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Preparedness for diphtheria epidemic among healthcare workers in Kano State, Nigeria

List of Authors

  1. Ayodele Arinola Feyisara ,  
  2. Noah David
    ,  
  3. Etim Utibe Efre ,  
  4. Kevin Dofwah Nuhu ,  
  5. Azibadighi Walter
    ,  
  6. Olufunmilayo Ibitola Fawole ,  
  7. Adeniyi Francis Fagbamigbe ,  
  8. Segun Bello
    ,  
  9. Onoja Matthew Akpa
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Abstract

Background

Ensuring epidemic preparedness is a critical responsibility of every sovereign nation. Every threat to health, particularly the spread of communicable diseases, constitutes a potential threat to human existence. Healthcare Workers (HCWs) are the first line of defense against disease outbreaks; however, their knowledge levels vary. This study aimed to assess the knowledge of and preparedness for the diphtheria epidemic among healthcare workers in Kano state, Nigeria, using a quantitative method.

Methods

This study used a descriptive, cross-sectional design. A two-stage sampling technique was used to select 421 HCWs, who responded to a semi-structured interviewer-administered questionnaire. Descriptive statistics and logistic regression were used for the analysis at the 5% significance level.

Results

Results showed that 51% of healthcare workers had poor knowledge of diphtheria and 53.4% demonstrated generally poor infection prevention control (IPC) practices. Factors such as age group, education level, ethnicity, and facility level were associated with knowledge and IPC practices of diphtheria. The sociodemographic predictors of knowledge of diphtheria were age group (OR = 1.320, CI 0.669–2.606, p-value 0.424). Facility level predicted IPC practices, those in primary health facilities were 91% less likely to have good IPC practices compared to those in tertiary facilities, with statistically significant finding of (OR = 0.097, CI 0.041–0.232, p-value 0.001).

Conclusions

Overall, 78.1% of respondents demonstrated good preparedness for diphtheria outbreaks. However, facility preparedness for diphtheria response was found to be lacking, with 70.8% of facilities having poor preparations. Preparedness is vital for effective disease outbreak responses, necessitating collective efforts for robust future responses.

Plain Language Summary

This study looks at how ready healthcare workers are to prevent and respond to diphtheria, a serious but preventable infectious disease, in Kano State, Nigeria. Diphtheria spreads easily from person to person and can be deadly, especially for children, if it is not detected and treated early. Because doctors, nurses, and other health workers are the first people to see and treat patients during outbreaks, their knowledge, safety practices, and readiness are very important.

The researchers asked over 400 healthcare workers questions about diphtheria—how it spreads, how to protect themselves and patients, and how prepared their workplaces are to handle an outbreak. The findings showed that about half of the health workers did not have good knowledge of diphtheria, and more than half did not consistently follow good infection prevention and control practices, such as proper use of protective equipment and hygiene measures. Although many individual health workers felt personally prepared to respond to an outbreak, most health facilities lacked important supplies, plans, and systems needed for a strong response.

The study highlights a clear message: improving training, supplies, and preparedness in health facilities—especially in primary healthcare centers—will better protect health workers, patients, and communities, and help stop future diphtheria outbreaks more effectively.

Corresponding author
Ayodele Arinola Feyisara
0009-0003-6757-3049
Grant information

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No [CSA2020E3134] (Masters Programme in Epidemiology and Biostatistics with Specialization in Disease Outbreak and Epidemic Response in sub-Saharan Africa [MPH Epid & Biostat]). The European and Developing Countries Clinical Trials Partnership (EDCTP) provided funds during the data collection. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright
© 2026 Ayodele Arinola Feyisara (Corresponding Author, Co-Author); Noah David (Co-Author); Etim Utibe Efre (Co-Author); Kevin Dofwah Nuhu (Co-Author); Azibadighi Walter (Co-Author); Olufunmilayo Ibitola Fawole (Co-Author); Adeniyi Francis Fagbamigbe (Co-Author); Segun Bello (Co-Author); Onoja Matthew Akpa (Co-Author) Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

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Authors & roles

Ayodele Arinola Feyisara

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria

Fellow, European and Developing Countries Training Program (EDCTP) MPH EBDOER, Ibadan, Nigeria

Roles
Corresponding Author, Co-Author, Conceptualization, Data Curation, Formal Analysis, Methodology, Writing – Review & Editing
0009-0003-6757-3049

Noah David

Pathology, Aminu Kano Teaching Hospital, Kano, Kano, Nigeria

Roles
Co-Author, Data Curation, Investigation, Writing – Review & Editing

Etim Utibe Efre

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Fellow, European and Developing Countries Training Program (EDCTP) MPH EBDOER, Ibadan, Nigeria

Veterinary and Pest Control Services, Ministry of Agriculture, Uyo, Akwa Ibom, Nigeria

Roles
Co-Author, Investigation, Writing – Review & Editing
0009-0005-2957-2066

Kevin Dofwah Nuhu

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Fellow, European and Developing Countries Training Program (EDCTP) MPH EBDOER, Ibadan, Nigeria

Roles
Co-Author, Investigation, Methodology, Writing – Review & Editing
0009-0001-8190-0443

Azibadighi Walter

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Fellow, European and Developing Countries Training Program (EDCTP) MPH EBDOER, Ibadan, Nigeria

Roles
Co-Author, Investigation, Methodology, Writing – Review & Editing

Olufunmilayo Ibitola Fawole

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Roles
Co-Author, Investigation, Supervision, Writing – Review & Editing
0000-0002-6982-8899

Adeniyi Francis Fagbamigbe

Department of Epidemiology and Medical statistics, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria

Roles
Co-Author, Software, Visualization
0000-0001-9184-8258

Segun Bello

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Roles
Co-Author, Investigation, Supervision, Writing – Review & Editing

Onoja Matthew Akpa

Epidemiology and Medical Statistics, University of Ibadan Faculty of Public Health, Ibadan, Oyo, Nigeria

Roles
Co-Author, Investigation, Supervision, Writing – Review & Editing

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