EFFECT OF TARGETED HEALTH EDUCATION ON KNOWLEDGE OF CHOLERA PREVENTION AND TREATMENT AMONG PHC WORKERS

1.1 Introduction

Cholera is an epidemic prone diseases that causes watery diarrhea, lives naturally in brackish-fresh water, without quick response or untreated, may lead to dehydration and possible human deaths. Cholera an infectious disease caused by a bacterium known as Vibrio cholerae usually found in contaminated food and water. Cholera continues to be a significant threat to global public health with an estimated 2.86 million cases and 95,000 associated deaths occurring annually, of which, only a fraction is reported due to inadequate surveillance systems and inconsistencies in case definitions as well as economic, political, and social disincentives (Ali et al. 2015).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

1.2 Background of Study

Globally, cholera is currently prevalent in Africa, Asia, and parts of the Middle East, where Yemen reported recently the most cholera cases in a single country (World Health Organization 2018). It has been accepted that the best form of defense against cholera remains prevention by ensuring that hygienic condition in living surroundings are maintained in order to stop the proliferation of the causative bacterium. A second important aspect to cholera control is the prompt, accurate and effective identification and management of outbreaks when they occur. In these two aspects, health workers play a critical role in several communities as they are regarded as verified sources of health education while their job function includes disease outbreak surveillance and notification (Bhattacharya et al., 2009; Global Workforce Alliance, 2008).

The prevalence of cholera has been associated to occurrence and numerous undiagnosed cases and regular cholera upsurge in Nigeria. According to (Chaignat, n. d), WHO cholera response group coordinator in Nigeria, - 13,000 cases of cholera was reported in 2009- and has spread rapidly in some places than in other areas especially in the northern cities and rural communities- Zaria, Jos, Kano, Maidugiri, Sokoto, and Ilorin- all these local and state have no microscope and trained health workers to diagnose cholera incidence as it occurs. The outbreak and severity of cholera infections has been reported in the northern region of Nigeria causing 781 human deaths, and Katsina state alone recorded highest number of cholera cases- 3,310 with 175 human deaths The epidemic did not spare the southern region of the country where most of the populations leaves around the lagoons, wetlands and dilapidated rural communities with no health care centers.

In Nigeria, number of significant factors has been linked in the widespread of infectious viruses that causes cholera. The risk of cholera infection from human to human is an isolated incidence unlike Ebola virus, transmitted with human contact; people visiting areas with epidemic cholera are unlikely to contract the infection that causes cholera. Another factor that enhances the transmissions of cholera disease includes population migration, crowded places (refugee camp), drinking polluted surface and ground water, well water, and water sold by vendors on the streets and highways not sanitized or chemically disinfected (Adagbada, et. al, 2012).

Cholera infections are commonly severe, and highly virulent (Tutu et al., 2019). Additionally, cholera outbreaks usually occur in areas which have contaminated water or food because of poor sanitary measures (Alkhaledi, 2016). The bacteria are transmitted along the gastrointestinal tract through contaminated food or water (Deen et al., 2020).

In addition to the watery diarrhea, other symptoms included vomiting and abdominal colic. Furthermore, the infection affects all age groups (Orimbo et al., 2020). Diagnosis of cholera depends mainly on culturing the causative bacteria from a stool sample of the patient (Talaei et al., 2015). Rapid testing can also provide a preliminary result to start a targeted treatment plan (Mutreja et al., 2020). The management of cholera consists of antibiotics for the infection, and rehydrating measures for the vomiting and diarrhea through electrolytes and fluids administration (Taylor et al., 2015).

Therefore, in Enugu State where the research was carried out, the activities that was conducted is to know the Effect of Targeted Health Education on Knowledge of Cholera Prevention and Treatment among PHC Workers.

1.3 Statement of Problems

Investigation revealed that the cholera outbreak is still a public health problem in Nigeria. Knowledge level, perceptions and hygiene practices contributes to the Cholera preventive measures that are implemented. Despite the vast body of knowledge on cholera, treatments and prevention measures, Cholera remains a challenge in Enugu municipality (Mpazi and Mnyika., 2005). As the levels of knowledge, perceptions and hygiene practices determine the preventive measures needed to combat the recurrence of Cholera; this study assessed the knowledge, perceptions and practices of the heads of households regarding cholera transmission and prevention measures.

1.4 Aim and Objectives of Study

The aim of the study is to investigate the Effect of Targeted Health Education on Knowledge of Cholera Prevention and Treatment among PHC Workers in Enugu State. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess the Knowledge, Perceptions and Practices on Cholera transmission and prevention measures among PHC Workers in Enugu State;
2. To provide cholera transmission and prevention information measures towards the knowledge and practices of PHC Workers;
3. To investigate the factors inhibiting the prevention of cholera among PHC Workers in Enugu State; and
4. To suggest possible solution towards eradicating the factors hindering the prevention practices of cholera among PHC Workers in Enugu State.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are there cholera transmission and prevention information measures towards the knowledge and practices of PHC Workers?
• Is there any possible solution towards eradicating the factors hindering the prevention practices of cholera among PHC Workers in Enugu State?
• What are the factors inhibiting the prevention of cholera among PHC Workers in Enugu State?
• What are the Knowledge, Perceptions and Practices on Cholera transmission and prevention measures among PHC Workers in Enugu State?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant cholera transmission and prevention information measures towards the knowledge and practices of PHC Workers
• H1: There are significant cholera transmission and prevention information measures towards the knowledge and practices of PHC Workers

Hypothesis Two

• H0: There are no significant factors inhibiting the prevention of cholera among PHC Workers in Enugu State
• H1: There are significant factors inhibiting the prevention of cholera among PHC Workers in Enugu State

1.7 Significance of Study

The relevance of this study will in maintaining and sustaining healthy environment for their mental and physical well-being. It will also help in improving the knowledge of hand washing benefits among health workers.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Effect of Targeted Health Education on Knowledge of Cholera Prevention and Treatment among PHC Workers in Enugu State.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.10 Definition of Terms

Cholera: Cholera is an epidemic prone diseases that causes watery diarrhea, lives naturally in brackish-fresh water, without quick response or untreated, may lead to dehydration and possible human deaths. It is a waterborne, life-threatening diarrheal infection caused by a bacterium (Momba & Azab El-Liethy 2019).