CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND TO THE STUDY: ROLE OF KNOWLEDGE AND PERCEIVED VULNERABILITY IN PERCIEVED CONTROLLABILITY OF ZIKA VIRUS AMONG CUSTOMS OFFICERS
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.
What roles does knowledge play in the perceived controllability of Zika virus infections? What roles does vulnerability play in the perceived controllability of Zika Virus infections? What roles do male and female play in the perceived controllability of Zika Virus infections?
1.3 PURPOSE OF THE STUDY: ROLE OF KNOWLEDGE AND PERCEIVED VULNERABILITY IN PERCIEVED CONTROLLABILITY OF ZIKA VIRUS AMONG CUSTOMS OFFICERS
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;
To examine the effectiveness of knowledge on perceived controllability Zika virus infections among customs officers working at the nations land borders. To investigate the role of vulnerability on perceived controllability Zika virus infections among customs officers working at the land borders. 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: ROLE OF KNOWLEDGE AND PERCEIVED VULNERABILITY IN PERCIEVED CONTROLLABILITY OF ZIKA VIRUS AMONG CUSTOMS OFFICERS