and in nature most

11
cause chronic infection in rodents from Africa, the Americas and Europe, with

each arenavirus infecting a single species of rodent or in some cases a

number of very closely related species. Tacaribe virus (TACV) is an exception

to this general rule since it has been isolated from bats. Most arenaviruses

do not cause human disease; however, some are known to infect humans,

and can even cause severe disease, such as a viral hemorrhagic fever (VHF)

that can be fatal.

Figure 2.1: Lassa virus structure and morphology.

12
2.2 Discovery of Lassa fever

On January 12 1969, L.W., a 69-year-old missionary nurse working in Lassa,

Nigeria, complained of a backache. The following week she developed a sore

throat, had difficulty swallowing and her oral temperature was 1000F. Over

the next few days her condition deteriorated: she appeared dehydrated, her

neck and face began to swell and hemorrhagic signs were present on her

skin. On January 25, she was transferred to the Bingham Memorial Hospital

in Jos, Nigeria. At her arrival, L.W. was in shock with low blood pressure,

irregular pulse and signs of cardiac failure. She died the following day (Frame

et al. 2007). This new disease was termed Lassa fever after the town where

L.W., the first reported confirmed case, worked (Frame et al. 2007). The

causal agent, named Lassa virus, was then isolated and based on its

characteristics was classified as a new member of the Arenaviridae family

(Buckley and Casals 2007; Buckley, Casals, and Downs 2007; Murphy 2007;

Rowe et al. 2007; Speir et al. 2007).

2.3 Pathology of Lassa fever

Post-mortem examinations of a small sample of human Lassa fever cases

(10 cases total) have revealed that the gross pathology cannot account for

13
the death of the individuals. Based on histological data and organ viral titers,

the liver appears to be the main target organ as it is the major site of viral

replication and tissue damage, although LASV can be recovered from several

organs, such as the lymphoreticular system, kidneys, adrenal glands, lungs

and heart (Walker et al. 1982b; Winn, Jr. and Walker 2007). In addition, the

severity of hepatic necrosis observed in several cases is sufficient to suggest

it plays a major role in the fatal outcome but it does not correlate with the

severity or duration of the disease prior to death (Winn, Jr. and Walker

2007).

2.4 Epidemiology

Conservatively, over 200,000 infections are estimated to occur each year in

West Africa, resulting in 3000 to 5000 deaths (Fisher-Hoch and McCormick

2004). Lassa fever is endemic in Guinea, Sierra Leone, Liberia and Nigeria

(Gunther and Lenz 2004). Seroepidemiological surveys have also

demonstrated the presence of antibody-positive individuals in Ivory Coast,

Ghana and Benin (Akoua-Koffi et al. 2006; Emmerich, Gunther, and Schmitz

2008; Frame 2007), but only one clinical case of Lassa fever has been

14
reported in these countries (Gunther et al. 2000). In addition, LASV-infected

M. natalensis (Safronetz et al. 2010) and antibody-positive individuals were

identified in Mali (Atkin et al. 2009; Frame 2007; Richmond and Baglole

2003). There have also been 28 reported cases of travelers importing Lassa

fever to Europe and North America since 1969 (E-alert 24 July: Case of Lassa

fever imported into Germany from Sierra Leone 2006; Amorosa et al. 2010;

Atkin et al. 2009; Gunther et al. 2000; Kitching et al. 2009; Macher and Wolfe

2006), of which 36% died, with the last case imported in the USA in 2010

(Amorosa et al. 2010).

2.5 Transmission

The virus is primarily transmitted to humans by contact with the urine and

feces of the reservoir host Mastomys natalensis, also known as the multi-

mammate rat (FichetCalvet et al. 2007; Keenlyside et al. 2003; Lecompte et

al. 2006; McCormick et al. 2008b; Monath et al. 2007b; Wulff, Fabiyi, and

Monath 2007). Another possible route of transmission from rodent-to-human

is through the ingestion of infected multi-mammate rats (ter Meulen et al.

2009). In addition, person-to-person spread can also occur, particularly in

hospitals, often resulting in significant outbreaks of disease and breakdowns

in the local health care system. In common with many other VHF outbreaks,

15
nosocomial transmission is believed to occur through close contact with

blood and secretions from infected patients (Frame et al. 2007; Fraser et al.

2007; Monath et al. 2007b).

2.6 Pathogenesis of LASV infection

2.6.1 Infection

As mentioned previously, humans are believed to become infected with LASV

through skin abrasions or inhalation of particulates from rodent’s urine. The

virus probably then spreads in the human body via the reticuloendothelial

system (Baize et al.2004; Lukashevich et al. 1999; Mahanty et al. 2003;

Walker et al. 1982b; Winn, Jr. and Walker 2007), resulting in a multi systemic

disease. Recent data from experimental infection of cynomolgus monkeys

provides evidence that dendritic cells (DCs) are the primary target cells in

vivo, as in many other VHF infections, and that the virus is present initially

in lymphoid tissues. It later migrates to the liver and adrenal glands to finally

reach endothelial cells of various tissues, including the central nervous

system and epithelial cells throughout the body, resulting in a multi systemic

infection (Hensley et al.2011).

16
2.6.2 Host immune response

Immunity to Lassa fever

LASV infection in humans is generally believed to provide life-long immunity,

although mild secondary infections might occasionally occur, as noted by an

increase in antibody titers in some individuals (McCormick et al. 2008b). An

antibody response has been demonstrated to occur during Lassa infection

against the glycoproteins, NP and the Z protein but the importance of

mounting an immune response targeted against one Lassa antigen versus

another one has not been investigated (Barber, Clegg, and Lloyd 2009;

Gunther et al. 2001a; Hummel, Martin, and Auperin 1992; Lukashevich,

Clegg, and Sidibe 1993; ter Meulen et al. 1998). Most evidence suggests so

far that the humoral immune response to LASV does not play a role in

clearance of the virus during natural infection. Viremia is present throughout

the course of the disease in humans, during which non-neutralizing

antibodies are detected (Johnson et al. 2008). In addition, no correlation has

been observed between clinical outcome and appearance of antibodies to

LASV (Johnson et al. 2008). Measurable amounts of neutralizing antibodies

only appear later, during the convalescence phase of the infection (Tomori

et al. 2008). Nevertheless, LASV-immune plasma studies in animals have

17
demonstrated that antibodies from convalescent animals can be protective

(Jahrling 2003; Jahrling and Peters 2008). Recent data from cynomolgus

monkeys also showed that antibodies appear earlier and to higher titers in

survivors than in non-survivors (Baize et al. 2009).

2.7 Level of awareness of Lassa fever and its vector

In 2001, a study on the knowledge, attitude, and practices regarding Lassa

fever was undertaken in Kenema (Sierra Leone) among 813 men and 867

women in four camps for internally displaced people and eight primary health

units. The survey revealed a reasonable knowledge of Lassa fever, its mode

of transmission, control measures, and the seriousness of the disease.

However, there were some worrying gaps in application of this

knowledge, such as inappropriate actions after killing rats (Merlin ;2012).This

was demonstrated by the occurrence of an outbreak of 823 cases, including

153 deaths (case fatality rate 19%), from January 2009 to April 1997, despite

an extensive outreach programme (Merlin ;2012). The study therefore

highlighted the need for an increased awareness on the appropriate methods

for disposing dead rats in this locality.

18
The need for greater understanding of the perceptions and beliefs of the

local population became apparent after a small pilot study (of 23 people)

was undertaken in 2002 in Sierra Leone (Merlin ;2012). In this study, Data

were collected by means of focus groups and semi-structured interviews,

which were facilitated by trained local health workers. Two groups consisting

of chiefs, elders, female, male adults and male youths were conducted, one

in an affected and the other a non-affected region of Sierra Leone. Two

interviews with relatives of patients on the Lassa fever ward and one with a

District Nurse sister were also conducted. Data were collected in or

translated into English, tape-recorded, transcribed and analysed

thematically. Participants were asked about the socio-economic impact of

issues relating to risk factors, early diagnosis, medical treatment and the

sequelae of Lassa fever (Merlin ;2012). One of the risk factors for Lassa fever

voiced by participants related to rodent control. Without exception, it was

suggested that rodent control and a clean environment would reduce the

risk of Lassa fever and other similar diseases. However, it was reported that

not everybody in the community shared this knowledge and that further

education relating to this is requirement13. More specific to Lassa fever, the

social calamities of miscarriage and deafness were discussed at length. In

19
relation to miscarriage, the blame appears to lie directly with the woman.

Participants suggested miscarriage is often attributed to witchcraft and

commonly leads to the breakdown of a marriage. Throughout the data,

repeated references were made to the social embarrassment caused by

Lassa fever. The issue of social exclusion appears to be linked with

reluctance to seek a diagnosis of, or medical treatment for, the symptoms of

Lassa fever. The need for further education, specifically in relation to the

safe disposal of rat carcasses and the mode of human transmission was

deemed necessary in order that people are absolutely clear about specific

risk factors, but do not fear and isolate people

unnecessarily(Inegbenebor;2005). It was reported that in reality, early

diagnosis is impeded by lack of knowledge and the absence of a test that

may be carried out in the community. Both groups discussed the need to

educate the population about the signs and symptoms of Lassa fever. In

addition, the group from the affected area discussed the necessity for a local

laboratory in their area. The deterrents met in seeking appropriate medical

treatment to the disease caused by the vector was highlighted in this small

pilot study, participants suggested for a variety of reasons that many people

were unlikely to seek medical care for the Lassa fever. In the first instance,

20
medical treatment is expensive and may be accessed at the direct expense

of other necessities such as food for the family and school fees. Participants

repeatedly explained that when one member of the family required medical

treatment, the other members suffered financial hardship, even hunger

(Merlin;2012). Cultural issues such as a belief in traditional remedies and

mistrust of the medical treatment offered at the hospital were also described

as important. Participants in each group and interview reported this

apparently common belief that people are killed after being admitted to the

Lassa fever ward. In addition to financial and cultural factors, participants

discussed the practical problems that arises when parents are hospitalized,

in particular, childcare and „maintaining agricultural commitment‟. It was

suggested that such commitments prevent people using medical facilities

(Merlin;2012, Richard and Deborah; 2003).

This study though qualitative is rather generalized since it interviewed only

few persons. A cross sectional study might therefore be needed for a better

understanding of the perception and belief of people in this locality as

regards Lassa fever and its vector.

In 2002 a local study was done in Ihiagwa, Owerri West Local Government

Area, Imo State in Nigeria to compare the case fatality rates of Lassa fever

21
and other medical diseases commonly seen in adult medical wards, as well

as to determine the community habits that make Lassa fever endemic in

Ihiagwa in Owerri west local Government, Imo State, with the aim of

prescribing preventive measures for its control in Nigeria. responses from

respondents interviewed by trained interviewers on their knowledge,

attitudes and practices pertaining to Lassa fever were used. The case-fatality

rate of Lassa fever in this centre was 28%. Cultural factors and habits were

found to favour endemicity of Lassa fever in Ihiagwa .

The large sample size of this study is an advantage since it must have

increased the validity of the result. However, this study was done 10 years

ago and might therefore not reflect the current level of awareness of the

disease and its vector control in the populace since subsequent Lassa

outbreaks have occurred in this locality.

2.8 Control measures adopted against the Lassa fever vector

Prevention of the Lassa virus from its host to humans can be achieved by

avoiding contact with Mastomys rodents, especially in the geographic regions

where outbreaks occur (Adewuyi et al;2009). Using these rodents as a food

source is not recommended. Trapping in and around homes can also help

22
reduce rodent populations. Putting food away in rodent-proof containers and

keeping the home clean help to discourage rodents from entering homes

(Barnes;2007). Various kinds of metal food storage bins have been devised

and are unquestionably effective(Barnes;2007). Adoption of these effective

means of rodent-proof food storage in individual houses would undoubtedly

reduce the Mastomys population and also reduce the attractiveness of such

houses to invading rats. In this way, rodents in houses would be reduced as

well as evaded15. Means of reducing pest numbers fall into two categories:

(1) those that affect the characteristics of the species (use of

chemosterilants, of toxicants such as zinc phosphide, and of anticoagulant

rodenticide); and (2) those that modify environmental conditions in such a

way as to be detrimental or lethal to the vector species such as keeping food

out of the reach of rodents(Barnes;2007). Although chemosterilants have

achieved some degree of success in the field trials, primarily against rats, in

actual use such materials possess most of the disadvantages of conventional

toxicants and, in addition, are extremely slow to act and to show effect. For

example, in a successful experiment done in 1973 in South Africa,

investigators were able to reduce a rat population by 75% in 6 months. In

many cases, unanticipated biological and physiological factors have been

23
said to reduce or prevent success in field trial and practice (Richard and

Deborah;2003). The use of anticoagulant rodenticides offers certain

advantages over acute toxicants in almost any situation requiring rodent

poisoning, not only because of their relative safety for man and other non-

target species, but also because their slow action makes bait shyness far less

likely to develop among target rodents than it would if acute poisons were

used (Richard and Deborah;2003). However, this control method in general

suffers from lack of knowledge and has often resulted in large amount of

chemicals being distributed in the environment without the desired control

effects (Richard and Deborah;2003). In order to achieve any degree of

success, rodenticidal programmes, if used alone, must be not only well-

founded and based on considerable knowledge of Mastomys and its

environment, but also, of necessity, persistent and repetitive (Richard and

Deborah;2003). How repetitive such a programme might need to be in

practice can be illustrated by available data, provided in the reviews

presented by Dr Coetzee and

Dr Isaacson in 2007. This review presented a composite picture of the

biology of Mastomys natalensis in West Africa as follows:

i. Breeding season-about 10 months of the year.

24
ii. Average age at sexual maturity-approximately 90 days.

iii. Gestation period-23 days.

iv. Average time between litters-25 days (postpartum oestrus).

v. Average number per litter-10.

vi. Average number in litter reaching recruitment age-8.5.

vii. Average longevity-approximately 1 year15.

From this data it was estimated that a hypothetical population would return

to its carrying capacity density in approximately 4 months even if a 90%

control was achieved with acute toxicants and rodenticides and migration

ignored. Thus, a well-conducted programme depending entirely on acute

toxicants would need to be carried out at least twice per yearperhaps three

times to achieve more than temporary success (Richard and Deborah;2003).

Although this review was done 37 years ago, it is however still very useful

and can be said to be up-to-date since it was done using the biological

properties of Mastomys which is unaffected.

Although it might have been postulated that a thorough and effective

poisoning campaign against Mastomys could conceivably bring its

25
populations down to a level at which rodentto-rodent virus transmission

would no longer occur and the cycle would be broken. Allan Barnes in 2007

noted two circumstances that would militate against this postulate. One is

the occurrence of Lassa fever in at least three countries, which indicates that

the disease is widespread in nature. It was noted that in such a case, a

rodent population recovering after cessation of control activities would soon

be re-infected. Another factor was that, at least in laboratory mice, virus can

persist in urine up to 82 days; thus, a single infected animal surviving the

control programme could re-infect the resurgent population.

In 1973, Howard and co-workers were able to produce experimentally a four-

fold resistance to the highly toxic compound sodium monofluoroacetate in a

laboratory population of African rats in 5 generations. It was evident that

persistent exposure of any highly reproductive rodent population, such as

Mastomys natalensis, to either an anticoagulant or an acute rodenticide is

quite likely to bring about resistance problem and that resistance to toxicants

usually develops gradually (Richard and Deborah;2003).

Most often in the tropics, when the need for rodent control becomes

apparent, the "firefighting" approach is taken, and strategies and methods

are used that are often inadequate and started too late to help solve the

26
problem. It is unfortunately true that such operations are often attempted

for political and social reasons as well as for disease control (Richard and

Deborah;2003).

In 2006, Steven Belmain in a RatZooMan workshop on rodent borne diseases

published by the Natural resource institute noted that in Africa, the politics

of rodent pests implies that providing government with new data which

shows the true extent of rodent disease problems is not actively encouraged

by most governments (Steven and Belmain; 2006). The worry was that the

figures will be alarming, cause panic, and add to the list of actions which

must be taken. It was also noted that rodent pest populations are worsening

for a greater proportion of people living in Africa, through urbanisation and

difficulties in providing basic standards for urbanised infrastructures

(sewage, water, rubbish collection, rat-proof housing) Urban and peri-urban

rodent populations generally increase with worsening sanitation, and urban

slums are growing in and around many African cities. Rural practices such

as deforestation, agricultural intensification and other anthropogenic

changes to the environment were said to change rodent species diversity,

bringing people (or peridomestic rodents and livestock) into contact with wild

rodents (Steven and Belmain; 2006). . Steven Belmain particularly made

27
statements like “We do not know if rodent disease problems are worsening.

However, rodent pest populations are undoubtedly increasing with

increasing human populations”, and “What people are doing in rural and

urban areas of Africa is fundamentally encouraging conditions for the spread

of rodent-borne diseases” (Steven and Belmain; 2006).

A research work reviewed by Allan M Barnes in 2007 on the problems of

rodents controls in rural tropical areas revealed that, although various kinds

of metal food storage bins have been devised and are unquestionably

effective against Mastomys, the chief obstacles to their use appeared to be

the initial cost, distribution, and convincing people of the need to use

them14. However, this might not be said to be a reflection of the current

obstacles encountered in the use of such storage bin, as the increased

number of outbreaks in tropics in recent times might have created some

awareness in the populace as well as endeared monetary support from the

government.

In another study done between 2005 and 2006 on the ecological based and

sustainable rodent control strategy in South Africa, it was noted that

conventional control methods such as trapping, clubbing, and use of human

friendly rodenticides have remained largely ineffective, forcing peri-urban

28
and rural communities to resort to the illegal use of highly toxic pesticide

(rodenticide) with acute toxicity or other poisons which induce fast and

painful death (Steven and Belmain; 2006). The consequence of this was

noted to include human poisoning and environmental contamination. This

use of acute poisons was also noted to be perpetuated by the perceived

value of collecting dead rodent bodies (which does not occur when using the

more effective anticoagulant poison) (Frikkie and Maltitz;2006) .

2.2 THEORITICAL FRAME WORK

The study employed the Media system dependency theory (MSD), proposed

by Ball-Rokeach & DeFleur (1976). The theory claimed that, an integral

relationship exists between the audiences, media and the larger social

system. According to MSD, an individual will depend on media information

to meet some needs and achieve certain goals. The theory identified two

basic reasons individuals will depend on the media for information. First, an

individual will become more dependent on media that meet a number of

their needs than media that provide just a few and secondly, dependence

on the media may be imperative for social stability especially when social

29
change and conflict are high and established institutions, beliefs and

practices are challenged.

Following these assumptions, this study can be explained on the premise

that individuals will depend largely on the media for information on Lassa

fever expecting to get adequate information required to prevent them from

being infected by the disease. It is also assumed that the source of

information of the disease would go a long way in determining an individual’s

level of understanding of the disease.

The theory has been criticized for not considering other means of information

such as inter-personal relationships which is ultimately linked to the media.

It has also been criticized for not taking into consideration problems that

may occur during the information process, like distortion of information or

recreating of media stories.

30
 CHAPTER THREE

MATERIALS AND METHODS

3.1 The Study Design

A descriptive cross sectional study design was utilized for this study.

3.2 The Study Area

(a) Location

The study area is located on latitude: 50251150.231N and longitude

70211149.331E. Ihiagwa is located in Owerri West Local Government in Imo
state which is in the South Eastern part of Nigeria. It is approximately 40m2
in area and it is surrounded by the Otamiri River .

(b) Climate

There are two distinct seasons which are rainy or wet season and
harmattan or dry season. The rainy season begins in the month of April and
lasts until October while the dry season begins in the month of November
and lasts until March. The vegetation is typical rainforest. It has an annual
mean temperature of about 2,250-2500mm and a mean temperature of 25
– 270C. It also has a relative humidity is 80%.

31
(c) Vegetation

The vegetation of Ihiagwa is typical rainforest, although some parts consist

of Guinea savannah due to poor environmental management and pollution.
Agricultural produce such as palm produce, cassava and yam are produced
there. The main crops produced are yam, cassava, cocoyam, and maize.
Economic trees like the iroko, mahogany, obeche, bamboo, palm rubber, and
oil palm are in abundance.

(d) Geology and Hydrology

Ihiagwa lies geologically within Benin formation. This formation is

made up of friable sands with intercalations of clay and shale. The sand is
mostly coarse grained pebbly, poorly sorted and contains lenses of fine-
grained sands. The area is well drained by rivers Otamiri, Nworie, and
seasonal and Okintankwo-an offshoot of Imo river. The Otamiri watershed
covers about 10,000km2 with annual rainfall of 2250mm – 2500mm. the
watershed is mostly covered by depleted rainforest vegetation. The Otamiri
River is joined by the Nworie River at Nekede in Owerri.

(e) Population characteristics

According to the National Population Census (NPC) which conducted a

census in 2006, the population stands at 127,213 in which 62,990 are males
and 64,223 are females respectively.

32
(f) Economic Activities

Ihiagwa, which is in Owerri West Local Government of Imo State, is

known for commercial activities. The inhabitants are traders, artisans, civil
servants, and farmers who are predominantly natives. The economy consists
of commercial, financial, and industrial production and services undertaken
by the formal and informal sectors. The formal sector is dominated with
services and manufacturing sub-sectors which have been shrinking due to
deteriorating economic situation of the country while the informal sector has
been thriving due to the indigenous involuntary survival response of the city’s
residents to urban poverty and unemployment.

3.3 The Study Population

The study population consisted of students, civil servants, young

and adult market women.

3.4 Sample Size and Sampling Method

3.4.1 Sample Size Determination

Using the formula for minimum sample size:

n = Z2pq
d2

33
 Where n =minimum sample size

Z = 1.96

p = prevalence persons with Lassa antibody= 21% = 0.21

(prevalence of a study done by Adewuyi on the overview of Lassa

fever in Nigeria) ( Adewuyi et al;2009).

q = prevalence of persons without Lassa antibody = 1-p = 1-0.21

= 0.79 d = Error margin = 0.05

Therefore, n = 1.96 X 1.96 X 0.21 X 0.79

0.05X0.05
=254.9 =255(approx.)

However, a total of 282 respondents were used in the study to make

allowance for non-respondents.

3.4.2 Sampling Method

The total number of respondents which was 282 was allocated to the

respondents whereby 94 respondents were students, 80 of the respondents

were civil servants, 45 of the respondents were farmers and 63 of the

respondents were artisans. Then a stratified sampling method was used to

34
select the respondents from each category. The respondents were divided

into 4 strata based on their knowledge on the prevalence of lassa fever. The

strata were;

1. students

2. civil servants

3. Farmers

4. Artisans

For each stratum involved, respondents were selected using balloting in a

simple random sampling method.

3.5 Instrument for Data Collection

3.6 Validity of the Instrument

The researchers took a number of measures to ensure the validity of the

instrument. First, the instrument was given to reputed scholars in the field

of mass communication for vetting. Later, statisticians were consulted to

check the testability of the research hypotheses and to ensure that the

instrument could actually be used to generate data for the testing the

hypotheses.

35
3.6 Reliability of the Research Instrument

A pre-test of 50 copies of the questionnaire were designed and

administered to sampled 50 respondents in the study area. After four weeks

interval, a re-test of the same copies of the questionnaire was carried out

on the same respondents, where three errors or inconsistencies were noted.

The Guttmann scale of coefficient of reproducibility was used to test the

reliability of the instrument. According to Akpoghiran and Okoro (2014

p.960), and Asika (1991, p.65), the formula is as follows:

Coefficient of

The computation above shows that the instrument yielded reliability

coefficient value of 94%, which is an indication that the instrument is

reliable.

3.8 Method of Data Collection

36
Data was collected using a structured, interviewer administered

questionnaire which consisted of both open and closed ended questions. The

questionnaire was designed based on the objectives of the study and

standardized before administration. It consisted of three sections. The first

section was on the socio-demographic data of respondents, the second

section had questions on the levels of awareness of Lassa fever and its

vector, and the third section had questions on the vector control measures

adopted by the respondents.

3.9 Method of Data Analysis

Data collected was analyzed using the Statistical Package for Scientific

Solutions (SPSS) Version 20.0.

A scoring system was used to assess the respondents‟ knowledge of Lassa

fever.

Those who knew Lassa fever to be a deadly disease and to be transmitted

by rats were assumed to have good understanding, while those who either

did not think of Lassa fever as a disease or did not know it’s mode of

transmission were scored as having poor understanding.

37
The results were presented in tables and charts. Statistical test where

applicable was done.

3.10 Ethical Consideration

Respondents were informed about the nature and benefits of the study and

their informed consent was obtained verbally before the questionnaires were

administered.

38
 REFFERENCES

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menace. African Journal of clinical and experimental microbiology

10(3): 144-155.

Asogun A D. (2008). Lassa fever in Nigeria. Institute of Lassa fever Control,

ISTH, Irrua.

Barnes A M. (2007). Problems of rodent control in rural tropical areas. WHO

bulletin.

Frikkie K, Maltitz E. 2006. Ecological based and sustainable rodent control

strategy in South Africa.

http://www.allcountries.org/health/lassa_fever.html. Retrieved 02-11-2011

Inegbenebor U, Okosun J, Inegbenebor J.(2005) Prevention of Lassa fever

in Nigeria. PMID: 19712954

Magaretha I (2007). The ecology of Praomys (Mastomys) natalensis in

southern Africa. WHO bulletin vol 52

Merlin. `Licking' Lassa fever: a strategic review. London: Merlin, 2002.

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National population commission (NPopC) 2006 population and housing

census. Federal Government official Gazette. Number 2, volume 96,

2009.

Nigeria: Tackling the Lassa Fever Epidemic. This day. The day newspapers.

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Obabori A O, Ebosele R, Mokidi SK (2006). Decay problems in cities: Renewal

options. JABS; 4(1 and 2): 144-153.

Ogbu, E Ajuluchukwu, C J Uneke. (2007). Lassa fever in West African sub-

region: an overview. Journal of Vector Borne Diseases vol. 44(1), 1-

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Omilabu S A, Badaru S O, Okokhere P, Asogun D, Drosten C, Emmerich

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Steven R Belmain, (2006). Rats and human health in Africa: proceedings of

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WHO newletter, Geneva 2005.

41
 QUESTIONNAIRE
SECTION A: (SOCIO-DEMOGRAPHIC DATA).

1. Age (a) 15-20 yrs. { ) ( b) 25-30yrs { } (c ) 35 yrs and above

2. Marital status (a) single [ ] (b) married [ ] (c) widowed [ ] (d) divorced [ ]

(e) separated [ ].

3. Tribe………………………

4. Religion (a) Christianity [ ] (b) Islam [ ] (c) ATR (d) others, please
specify……………………

…
SECTION B: LEVEL OF AWARENESS.

5. Have you heard of the word Lassa fever (a) Yes [ ] (b) No [ ] If yes, from where

(a) Hospital [ ] (b) Media (television, radio, newspaper e.t.c ) [ ] Church (d) from the

market [ ] (e) others, specify…………

6. What do you understand Lassa fever to be……………………………………?

7. Do you know what causes Lassa fever (a) yes [ ] (b) no [ ]

8. If yes, then what? (a) Dirty environment [ ] (b) rat [ ] (c) drinking unclean water [ ]
others, please specify………………………………………………………………….

9. Do you think Lassa fever can kill? (a) yes [ ] (b) no [ ]

10. Do you know anyone that was sick of Lassa fever (a) yes [ ] (b) no []

11. If yes, who is this person to you? (a) a relative [ ] (b) a friend [ ] (c) a neighbour [ ]

(d)others, please specify……………………………………………………

42
 SECTION C: VECTOR CONTROL MEASURES

12. Are there rats in your home? (a) yes [ ] (b) no [ ]

13. If yes, have you ever tried to eradicate the rats in your home? (a) yes [ ] (b) no [ ]

14. If yes, what did you use (a) Indocid [ ] (b) Rodenticide [ ] (c) kill and dry [ ] (d) traps [ ]

(e) others, specify………………………………………………

15. How often do you eradicate the rats in your home (a) anytime a rat is in the house [ ] (b)

everyday (c) once a week [ ] (d) once a month [ ] (e) once a year [ ]

16. Do the rats get killed (a) yes [ ] (b) no [ ]

17. If yes, is it (a) all at once (b) only a few are killed (c) most of them are killed.

18. What do you do to the dead rat (a) eat it [ ] (b) dispose it [] (c) ignore it [ ]

19. If dispose it, how? .................................................................................

43