ROLE OF KNOWLEDGE AND PERCIEVED VULNERABILITY IN PERCIEVED CONTROLLABILITY OF ZIKA VIRUS AMONG CUSTOMS OFFICERS

ABSTRACT

Zika virus is widely recognized to be one of the deadly infections in the world, which has led to the demise of some of its victims in different parts of the world. The study examined the role of knowledge and perceived vulnerability on perceived controllability among Nigerian custom officers. 500 custom officers in Seme (Lagos State), Idiroko (Ogun State) and Jibia (Kastina State) border were judgmentally selected as participants in the study. Data were collected via a standardized questionnaire that consisted of Zika Knowledge Scale, Perceived Vulnerability Scale and Perceived Controllability Scale. The data collected were analyzed using the Pearson correlation analysis, linear regression analysis, one-way analysis of variance and t-test statistic. The results revealed amongst others that there is significant relationship between zika knowledge and perceived controllability (r=0.198; p<0.05) and no significant relationship between perceived vulnerability and perceived controllability (r=-0.042, p>0.05); there existed no educational differences among respondents in perceived vulnerability (F=4.12; p>0.05); perceived controllability (F=7.36; p>0.05) and zika knowledge (F=2.11; p>0.05). In addition to these, it was found that gender differences existed in perceived controllability (t=2.39; p<0.05). Based on this, the study suggests that Public health authorities in the Nigeria should continue to raise awareness among women of reproduc­tive age about the risk for Zika virus infection from travel, enabling them to better make informed decisions.

CHAPTER ONE

INTRODUCTION

1.1        BACKGROUND TO THE STUDY

Perceived controllability is a generalized expectancy pertaining to the connection between personal characteristics or actions Rotter, Chance & Phares (1972). People who perceive controllability may evaluate their health positively Bailis & Chipperfield (2002) Chipperfield (1993) and estimate lower risk estimates (Dolinski, Gromski, & Zawisza (1987) ; Kreuter & Strecher (1995) Weinstein & Lachendro  (1982). Also, many studies have found that friend support may be positively associated with perceived controllability Bailis, Segall, Mahon, Chipperfield, & Dunn (2001) ; Prenda & Lachman (2001) ; Turner & Noh (1983).

Zika virus (ZIKV) is a mosquito-borne virus (genus Flavivirus, family Flaviviridae) related to yellow fever, dengue, West Nile, Japanese encephalitis and tick-borne encephalitis viruses. ZIKV was first isolated in 1947 from Rhesus macaques living in the eponymous forest in Uganda. Up to 2006, only sporadic cases of ZIKV human infections were reported in literature Hayes (2009). Accordingly, ZIKV was long considered a low-impact human pathogen, which might explain the limited literature PubMed in January (2016), compared to other mosquito-borne viruses such as dengue virus, West Nile virus or chikungunya virus Martinez-Pulgarin , Acevedo-Mendoza, Cardona-Ospina, Rodriguez-Morales, Paniz-Mondolfi  (2015).

Perceived controllability play a key role in engaging in exercise Calnan (1989) through positive self-rated health because control beliefs could be associated with positive self-rated health Brandtstädter & Baltes-Götz, (1990) and lower risk estimates Harris, (1996); Klein & Helweg-Larsen, (2002). These psychological conditions could increase exercise. On the other hand, office  visits may be increased by poor control beliefs Krause, (1988) through poor self-rated health and high susceptibility to diseases because experience of distress was associated with the use of medical facilities Mechanic & Volkart, (1961); Parsons, (1951), which may be associated with poor-self-rated health Berkman (1986); Fylkesnes & Førde, (1992). Even though perceived controllability may have a strong impact on the relationships between the variables, little is known about the moderation effects of perceived controllability on these relationships.

Perceived illness vulnerability is defined as beliefs or perceptions about the chance of getting a specific disease. A strong positive impact of perceived illness vulnerability on health-promoting behaviors has been consistently observed Hochbaum, Janis & Mann, (1965); Leventhal, Watts, & Pagano, (1967). Relative-risk estimation is defined as perceiving ourselves to be at a lower, the same, or a higher risk than similar persons in a reference group Weinstein, (1982). When participants saw others as being more at risk, participants overestimated their relative-risk judgments regarding heart attacks, cancer, and drinking Weinstein, (1984). It is possible that relative-risk estimation operates in a manner similar to social comparison.

Many studies have shown that perceived illness vulnerability generates healthpromoting behaviors because of the effects of fear on attitude and behavioral changes Calnan, (1984); Katapodi, Lee, Facione, & Dodd, (2004); Leventhal et al., (1967). However, studies have not investigated the relation of perceived friend support to perceived illness vulnerability and the effects of perceived illness vulnerability on health-promoting behaviors in a large national sample.

On 1 February 2016, the World Health organization (WHO) declared that the recent cluster of microcephaly cases and other neurological disorders reported in the America’s, where an outbreak with Zika virus (ZIKV) is ongoing, constitutes a Public Health Emergency of International Concern PHEIC WHO (2016).

ZIKV infection is unapparent in approximately 80% of the cases as observed during the Micronesia and French Polynesia epidemics in 2007 and 2013-2014, respectively. Incubation can range from 3 to 12 days. Common symptomatic forms are characterized by a macular/ papular rash (90-96%), fever (62-65%); myalgia and arthralgia (48-65%), headache (45-58%), non-purulent conjunctivitis (38-55%) and retro-orbital pain (40%) Duffy, Chen, Hancock, Powers, Kool, Lanciotti (2009). The current major concerns, besides globalization and an expected huge number of cases including an increase of exported ZIKV cases, are the possible association with Guillain-Barré syndrome (GBS), and microcephaly and other neurological manifestations in new-borns in the current epidemic region.  Both noticed and identified retrospectively in French Polynesia respectively Loos, Mallet, Leparc Goffart, Gauthier, Cardoso, Herida (2014).

Although the link between ZIKV and GBS or microcephaly still needs to be established unequivocally, the question arises whether the increased incidences of  GBS and microcephaly in the current outbreak region are due to a specific virulence of certain viral strains or a common pattern of all ZIKV strains that went unnoticed because of the lower number of cases in previous outbreaks. In Brazil, more than 4,700 cases of suspected microcephaly have been recorded from mid-2015 to end January 2016, where the usual number is consistently below 200 cases per year (13), while Brazil, Colombia, Surinam, Venezuela and El Salvador have reported spikes in GBS cases in January 2016 ECDC; (2016) . While it remains to be determined if ZIKV infection causes these complications, several governments and health agencies have issued a travel warning for the affected region, with specific attention to pregnant women, as a precautionary measure Petersen, Staples, Meaney-Delman, Fischer, Ellington, Callaghan (2016).

The current epidemic with ZIKV has resulted in a large increase in diagnostic requests for ZIKV in the America’s but also in returning travellers from the affected areas, especially for pregnant women with or without (past) clinical symptoms of a ZIKV infection. Therefore, the preparedness for ZIKV in both affected and unaffected regions needs an assessment of the current situation from the laboratory perspective to ensure an adequate (timely, accurate) laboratory response. Hence, the role of knowledge and perceived vulnerability on Zika Virus infection in Nigeria has not been well documented.

In most cases, Zika virus infection causes a mild, self-limited illness. The incubation period is likely 3-12 days. (Petersen, Wilson, Touch, McCloskey, Mwaba, Bates (2016).  Owing to the mild nature of the disease, more than 80% of Zika virus infection cases likely go unnoticed Petersen, et al., (2016).  The spectrum of Zika virus disease overlaps with other that of arboviral infections, but rash (maculopapular and likely immune-mediated) typically predominates.

In April 2016, a deputy director at the Centers for Disease Control and Prevention (CDC) warned that the risk of Zika virus infection in the United States may have been previously underestimated, citing the increased range of the mosquito vectors (now in 30 US states, up from 12 as previously thought) and the travel risks associated with the 2016 Olympics in Brazil. Gardner, Mason (2016).Zika virus was first described in a febrile rhesus monkey in the Zika forest of Entebbe, Uganda, and was reported in a human field worker shortly thereafter. Bennett, Dolin, Blaser, Mandell, and Douglas (2015). Currently, Zika virus is known to be widely distributed outside of Africa. Outbreaks have been described previously in Micronesia and French Polynesia.

The Centers for Disease Control and Prevention (CDC) currently lists the following countries as areas of active virus transmission: Aruba, Barbados, Bolivia, Bonaire, Brazil, Colombia, Commonwealth of Puerto Rico (US territory), Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten, Suriname, Trinidad and Tobago, US Virgin Islands, Venezuela, American Samoa, Fiji, Kosrae (Federated States of Micronesia), Marshall Islands, New Caledonia, Samoa, Tonga, and Cape Verde. Centers for Disease Control and Prevention, (2016).

Zika virus infection is among the nationally noticeable diseases in the United States. State and local health departments should be informed by healthcare professionals of suspected cases of Zika virus infection to facilitate diagnosis and to reduce the risk of local transmission.

1.2         STATEMENT OF PROBLEM

Recent reports of high rates of primary microcephaly and Guillain–Barré syndrome associated with autochthonous transmission of Zika virus in French Polynesia and now in Central and South America have raised concerns that the virus circulating in these regions may represent a rapidly developing neuropathic, teratogenic, emerging public health threat.

Brazil has represented a focus of interest within the broader of context of the crisis due to the intensity of Zika transmission and reported clinical outcomes. Brazil has reported 497,593 to 1,482,701 cases of Zika infection, and from October 2015 to January 30, 2016, 5,640 cases of suspected perinatally acquired microencephaly. Investigations for 1,533 of these cases resulted in exclusion of 950 cases (62%) due to over categorization of microencephaly or perinatal CNS malformation Hayes (2009), which has highlighted the challenges in determination of the true extent of perinatal impact of Zika infection.

While investigations are ongoing to establish causality of Zika infection and microencephaly, the international community has adopted an assumption that Zika virus is the likely cause of the unusual increase in microencephaly and Guillain–Barré syndrome in Brazil and French Polynesia. There are no licensed medical countermeasures available for Zika virus infection in Nigeria. Thus, it is in view of the above statement that this study would investigate the role of knowledge and perceived vulnerability in perceived controllability of Zika virus infections among customs officers in Nigeria.

Therefore, this study would provide answers to the following research questions.

1. What roles does knowledge play in the perceived controllability of Zika virus infections?
2. What roles does vulnerability play in the perceived controllability of Zika Virus infections?
3. What roles do male and female play in the perceived controllability of Zika Virus infections?

1.3       PURPOSE OF THE STUDY

The main purpose of this study is to investigate the role of knowledge and perceived vulnerability in perceived controllability of Zika Virus infection among customs officers working at the land borders. Specifically;

1. To examine the effectiveness of knowledge on perceived controllability Zika virus infections among customs officers working at the nations land borders.
2. To investigate the role of vulnerability on perceived controllability Zika virus infections among customs officers working at the land borders.
3. To explore the influence of socio-demography variable on perceived controllability Zika virus infections among customs officers working at the land borders.

1.4       RELEVANCE OF THE STUDY

This study through its findings would create the necessary awareness among parents on the influence of what they do on the teenage pregnancy of their adolescent children. It will shed more light on the relevance of parents monitoring/supervision on the present and future well being of the teenagers. It will also equip the teenagers with some of the dangers involved in pre-marital sexual intercourse and therefore make them to manage their teenage age with more caution.

The findings of this study would be very useful to governmental ministries and agencies like Ministries of Health and Education; Non-Governmental Agencies as well as sundry stake-holders in packaging effective and result oriented interventions on teenagers. Lastly, it will contribute positively to the expansion of knowledge in the area of adolescent teenage pregnancy and also serve as an important reference tool for future researchers in the field.

1.5       HYPOTHESIS

1. There will be a significant relationship between Zika vulnerability, Zika Knowledge and Perceived Controllability among customs officers working at the land borders in Nigeria.
2. Perceived controllability, zika knowledge and age will jointly and independently predict perceived vulnerability.
3. There will be educational differences in Perceived vulnerability, Zika Knowledge and Perceived Controllability.
4. There will be gender differences in Perceived vulnerability, Zika Knowledge and Perceived Controllability.

1.6       OPERATIONAL DEFINITION OF TERMS

1. 1.      Vulnerability: refers to a function of exposure, sensitivity, and adaptive capacity for assessing risk to human societies from Zika Virus infections. This construct will be measured using vulnerability scale developed by Duncan, L. A., Schaller, M., & Park, J. H. (2009).
2. 2.      Knowledge: refers to the understanding or information about Zika Virus infections. This construct will be measured using Zika Virus Knowledge Scale developed by Adejumo O, (2015).
3. 3.      Controllability: defined as controllable to the origin from any state where it can be driven to the zero state. This construct will be measure using controllability, stability, global & universality attributions scale (CSGU, 2016)
4. 4.      Zika Virus Infection:  is a viral infection that is usually spread by the bite of an infected mosquito. It can sometimes be spread by having sex with an infected man.
5. 5.      Length of Service: defined as the length of regular full or part time service with the university or adjusted date of hire of the employee.
6. 6.      Age: is the state of being old or the process of become older.
   1. 7.      Gender: refers to the psychological and social meanings attached to being biological male or female.
   2. 8.      Years in service: Number of the years used by the employee in the place of work. 1-6 years were considered short year while 7 and above is long years in the service.
   3. 9.      Custom Officers: A customs officer is a law enforcement agent who enforces customs laws, on behalf of a government.