Pa ge 1 Pa ge 14 2 Perception of Asaba People in Delta State Nigeria towards National Community Response to Covid-19 Ngozi G. Orofuke1, Ayirioritse P. Ighosewe2, Christiana I. Elusoji3, Uzochukwu Ofonakara4, Matthew Chindeum Ezeh5 Charles C. Ofili1, Michael O. Otutu1, Eugene O. Ohanme4* Article Information ABSTRACT Received: August 28, 2024 Accepted: October 01, 2024 Published: December 10, 2024 The 2019 coronavirus pandemic has caused global concern and led to measures such as hygiene, isolation, and social distancing. 99.5% of respondents knew about COVID-19, according to a Nigerian newspaper report, and most of them cited the internet, social media, and television as their main information sources The majority of defensive methods, according to 82.3% of respondents, include good cleanliness, self-isolation/social distance, face masks/gloves, and prayer. Also, 52.1% of respondents, however, said that the government was not doing enough to stop the pandemic in Nigeria. People who were well-informed on COVID-19 felt favorably about the country’s reaction. Most responders did not comply with preventive measures because they thought the pandemic was more of a hoax than a real threat. An accurate information dissemination plan is advised to guarantee adherence to preventive measures and to increase public awareness of the pandemic. In view of the ongoing epidemic, the study emphasizes the necessity of precise information dissemination tactics to guarantee adherence to preventive measures. Keywords Covid-19, Delta State, Pandemic, Perception About Covid INTRODUCTION A new virus known as COVID-19 was identified in Wuhan, Hubei Province, China, in 2019. Severe acute respiratory syndrome coronavirus 2 is the virus’s cause. SARS-CoV-2) (Zhu et al., 2020). First diagnosed as a pneumonia-like illness in December 2019 from an idiopathic perspective, the sickness was officially recognized as a global public health emergency on January 30, 2020 (Zhu et al., 2020). Since then, additional research and reports from many locations around the world have revealed more about COVID-19. As of May 9, 2020, there were 4,067,112 confirmed cases of COVID-19 worldwide and 280,507 documented deaths. As of May 14, 2020, there were 4,308,809 reported cases of COVID-19, including 296,680 deaths (Zhang et al., 2021). On February 27, 2020, the first verified case of COVID-19 was reported in Nigeria. The first case of COVID-19 in Nigeria, according to the National Center for Disease Control (NCDC), involved an Italian national who arrived on a Turkish Airlines flight from Milan via Istanbul on February 24. (Harapan et al., 2020). From that point on, the number of cases has increased steadily. As of May 14, 2020, 5,962 coronavirus infections had been confirmed, 1,180 cases had been discharged, and 168 deaths had been reported. The majority of COVID-19 infections in Nigeria have been linked to contacts with previously confirmed cases and returning tourists (Harapan et al., 2020). In attempt to stop the virus’s spread, the Nigerian federal government has implemented a number of measures, such as the closure of all educational institutions, lockdowns in Lagos and the Federal Capital Territory (FCT), instructions for people to stay at home, and prohibitions on public gatherings (Jacobs & Okeke, 2022). The NCDC has also raised public awareness of the coronavirus pandemic by employing crucial communication techniques in print, social, and electronic media to inform Nigerians of its spread (Dan-Nwafor et al., 2020). Social workers are essential in supporting efforts to avoid disease because they assist in managing anxiety and other pandemic-related issues while also providing accurate information from reliable sources (Ross & de Saxe Zerden, 2020). Many people find lockdown procedures and physical segregation to be unavoidably upsetting, startling, confusing, and alienating, especially vulnerable populations like people with disabilities (PWDs) (Bhattad & Pacifico, 2022). Thus, the advocacy role of social workers is to shape social policy with respect to the safety of the economically disadvantaged and disabled, for whom lockdowns would have adverse consequences. Social service providers in China played a crucial role in the COVID-19 response by assisting in the identification of vulnerable populations’ needs, planning volunteer aid, mobilizing local resources, and conducting studies on the quality of life in Sichuan province (Wang & Liu, 1 Department of Community Medicine, Delta State Primary Healthcare Development Agency, Delta State Nigeria 2 Department of Paediatrics, Delta State Specialist Hospital, Asaba, Delta State, Nigeria 3 Department of Nursing Sciences, Benson Idahosa’s University, Benin City. Edo State, Nigeria 4 Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, Alex Ekwueme Federal University Ndufu- Alike Ikwo, Ebonyi State, Nigeria 5 Department of Economics, Dennis Osadebay University, Asaba, Delta State, Nigeria * Corresponding author’s e-mail: eugene.ohanme@funai.edu.ng American Journal of Medical Science and Innovation (AJMSI) Volume 3 Issue 2, Year 2024 ISSN: 2836-8509 (Online) DOI: https://doi.org/10.54536/ajmsi.v3i2.3506 https://journals.e-palli.com/home/index.php/ajmsi Pa ge 14 3 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 2022). However, the governments of Nigeria’s failure to recognize or understand the role of social workers highlights the absence of a professional mandate and the challenges associated with putting social work practice into practice (Androff & Mathis, 2022). The Novel Coronavirus Disease With no known cure or vaccine, COVID-19 is a worldwide epidemic that has significantly increased morbidity and death. 95,714 fatalities, 356,440 recoveries, and 1,603,428 confirmed cases were reported globally as of April 9, 2020. An Italian national was designated as the index case in Nigeria, where there were 288 laboratory-confirmed infections, 51 discharges, and 7 fatalities (Mallah et al., 2021). Civil societies and government organizations started educating the public about proper hygiene and social separation in order to stop the disease’s spread. Airports screened passengers for temperature, and travelers returning from nations where there had been many confirmed cases were advised to separate themselves (Pollard et al., 2020). The Nigerian government instituted containment measures, such as sealing national borders, closing schools, and putting in place lockdowns, and it banned meetings with more than fifty participants for a period of four weeks. The state governments established isolation facilities and curfews, while testing laboratories were established in Lagos, Abuja, and Irrua (Ibrahim et al., 2020). The Corona Virus (COVID-19) The virus that causes COVID-19, a serious respiratory illness first identified in Wuhan, China in December 2019, is called SARS-CoV-2. It spreads via the mouth, nose, and eyes and produces symptoms like fever, coughing, and shortness of breath (Khan et al., 2020). The virus can cause serious respiratory issues or even death during its one to fourteen-day incubation period, particularly in the elderly and those with chronic conditions. Since no known cure or vaccination for COVID-19 exists, medical interventions are restricted to supportive care, experimental medications, and therapies (Hu et al., 2021). MATERIAL AND METHODS Study Design For this study, a cross-sectional survey of 589 volunteers who were chosen at random from the communities of Umuagu, Umuaji, and Akwebulu in Asaba, was employed. The volunteers were given a questionnaire and interviewed about covid-19 compliance and preventive strategies. Residents of Asaba in Oshimili North LGA Delta in State made up the study’s population. Before the final form was given to the participants in Asaba, the questionnaire underwent peer review and a pilot test in two hospitals in Amai, which is not the location of this study. The questionnaire were structured into five distinctive parts to collect information on (i) Demographic characteristics (ii) Knowledge of Covid-19 disease (iii) Awareness of the preventive measures in the metropolis (iv) The compliance rate with preventive measures in the metropolis (v) Factors that affect the awareness of Covid 19 preventive measures Community members were chosen through the use of the convenient sampling technique. Data were gathered over a two-week period. The data that was gathered was examined to ascertain the degree of adherence to recommended preventive actions. Study Area The study was carried out at Asaba, a city in Delta State, South-South Nigeria’s Oshimili North Local Government Area. Oshimili North had 172, 773 residents as of the 2006 population census (National Population Commission, 2010). This community’s decision was influenced by its urban status and the congestion brought on by Onitsha Market’s enormous market area (Yimer et al., 2022). Scope of Study This study was limited to the knowledge, awareness of prevention methods and the factors influencing the practice of preventive measures in 589 randomly selected volunteers within the ages 18 and above in Oshimili North Local Government Area of Delta State, Nigeria. Study of Population The target population were people from age 18 years upwards from which the sample size was selected by simple sampling technique. The research study populations were residents in Oshimili North Local Government Area. Sample Size Determination The sample size was determined using Fisher’s Formula: n = z2p (1-p)/e2 Where n = Minimum required sample size in population >10,000. Z = Standard normal deviation at 95% confidence interval. Level of significance is 1.96. P = Prevalence of women who have knowledge of good nutrition from literature reviewed = 0.185. E =Acceptable margin of sampling error (0.05). n= 589 (Jung, 2014) Sampling Procedure To choose the three villages and three areas that make up the community, simple random sampling was utilized. This was done to ensure that every region had an equal chance of being chosen for the study. To choose respondents who agreed to take part in the study, the availability sampling technique was used. This was predicated on earlier phone conversations in which the respondents were invited to take part in the research. Ten houses from each of the chosen villages made up the total of thirty homes that were chosen for the study. Heads of households, both male and female, fifty years of age and older, were chosen for the interview. Pa ge 14 4 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 Inclusion Criteria Volunteers who have been resident in the Umuagu, Umuaji and Akwebulu communities in Asaba of Oshimili North Local Government Area for at least ten years from 18years old, were selected for the study Exclusion Criteria Volunteers under the age of eighteen who did not live in the Asaba Oshimili North Local Government Area’s Umuagu, Umuaji, or Akwebulu villages were not chosen for the study. Method and Instrument for Data Collection Data was gathered using a semi-structured questionnaire that the interviewer provided. The poll was adapted from a similar study conducted among Chinese citizens (18) to fit the objectives of the research. The questionnaire’s reliability coefficient (Cronbach’s alpha) after pretesting and reliability testing was 0.82 (Tavakol & Dennick, 2011). Face validity was established from the pretest to confirm that the answers accurately reflected the questions and that the questions themselves fit the study’s objectives. Public health experts concluded that the questions addressed all relevant aspects of the topic, proving the questions’ content validity. The questionnaire asked questions about sociodemographic data, information availability, awareness of COVID-19 symptoms, transmission, and prevention, views against foreigners of Asian or Caucasian heritage living abroad, recent returnees from international travel, and COVID-19 survivors. Other subjects included were COVID-19 pandemic associated behaviors such handwashing, using face masks, social distancing, utilizing over-the-counter drugs, and using herbal medicines (Adesegun et al., 2020). True/false questions were utilized to construct the knowledge section’s questions, and a scoring system was developed to assess knowledge. The first nine questions, which concentrated on COVID-19 symptoms and transmission, were awarded one point each, while the next eight questions, which addressed COVID-19 prevention, were worth two points each. In total, there were twenty- five points. Each incorrect answer was assigned a zero. 13–17 (50–69%) was regarded as having intermediate knowledge, 18–25 (>70%) as having strong knowledge, and less than 13 (<50%) as having inadequate information. To the next whole number, the overall score was rounded. To construct a 5-point attitude scale. Twelve questions were used to score attitudes using a Likert scale and yes/ no questions. A positive attitude was worth one point, while a negative attitude was worth zero. A total score of less than fifty percent was considered to be poor, and a total score of more than fifty percent was considered to be good. Multiple-choice and yes/no questions made up the practice component. Five questions were used to grade practice; a score of less than fifty percent indicated bad practice. Positive practice received one point. Validity of the Research Instrument The researcher used a self-structured questionnaire with contents relevant to the topic and was assessed by the researcher’s supervisor prior to the administration of questionnaire, so as to ensure the questionnaire is valid and subsequently approved (Ranganathan & Caduff, 2023). Reliability of the Research Instrument Test-re-test was used prior to this study. The pretesting replies were utilized to adjust the questions. Subsequently, the same respondents took a second test to ascertain the questionnaire’s validity, and the results of both tests were correlated after calculation. (Ranganathan & Caduff, 2023). Ethical Considerations This study involved children from Novena University, who were interviewed in the presence of their parents. Parental consent was obtained, and the study aimed to respect the indigenous belief system and interview children first before adults to avoid influencing their views. Data Collection The study used in-depth interviews to gather data from 36 respondents, including 6 children and 30 household heads, between October 10 and November 5, 2020. The interviews were conducted in Igbo and English, with participants informed about the research’s objectives, anonymity, confidentiality, and the freedom to withdraw at any time. The interviews were transcribed into English, and the original meaning of the participants’ words was preserved to ensure reliability and validity of the data (Jamshed, 2014). The study analyzed respondents’ responses on COVID-19, physical/social distancing, hand washing, and lockdown impact on child care. Analytical themes were identified, and the data was manually analyzed to maintain originality and avoid manipulation. RESULTS AND DISCUSSION Results Table 1: Sociodemographic characteristics of Participants Variable Frequency (n = 589) Percent (%) Age (years) 18–29 years 261 44.3 30–39 years 214 36.3 40–49 years 93 15.8 50–59 years 21 3.6 Pa ge 14 5 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 Table 2: Perception of respondents towards national community response to covid 19 S/N Variable Frequency (n = 598) Percent (%) 1 Do you think that the government has/is doing enough to stop the global pandemic in Nigeria? Yes 139 23.6 No 307 52.1 Maybe 143 24.3 2 Do you agree with the obligatory lockdown/measures Nigeria is taking? Yes 374 63.5 No 115 19.5 Maybe 100 17.0 3 Do you agree with the government stay-at-home order? Yes 428 72.7 No 84 14.3 Maybe 77 13.1 4 Are you complying with the government stay-at-home order? Yes 460 78.1 No 25 4.2 Sometimes 104 17.7 5 Do you believe in Chinese doctors’ intervention in Nigeria? Yes 73 12.4 No 401 68.1 Maybe 115 19.5 6 Will you accept COVID-19 vaccine? Yes 171 29.0 No 268 45.5 Maybe 150 25.5 7 On a scale of 1–5, how satisfied are you with your country’s response against the COVID-19 pandemic? Not satisfied 141 23.9 Partly satisfied 155 26.3 Satisfied 234 39.7 More than satisfied 34 5.8 Very satisfied 25 4.2 Gender Female 238 40.4 Male 351 59.6 Marital status Married 230 39.0 Single 354 60.1 Divorced 3 0.5 Widow/widower 2 0.3 Level of education High school 26 4.4 College/bachelor 348 59.1 Master 153 26.0 PhD 31 5.3 Others 31 5.3 Residential location Urban 331 56.2 Semi-urban 213 36.2 Rural 45 7.6 Pa ge 14 6 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 8 How satisfied are you with the media/social media coverage of the COVID-19 pandemic? Very satisfied/keeps me updated 267 45.3 Makes me worry more/stressful 55 9.3 Not enough information 70 11.9 There are more lies than truth 138 23.4 I don't follow any media update 8 1.4 No comment 51 8.7 9 What do you think we can do as a community to reduce the spread COVID-19 (select all that applies)? Follow/respect the health recommendations of my country 531 90.2 Eat healthy/practice sports 311 52.8 Attending religious gatherings 28 4.8 Social distancing/avoid crowd 464 78.8 Volunteer to support whenever possible 268 45.5 Avoid handshakes and face kissing 438 74.4 I don’t know 5 0.8 10 Do you think we can prevent such a global pandemic in the future? Yes 415 70.5 No 34 5.8 Maybe 140 23.8 11 Which of these can prevent/help against the occurrence of such a global pandemic in the future? (select all that applies) Reduced international travels 266 42.2 Improve surveillance in the human and animal health sectors 394 66.9 Establish early alerts and global warning systems for infectious diseases 486 82.5 Collaboration between environmental, animal and human health workers 344 58.4 Intensify research on preventive measures such as vaccines/diagnosis 460 78.1 Raise public awareness of proper hygiene/healthy habits 452 76.7 Prioritize human life/health welfare over animal or environmental ones 208 35.3 12 Are you willing to read and share with others the right information about COVID-19? Yes 552 93.7 No 8 1.4 Maybe 29 4.9 Table 3: Mean score of COVID-19 knowledge in relation to attitude and perception towards preventive measures and national response Attitudes towards preventive measures, perception towards national response Mean score Std. error 95% Confidence interval Lower bound Upper bound Negative attitude 1.886 0.018 1.852 1.921 Positive attitude 1.961 0.014 1.934 1.988 Negative perception 1.896 0.014 1.868 1.925 Positive perception 1.951 0.017 1.917 1.984 Table 4: ANOVA source table for knowledge of covid 19 attitude and preventive measures and perception of national responses Source Type III sum of squares Df Mean square F p-value Corrected model 1.756a 3 0.585 8.789 0.000 Intercept 1983.049 1 1983.049 29,778.429 0.000 Attitude towards preventive measures 0.740 1 0.740 11.116 0.001 Perception of national response 0.393 1 0.393 5.896 0.015 Pa ge 14 7 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 589 people in all took part in this online survey. The majority of the study’s participants were men: 59.6% (351), 80.6% (475) were in the 18–39 age range, 90.4% (522) held a bachelor’s degree or above, and 56.2% (331) were city dwellers. The majority of respondents, 56.5% (333) and 58.7% (346), reside in homes with a maximum of five occupants and those organized in linear (straight) street patterns (Table 1). Regarding the national and community reaction to COVID-19, only 63.5% (374) of the respondents agreed with the mandatory lockdown implemented, indicating that 52.1% (307) of the respondents thought the government was not doing enough to contain the pandemic in Nigeria. The majority of respondents, 45.5% (268) and 68.1% (401), respectively, do not think Chinese doctors should be involved in Nigeria’s effort to combat COVID-19 and would not take COVID-19 vaccinations if they become available. Yet, as indicated by 90.2% (531), 78.8% (464), and 74.4% (438) of the respondents, observing/respecting health advice, social distancing/ avoiding crowds, avoiding handshakes, and face kissing were some of the measures to limit community spread COVID-19. The majority of respondents 45.3% (267), 70.5% (415), and 93.7% (552) were pleased with how the COVID-19 pandemic was covered by the media, hopeful that a repetition of the pandemic might be avoided, and ready to read about and distribute accurate information about the virus to others (Table 2). People who are well-informed about COVID-19 will view the virus favorably. With a mean score of 1.961 for positive attitudes toward COVID-19 and 1.886 for negative attitudes toward COVID-19 (Tables (Tables4,4,,5),5), residents of north-central Nigeria who were well-versed in the virus had a significantly positive attitude toward COVID-19, F(1,585), = 11.116, p = 0.001 (p < 0.05). As a result, hypothesis 1 was supported. People who are well-informed about COVID-19 will view the national response to the pandemic favorably. (Table 3). Residents who were well-versed in COVID-19 had a positive impression of the national response to the virus, F(1,585) = 5.896, p = 0.015 (p < 0.05); the mean scores for positive and negative perceptions of the national response to COVID-19 were 1.951 and 1.896, respectively. The theory that people who are well-informed on COVID-19 will see the country’s response to the pandemic favorably was validated (Table 4). The spread of the COVID-19 virus in Asaba is inversely correlated with high COVID-19 knowledge. Regression model 1 summary findings showed that the 95% confidence interval for the coefficient of determination, R2 = 0.04.1, F(1,587) = 0.316, and DW = 2.075, were as follows. This demonstrated that the model can account for a 4.1% variation in the COVID-19 virus’s propagation. The model’s ANOVA’s F-statistic revealed no closeness of fit, indicating that the model is not statistically significant at the 95% confidence interval (p < 0.05) level. The Durbin-Watson score of 2.075 indicates that there is no multicollinearity in the autocorrelation between the variables being examined. (Table 5). Discussion With the COVID-19 epidemic affecting more than 200 countries, it has grown to be one of the biggest in history. The purpose of this study was to evaluate people’s awareness and adherence to information about COVID-19, including its source, transmission, symptoms, preventive measures, mortality rate, and main sources of information in Asaba, Nigeria. The findings demonstrated that a sizable segment of Nigerians are aware of and informed about COVID-19, and a sizable fraction of them think China is the country that created the biological weapon. This view could make it more difficult for Nigeria to accept aid from the Chinese government and have an impact on bilateral relations between Nigeria and China (Khalifa et al., 2021). Religious leaders are also affected because a sizable portion of the population thinks COVID-19 is a disease brought on by sins and disbelief. Contrary to popular belief, Nigerians are very aware of preventive measures. Most of them concur that the best ways to stop the virus from spreading are to wash your hands, avoid close contact with others, disinfect surfaces, close schools, and fumigate public areas. (Sisti & Buonsenso, 2023). Attitude towards preventive measures * perception of national response 0.393 1 0.393 5.896 0.015 Error 38.957 585 0.067 Total 2224.000 589 Corrected total 40.713 588 aR Squared = 0.043 (Adjusted R Squared = 0.038) Table 5: Pearson’s correlation table for relationship between knowledge of COVID-19, attitude towards preventive measures and perception of national response Perception of national response Pearson’s correlation (r) p-value Knowledge of COVID-19 0.177 0.004 Attitude towards preventive measures 0.137 0.001 Pa ge 14 8 https://journals.e-palli.com/home/index.php/ajmsi Am. J. Med. Sci. Innov. 3(2) 142-149, 2024 Over 90% of respondents agreed that COVID-19 has high fatality rates, with 79,384 deaths worldwide as of April 7, 2020. The mass media and traditional media are identified as major sources of information about COVID-19, with the internet being the premier source of knowledge during outbreaks. The survey aimed to assess compliance and identify key areas of concern for optimal sub-national and community intervention (Alimohamadi et al., 2021). A survey in Asaba, Nigeria, revealed that the majority of respondents were educated and knowledgeable about COVID-19, with a high percentage of males and singles. They believed the virus was caused by a virus, but a majority believed everyone was at risk. Despite taking precautionary measures during lockdown, 27.5% visited crowded places, indicating the government’s inability to implement strict measures. The study found a significant relationship between COVID-19 knowledge and positive attitudes (Adedeji-Adenola et al., 2022). A study on Nigerians found that 45.3% believe prayer is effective in COVID-19 prevention, largely due to strict religious beliefs. Despite the lockdown, many were bored, nervous, and stressed. Only 25.3% were satisfied with government efforts, and only 29.0% would accept vaccines (Bentzen, 2021). The underprivileged and vulnerable population had limited knowledge about COVID-19, affecting their KAP. The Nigerian government and NCDC should take proactive measures to counter misconceptions and promote information dissemination (Tolstrup Wester et al., 2022). A study in Nigeria found a positive attitude towards COVID-19, with three-quarters believing it will be successfully controlled. Factors such as information and educational qualifications influenced the belief in confirmed cases. However, age or gender did not significantly influence attitude (James et al., 2022). CONCLUSION The findings from this study affirm that Nigerians are highly knowledgeable, believe in the lethality of this pandemic but show very poor preventive practices due to local belief in the black African adaptations against COVID-19. Though compliance to the preventive measures is very low, very educated people and the female gender showed more compliance than me. The data imply that the mitigation of the COVID-19 outbreak is imminent provided people adopt a positive outlook and follow the government’s recommended course of action. Notwithstanding their drawbacks, social media and the internet made a substantial contribution to the knowledge that was required. Not much was noteworthy about the government’s attempts to contain COVID-19. Contribution to knowledge This study has established that there is strong evidence of a number of factors between the knowledge levels of the patients with their attitude and preventive practice. The essential factor - local belief has grave effect on preventive practices Recommendation i. Public health education campaigns should go on, dispelling myths and offering updates on clinical presentation, prevention, and control strategies, evidence- based policies, and other topics. 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