ABSTRACT
BACKGROUND: Lassa fever is one of the neglected tropical diseases that is endemic in West Africa. It has important global health implications given that it is the most exported of all viral haemorrhagic fevers. In Student hostels, overcrowding, poor food hygiene practices, and poor solid waste disposal predispose them to a higher risk of harbouring vectors of Lassa fever infection. Understanding the risk perception of Lassa fever among undergraduate students will help identify potential gaps in knowledge and practices, guiding the development of targeted interventions to prevent and control outbreaks.
OBJECTIVES: In this study, we sought to assess the knowledge of Lassa fever, to conduct a risk assessment of Lassa fever, and to ascertain the determinants of high risk perception of Lassa fever among undergraduates of the University of Benin. We also sought to identify the preventive and control measures employed by undergraduates of the University of Benin against Lassa fever and to assess their adherence to Lassa fever prevention and control measures. We provided a general review of the literature on the knowledge, risk assessment, risk perception, preventive and control measures, and adherence to preventive and control measures of Lassa fever among university undergraduates.
METHODOLOGY: A descriptive cross-sectional study design was used. The study was conducted from August 2023 to February 2024 among undergraduates at the University of Benin. The sample size was calculated using Cochran’s formula for descriptive studies. A multi-stage sampling technique was used. Data was collected using a structured self-administered questionnaire. Knowledge of Lassa fever was assessed using 29 questions in 7 knowledge domains; mode of transmission, signs and symptoms, treatment, complications, prevention, and 2 people at risk. A total of 10 questions was used to assess the perceived risk of respondents to Lassa fever. An observational checklist comprising of 7 domains; overcrowding, surroundings, roofs, doors/windows, waste disposal, sewage disposal, and drainage was used to assess the environmental risk of Lassa fever. A total of 9 questions was used to assess the common preventive and control measures employed by the students, and their adherence to the preventive and control measures. Univariate analysis was carried out on the outcome variables, bivariate analysis was carried out for parametric and non-parametric testing. Multivariate analysis using binary logistic regression was carried out to further determine the significant predictors of outcome variables. Results obtained was presented using tables, charts, and prose. Ethical approval was obtained from the Ethics and Research Committee, University of Benin Teaching Hospital. Data were analyzed using the IBM SPSS version 25.0 and the level of significance was set at p < 0.05. Data was presented using prose, frequency tables, and graphs.
RESULTS: A total of 802 respondents participated in the study. Results from the study showed that the mean age of the respondents was 20.96 ± 2.2 years. The majority, 699 (87.2%) of the respondents had good knowledge of Lassa fever, while 103 (12.8%) had poor knowledge of Lassa fever. The statistically significant associations between the sociodemographic characteristics of the respondents and their knowledge of Lassa fever were their ages (χ 2 = 9.715, p = <0.001), level of study (χ 2 19.144, p = 0.002), and their hall of residence (χ 2 = 36.876, p = <0.001). Respondents aged between 19-21 years were more likely to have a good knowledge, respondents in 600 level, and those residing in Clinical hostel were more likely to have a good knowledge of Lassa fever. Predictors of good knowledge of Lassa fever were respondent’s age, faculty, and hall of residence. The majority, 607 (75.7%) of the respondents had an overall high risk perception of Lassa fever, 127 (15.8%) had a moderate risk perception, and 68 (8.5%) of the respondents had a low risk 3 perception of Lassa fever. There was a statistically significant association between the respondent’s age (χ 2 = 43.722, p = <0.001), faculty (χ 2 = 46.876, p = <0.001), level of study (χ 2 = 47.209, p = <0.001), and hostels (χ 2 = 26.891, p = <0.001) with their risk perception. Respondents aged 19-21 years, those in the faculty of Arts and Humanities, respondents in 300 level, and those residing in Non-medical hostels were more likely to have a high risk perception of Lassa fever. Predictors of high risk perception were respondent’s faculties, hostels, and knowledge of Lassa fever. The overall risk assessment of Lassa fever was low in 61.1% of the hostels, while 38.9% of the hostels had a high-risk assessment. There was a significant association between risk perception and risk assessment (χ 2 = 9.150, p = 0.010). The majority, 715 (89.2%) of the respondents employed good preventive measures against Lassa fever, while 87 (10.8%) of the respondents had poor preventive measures against Lassa fever. There was a statistically significant association between the respondent’s age (χ 2 = 19.861, p = <0.001), faculty (χ 2 = 6.919, p = 0.045), level of study (χ 2 = 30.659, p = <0.001), and their hall of residence (χ 2 = 32.140, p = <0.001). Respondents aged 19-21 years, those in the Faculty of Sciences, respondents in 600 level, and those residing in Clinical hostel were more likely to employ good preventive measures against Lassa fever. Predictors of good preventive measures were the respondent’s faculty, knowledge of Lassa fever, and risk perception of Lassa fever. A greater proportion, 487 (60.7%) of the respondents had good adherence to preventive practices against Lassa fever, while 315 (39.3%) of the respondents have poor adherence to preventive practices against Lassa fever. There was a statistically significant association between the respondent’s age (χ 2 = 12.802, p = 0.005), faculty (χ 2 = 55.266, p = <0.001), and level of study (χ 2 = 50.079, p = <0.001). Respondents aged 22-24 years, those in College of Medical Science, and respondents in 600 level were more likely to adhere to Lassa fever prevention and control 4 measures.
