Background: Lassa fever (LF) is an epidemic-prone zoonotic disease prevalent in Nigeria and Ebonyi State is a high burden area in Nigeria. Low risk perceptions have been reported to prevent appropriate preventive behaviours. We investigated the knowledge and risk perception of residents towards LF and determined the factors influencing their risk perception in communities that have reported confirmed cases of LF. Methods: We conducted a cross-sectional study in the affected wards in Abakaliki Local Government Area (LGA). We interviewed 356 adult respondents recruited across 6 settlements in 3 of the affected wards through multistage sampling technique. Information on participants' knowledge of LF, their risk perception using the health belief model as well as factors influencing risk perception were obtained. We estimated the proportions of respondents with good knowledge and high risk perceptions. We also explored the relationship between risk perception, knowledge and sociodemographic characteristics using Chi Square and logistic regression at 5% level of significance. Results: The mean age of the participants was 33.3 ± 12.2 years, 208 (63.2%) were females, 230 (69.9%) were married and 104 (31.6%) had attained tertiary education. Though 99.1% were aware of LF infection, 50.3% among them had poor knowledge of LF symptoms and risk factors, 92.9% had high risk perception of severity, 72.4% had a high feeling of susceptibility towards LF infection, 82.5% had a high perceived self-efficacy towards LF infection, 63.5% had a low perceived benefit of LF preventive practices and 31.8% had high perceived barrier towards LF preventive practices. Good knowledge of LF was the only significant factor influencing risk perception; perceived severity: (COR: 3.0, 95%CI: 1.2-7.8), perceived susceptibility (AOR: 2.0, 95%CI: 1.25-3.3) and perceived benefit (COR: 2.1, 95%CI: 1.3-3.3). Conclusions: Good knowledge of LF influences risk perception towards LF which has great import on LF preventive practices. A gap exists in the content and acceptance of LF risk communication information in the LGA. There is a need to review the risk communication messages in the state towards LF in the community with special focus on the males and younger population.

Background Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria with low physician–population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms, curtail the trend and safeguard the country’s health system. Methods Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using Google form shared via WhatsApp and Telegram forums of Nigeria Medical Association. Data were analysed with IBM-SPSS version-25 and charts were created with Microsoft-Excel. Chi-square and multiple regression tests were done with p-value set at 0.05. Results The mean age of respondents is 37.6 ± 7.9 years; majority of them are males (63.2%), married (75.5%) with postgraduate qualifications (54.1%) and working in public health facilities (85.4%). Whereas 13% and 19.3% are, respectively, satisfied with their work and willing to continue practice in Nigeria, 43.9% want to emigrate and 36.8% are undecided about future location of their practice. The commonest reasons for emigration are poor remuneration (91.3%), rising insecurity (79.8%) and inadequate diagnostic facilities (61.8%). Physicians working in public health facilities are 2.5 times less satisfied than their counterparts in non-public sector (AOR = 0.4; 95% CI = 0.3–0.8). Physicians in their thirties, forties and fifties are 3.5 (95% CI = 1.5–8.0), 5.5 (95% CI = 2.1–14.5) and 13.8 (95% CI = 3.9–49.3) times, respectively, more willing to retain practice in Nigeria than those younger and those satisfied with their work are 4.7 (AOR = 4.7, 95% CI = 2.9–7.4) times more willing to practice in Nigeria than those not satisfied. Conclusion Majority of Nigerian physicians want to emigrate for professional practice and top among the push factors are poor remuneration, rising insecurity and inadequate diagnostic facilities. The observed trend portends danger to the country’s health system due to the foreseeable negative consequences of physician deficit to the system. We recommend upward review of physician remuneration, a root cause analysis of insecurity to determine workable preventive measures and increased funding of the health sector to improve the diagnostic infrastructure, retain physicians and save the health system from imminent collapse.

BackgroundMalaria in pregnancy has adverse effects on maternal and child health. Intermittent preventive treatment (IPTp) with three doses of Sulfadoxine/Pyrimethamine is an effective preventive measure for malaria in pregnancy. However, 24.0% of women use this prophylactic regimen in Ebonyi State. Previous studies have focused on the level of uptake with less attention given to factors influencing uptake. Therefore, we examined the predictors of IPTp uptake in the last pregnancy among women in Ebonyi State, Nigeria.MethodsThis was a community-based cross-sectional study among 340 women of reproductive age selected using multistage sampling technique. A semi-structured interviewer administered questionnaire was used to collect data on socio-demographic characteristics of respondents, IPTp uptake and reasons for not taking IPTp. Adherence was judged adequate if three or more doses of IPTp were taken, otherwise inadequate. Data were analyzed using descriptive statistics, Chi- square test and logistic regression model at 5% level of significance.ResultsMean age of respondents was 28.8 ± 5.2 years, 96.5% were married, 19.4% had tertiary education, and 11.2% were from polygamous family. Uptake of IPTp was 74.2%. The level of IPTp uptake was 12.5 and 41.0% among women with no formal and tertiary education respectively. A similar pattern of IPTp uptake was observed among women from monogamous (38.0%) and polygamous (39.5%) families. Women education, husband education and family type were associated with uptake of IPTp, however only husband education remained a predictor of uptake. Women whose husband had secondary education (aOR = 4.1, 95%CI: 1.66–10.06) and tertiary education (aOR = 4.8, 95%CI: 1.76–12.90) were more likely to have IPTp uptake than those whose husbands had below secondary education.ConclusionAdequate IPTp uptake among women in their last pregnancy was below WHO recommendation. Intervention aimed at improving couple’s education could facilitate increase in IPTp uptake in Ebonyi State.