Effects of enhanced health education intervention on Lassa fever preventive practices in Ondo State, Nigeria

Abstract

Introduction: Lassa fever is prevalent in Ondo State, Nigeria. Despite routine health education interventions (RHEI) community participation in prevention remains low. This study assessed the impact of enhanced health education interventions (EHEI) on community engagement in adopting preventive practices in Owo LGA. Methods: An exploratory sequential mixed-methods study, including qualitative research and a cluster-randomised trial, was conducted in Iyere (intervention) and Isaipen (control) in Owo LGA. Baseline data were gathered via focus group discussions, interviews, and questionnaires from 230 households. A three-month Enhanced Health Education Intervention (EHEI) included community leader discussions, educational material distribution, and weekly household health sessions by trained health workers. Control communities continued Routine Health Education Interventions (RHEI). End-line data assessed participation in Lassa fever prevention (bush clearing, deratting, or fumigation). Bivariate and logistic regression analyses evaluated EHEI’s impact. Statistical significance was set at 5%. Results: At baseline, the mean age was 34.2 ± 12.0 (intervention) and 45.3 ± 16.3 years (control), with females comprising 140 (56.0%) and 149 (59.6%), respectively. At baseline, 90 (36%) households had good participation in Lassa fever preventive practices in the intervention compared to 117 (46.8%) of the control community (p = 0.014). At end-line, 213 (85.2%) households in the EHEI community had good participation in Lassa fever preventive practices compared to 128 (51.2%) from the RHEI community (p < 0.001). Respondents with tertiary education had higher odds of having good participation in Lassa fever preventive practices (OR = 5.5, 95%CI = 1.61 – 18.81). At the end-line, odds of good participation in Lassa fever preventive practices among households in the EHEI community was 19.0 (95%CI = 5.8 – 63.8) compared to RHEI households. Conclusion: EHEI improved community participation in Lassa fever prevention. The Ondo State Ministry of Health should integrate EHEI into existing RHEI measures.