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Impact of Lassa Fever Awareness on Early Healthcare-Seeking Practices among Residents of Endemic Communities in Nigeria

Abstract

Lassa fever remains an important public health concern in Nigeria, particularly in communities where environmental, social, and socioeconomic conditions may increase the risk of transmission. Early recognition and prompt healthcare seeking are critical for improving clinical outcomes and reducing the risk of further transmission. Lassa fever is primarily transmitted to humans through contact with food or household items contaminated by infected rodents, while person-to-person transmission may occur through contact with infected body fluids, particularly in healthcare and household settings. Lassa fever awareness provides residents with information about the causes, modes of transmission, signs and symptoms, risk factors, preventive measures, and the importance of seeking appropriate healthcare promptly when symptoms occur. Early healthcare-seeking practices refer to the actions taken by individuals to obtain professional healthcare soon after the onset of symptoms that may be associated with Lassa fever, rather than delaying care or relying solely on self-medication, traditional remedies, or other non-professional sources. In endemic communities in Nigeria, inadequate awareness, misconceptions, fear and stigma, financial constraints, geographical barriers, reliance on self-medication, and limited access to healthcare facilities may contribute to delays in seeking appropriate care. Effective Lassa fever awareness may improve recognition of concerning symptoms and encourage timely utilization of healthcare services. Against this background, this study investigates the impact of Lassa fever awareness on early healthcare-seeking practices among residents of endemic communities in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains healthcare-seeking behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding residents' decisions to seek care when experiencing symptoms. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from Lassa fever awareness may influence early healthcare-seeking practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how Lassa fever awareness may influence early healthcare-seeking practices among residents of endemic communities in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adult residents of selected Lassa fever-endemic communities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, endemic communities, households, and eligible participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured Lassa fever awareness education covering the nature of Lassa fever, transmission routes, common signs and symptoms, risk factors, rodent-control measures, food and household hygiene, prevention of person-to-person transmission, recognition of symptoms requiring urgent medical attention, appropriate healthcare facilities, and the importance of avoiding delays in seeking professional care. Early healthcare-seeking practices will be assessed using indicators such as time between symptom onset and healthcare contact, first source of care, prompt reporting of suspected symptoms, utilization of formal healthcare facilities, avoidance of prolonged self-medication, and compliance with recommended referral or follow-up. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, Lassa fever awareness, exposure to health education, and healthcare-seeking practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of Lassa fever awareness on early healthcare-seeking practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that Lassa fever awareness has a significant positive impact on early healthcare-seeking practices among residents of endemic communities in Nigeria. Residents exposed to structured Lassa fever awareness education are expected to demonstrate improved knowledge of transmission, symptoms, risk factors, and prevention and greater willingness to seek professional healthcare promptly when concerning symptoms occur. Awareness may reduce delays associated with self-medication, traditional remedies, misinformation, and failure to recognize early symptoms. It may also improve residents' knowledge of appropriate healthcare facilities and encourage early reporting and referral. However, awareness alone may not guarantee early healthcare seeking because residents may continue to face barriers such as poverty, transportation difficulties, distance to healthcare facilities, limited availability of diagnostic and treatment services, fear of stigma, and concerns about healthcare costs. Consequently, Lassa fever awareness is expected to be most effective when supported by accessible healthcare services, effective disease surveillance, reliable referral systems, affordable care, community engagement, and timely public health communication. The study is expected to contribute to the literature on Lassa fever, infectious disease prevention, healthcare-seeking behaviour, health education, outbreak preparedness, community health, and public health in Nigeria by providing empirical evidence on the impact of Lassa fever awareness on early healthcare-seeking practices among residents of endemic communities. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention (NCDC), National Primary Health Care Development Agency (NPHCDA), state ministries of health, local government health authorities, healthcare facilities, community health workers, public health practitioners, development partners, and policymakers regarding strategies for improving early detection and treatment of Lassa fever. The study will also provide evidence-based recommendations for strengthening community-based Lassa fever education, improving recognition of early symptoms, strengthening referral and surveillance systems, increasing access to appropriate healthcare services, reducing stigma and misinformation, and promoting prompt healthcare seeking in endemic communities across Nigeria.

Keywords: Lassa fever awareness, early healthcare-seeking practices, endemic communities, Lassa fever, infectious disease prevention, health education, disease awareness, early detection, healthcare seeking, outbreak preparedness, community health, public health, Nigeria.