Knowledge and attitude of disease surveillance and notification officers towards integrated disease surveillance and response strategy in priority health facilities in Lagos and Oyo States

Abstract

In Nigeria, Lagos and Oyo states have recorded several cases of disease outbreaks lately despite the funding and capacity building for a robust IDSR system. Some of the challenges observed include poor attitude of personnel, knowledge gaps, lack of supportive supervision as well as lack of data banks that affects reporting at all levels. These findings are critical to the global control of both infectious and non-infectious diseases as a robust surveillance and response capacity, along with trained and informed personnel, are key to a strong public health system.This study aimed to assess the knowledge and attitudes of DSNOs towards the IDSR program in priority health facilities in Lagos and Oyo states. This was a comparative cross-sectional study on IDSR carried out among DSNOs working in the priority health facilities in Lagos and Oyo States.  A multi-stage sampling technique was used to select a sample of 220 healthcare workers from priority health facilities in Lagos and Oyo states. Interviewer-administered questionnaires were used to collect socio-demographic characteristics, knowledge and attitude of respondents towards IDSR strategy. Data was analyzed using IBM Statistical Product and Service Solutions version 26 (SPSS Inc., Chicago, IL, USA); values of p < 0.05 were considered statistically significant. Respondents from priority health facilities in Lagos and Oyo states comprised 110 (50.9%) and 106 (49.1%), respectively. The mean age and SD of respondents was 39.0 ± 8.6 years and 41.3 ± 8.0 years with female preponderance (80.9% and 80.2%) in Lagos and Oyo states respectively. More than half (52.7%) of the respondents in Lagos compared to 42.5% of the respondents in Oyo state were CHEW/CHOs. Only about one-third (37.7%) of the respondents said they could correctly identify Buruliulcer as one of the diseases targeted for elimination in Oyo compared to 88.2% in Lagos state. About one-quarter (28.3%) of the respondents in Oyo state, compared with 11.8% of the respondents in Lagos state, felt that reporting to higher authorities was a waste of time and interferes with clinic work. Also, 10.9% and 27.4% of the respondents in Lagos and Oyo states, respectively, felt reporting to higher authorities violates patients' privacy, is cumbersome (20.9% and 36.8%), it does not limit disease transmission (24.5% and 37.7%) and these were statistically significant. The majority (80.9%) of respondents in Lagos state had overall good knowledge of IDSR strategy compared to Oyo state with 64.2% and this was statistically significant (χ2 =7.64; p=0.006*). Also, 90.9% of the respondents in Lagos state had an overall positive attitude towards IDSR strategy compared to 85.8% in Oyo state. This study revealed that the respondents in Lagos state had overall good knowledge of IDSR strategy compared to Oyo state. Also, majority of them had a positive attitude towards IDSR strategy. However, the adequacy of respondents' knowledge to correctly identify epidemic-prone diseases and those targeted for elimination in Oyo state was low. Therefore, it is recommended that the Federal Ministry of Health, Nigeria ensures regular assessment of health workers' knowledge and attitude towards the IDSR strategy to identify gaps that require interventions for optimal performance of the country's surveillance and response system.