COVID -19 PREVENTION GUIDELINES AND ASSESSMENT OF ITS APPLICATION AND ADHERENCE AMONG PEOPLE OF USHONGO LGA OF BENUE STATE, NIGERIA

1. PhD Student,Department of Sociology, Federal University of Lafia, Nasarawa state 2. Department of Sociology Benue State University, Makurdi, 3. Department of Sociology, Benue State University, Makurdi 4. Department of Sociology, Benue State University, Makurdi 5. Saviour Model Schools, Makurdi Authors’ contributions This work was carried out in collaboration between all authors. Author Iorkosu, T.S wrote both the Protocol and the first draft of the manuscript, while Author Tarfa, E.D designed the study and managed the literature searches. Author Benedict, T.I wrote the second draft of the manuscript. Author Nyajoh, M.E and Yaaghku, V collected the data from the respondents. All authors read and approved the final manuscript. ............................................................................................................................................. Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: xxxxxxxxxxxxxxxx Final Accepted: xxxxxxxxxxxx Published: xxxxxxxxxxxxxxxx

The deadly episode created by COVID-19 posed scary health challenges that the globe is actually facing. Aside from the individual health challenge, this virus also createsconsiderable economical, organization and industrial effects being felt around the globe. So far, the disease has no acceptable medication, but there are scientific preventive measures outline by WHO and NCDC to prevent this disease that is spreading like an inferno. However, it was observed that more emphasis has been placed on creating awareness caution the effect of the disease less attention on the proper application and adherence to the preventive guidelines. Considerably, this study set to assess the application and level of adherence to these guidelines among the people of Ushongo LGA of Benue State, Nigeria for improves action. Base on this, the study, therefore, adopts a survey method using a structured questionnaire to elicit information from 165 respondents who accepted to participate in the study. The fishbowl method was used to select three districts in the local government. Key informants were also interviewed. The data was collected and analysed using a frequency distribution table followed by the interpretation. The study found among others that people of the area heard about COVID-19 but thought it is a disease of the rich and political propaganda aimed to root government treasury. It was also found that people are not applying these guidelines, the few that were applying failed to properly apply them. The social distance of 3 feet, use of face mask, regular washing of hands with running water among others were not properly practised and adhered to. Base on the findings, it was recommended among others that more awareness should be carried out to educate this rural populace of the application and adherence to these preventive measures.

Introduction:-
The COVID-19 pandemic is actually considered as the absolute most essential global health catastrophe of the century and the greatest challenge that the humankind experienced after the 2nd World War. In December 2019, a new transmittable respiratory system illness developed in Wuhan, Hubei district, China and actually called by the World Health Organization (WHO) as COVID-19 (WHO, 2020). A new class of coronavirus infection known as referred to as SARS-CoV-2 (severe acute respiratory syndrome corona-virus 2) has been actually found to be behind the disease. As far as the history of human civilization is concerned there are instances of severe outbreaks of diseases trigger by a number of viruses. According to the report of the World Health Organization (WHO since April 18 2020), the existing break out of COVID-19, has had an effect on over 2164111 individuals and also eliminated greater than 146,198 individuals in more than 200 nations throughout the planet ( WHO as from June 2020). Till right now, there is actually no clinically approved medically antiviral medicine or even injections that work versus COVID-19 (Qiao, 2020). It has swiftly spread around the globe, positioning substantial health, economical, social and also ecological obstacles to the whole individual populace. The corona-virus episode is gravely interrupting the world social and economic situation.
In addition to COVID-19, the individual society has actually witnessed a minimum of 5 pandemics in the present century, e.g. H1N1 in 2009, polio in 2014, Ebola (in West Africa in 2014), Zika (2016) and Ebola (WHO, 200). Ultimately COVID-19 break out has been proclaimed as the 6th hygienic urgent of world concern on 30 Jan 2020 by the WHO. These all over the world breakouts induced a lot of casualties, gloom, and also price billions of bucks ( Babymed, 2020). COVID-19 is most likely to lead to as a lot or even better individual suffering than various other infectious conditions in the entire planet. Moreover, various other worldwide ecological adjustments like dirt deterioration, ozone coating deficiency, urbanization, and also contamination, transforming atmosphere generates an unassailable danger to our world and also individual health and wellness (Sumaria & Zaheer, 2020). Global warming possesses its own origins in economic development, along with the substantial launch of CO2 in the course of the economic change, ultimately making it possible for the pollution to happen ( Qiao, 2020). Somewhat COVID-19 episode might be taken into consideration as a secondary repercussion of international ecological adjustments (Lu et al, 2020;Zhu et al, 2020). Besides its own distressing results on individual lifestyle, the unique coronavirus illness (COVID-19) possesses the possible to substantially stagnation the economic situation certainly not merely of China, USA, or even India however likewise of the globe overall. Consequently, WHO, UN, health care staffs, government and everyone as a whole requirement to reveal teamwork and battle side by side for avoidance and prevention of the pandemic . Mostly, all the countries of the world are constantly making efforts to reduce or prevent the transmission of the disease by carrying out the test as well as treating patients, quarantining suspected individuals through contact tracing, the prohibition of large gatherings, maintaining complete or partial lockdown among others.
The COVID-19 break out impacts all sections of the populace and is actually especially damaging members of the social group in one of the most prone scenarios, remains to have an effect on populaces, including individuals staying in destitution conditions, much older individuals, individuals along with handicaps, young people, and also poor people. Recent documentation shows that the health and also financial influences of the infection are actually being tolerated overmuch through poor people. As an example, destitute individual, considering that they might be incapable to safely and securely home, are actually much revealed to the threat of the infection. People without access to running water, refugees, migrants, or displaced persons also stand to suffer disproportionately both from the pandemic and its aftermath (WHO, 2020; UN, 2020).
There is no gainsaying that we are actually in the era of finding solution and treatment to the lavishing COVID-19 that spread like an inferno across the globe. As a preventive measure, the WHO, National Centre for Disease Control (NCDC) Presidential Task Force on COVID-19 (PTF) among others outlines some COVID-19 preventive measures to be necessary practice by the people to stay safe. Such preventive measure includes among others as wearing of face mask, regular washing of hands with alcohol-based sanitizer, avoiding overcrowded gathering, maintenance of physical distance among others. However, it has been discovered that more emphasis has been placed on the provision of palliative like food items as a result of lockdown and directive to wear at least locally produced face mask, maintaining of social distance etc. Regrettably, proper education on the proper application and strict adherence to these guidelines that could prevent the Virus was given less attention. Therefore, there is felt needs to critically assess the application and adherence to deadly COVID-19 preventive guidelines among people in Ushongo LGA of Benue State, Nigeria. This will enable WHO, Presidential Task Force (PTF), NCDC, health workers to have a better knowledge of the real and factual situation on the ground for improved health policymaking and implementation. In addition, there is no scholarly work on this topic and it is based on this light that the present paper becomes unavoidable in the face of ravaging COVID 19 pandemic.

COVID-19 prevention guidelines and measures (WHO, 2020, NCDC, 2020):
COVID-19 is actually an international danger that needs an international action including all nations. The government, health workers, WHO, NCDC and other relevant agencies spread the precise relevant information and healthy guidelines to aid the general public on the preventive measures of the disease. To lower the harm associated with COVID-19, hygienic strict adherence to the guidelines are promptly important to confine the international spreading of the infection. Some of the COVID-19 prevention guidelines can be explained below: Restricting mass gathering: Stopping COVID-19 pandemic through limiting mass celebration is actually a vital goal of hygienic prevention of the disease. COVID-19 is spread out from one person to another through direct contact. Thus, the spread of respiratory illnesses during the mass gathering is a major public health concern with the potential of distribution of these infectious diseases. Based upon an earlier understanding of SARS and also MERS contaminations, thus, restraining mass party might be the major preventative approach for COVID-19.
Avoid touching eyes, nostrils and mouth. Hands contact lots of surface areas as well as may get infections. When infected, hands may move the infection to your eyes, nostrils or even oral cavity. Coming from certainly there, the infection may enter your body system as well as affect you.
Make certain you, and individuals around you, adhere to really good respiratory system hygiene. When you sneeze or even hack, this indicates covering your mouth and also nostrils along with your elbow. At that point deal with the made use of cells right away and clean your palms. This is because through observing great breathing care, you shield individuals around you coming from infections like chilly, influenza and also COVID-19.
Maintain at the very least 1 metre (3 feet) proximity in between you and others. This is because when a person coughing, sneezes, or even talks they spray tiny fluid beads coming from their nostrils or even oral cavity which might consist of infection. If you are actually as well close, you can easily inhale the beads, consisting of the COVID-19 infection if the individual possesses the ailment.
Avoid visiting busy spots. Where individuals integrated in groups, you are actually most likely ahead right into near exchange somebody that possesses COIVD-19 and also it is actually harder to preserve bodily proximity of 1 metre (3 feet).
Regularly and also extensively wash your hands along with an alcohol-based sanitizer or even clean all of them along with detergent and also running water. This is because your hands along with detergent as well as water or even making use of alcohol-based sanitizer wipe or eliminates infections that might get on your hands Stay in-house and self-isolate despite having small indicators like coughing, migraine, moderate-high temperature, up until you recoup.
Use a face mask to stay away from contaminating others if you require leaving your residence. This staying away from exposure to others will certainly shield all of them coming from achievable COVID-19 and also various other infections.
Social or Physical distancing: Social distance is another guideline issued by WHO (2010). Social distancing is made to lower communications between individuals in a wider neighbourhood, through which people might be actually transmittable. As disease transferred through respiratory droplets call for a particular distance of individual, the social distancing of individuals will definitely minimize transmittal. Instances for social distance include the closure of universities or even office complex and revocation of social markets, as well as the termination of events.
Cleaning and disinfection: It is recommended by the WHO that high-touch areas such as bedside tables and door handles should be disinfected daily with a regular household disinfectant containing a diluted bleach solution (that is, 1-part bleach to 99 parts water). For surfaces that cannot be cleaned with bleach, 70% ethanol can be used. Toilets and bathrooms should be cleaned and disinfected with a diluted bleach solution (one-part bleach to 9 parts water to make a 0.5% sodium hypochlorite solution).

Safe use of alcohol-based hand sanitizers:
To shield your own self and also others against COVID-19, clean your hands often as well as completely. Use alcohol-based hands sanitizer or even clean your hands with detergent or soap with running water. This is reliable against COVID-19.
Avoid touching your eyes, mouth and also nose quickly after making use of an alcohol-based sanitizer, as it may lead to irritability.
The approved way of using face masks In the case that you are instructed to wear a mask, the World Health Organisation advises the following: 1. Make sure it covers the mouth and nose and fits snugly, minimising any separation between the mask and the face. 2. Avoid touching the fore front of the mask while you are wearing it. 3. When removing the mask, do not touch the front of it. Instead, use the strap at the back. Once you have taken it off, wash your hands. 4. When the mask is wet, it should be replaced with a clean, dry one. 5. Disposable masks should be thrown away. They should not be recycled to save money, as they do not guarantee protection.

Methodology:
Ushongo local government area is located in Benue state, North-central geopolitical zone of Nigeria. The headquarters of the LGA is in the town of Lessel. The LGA comprises of 11 council wards, they are Atikyese, Ikyov, Lessel, Mbaaka, Mbaanyam, Mbagba, Mbagwaza, Mbagwe, Mbakuha, Mbayegh and Utange. The present estimated population of Ushongo LGA is put at 214,357 (2019, estimation). The Tiv language is the major language commonly spoken by the people in the LGA while Christianity is mostly practised in the area. Ushongo LGA has covered a total area of 1,228 square kilometres and has an average temperature of 30 degrees centigrade (Wikipedia, 2020). The LGA has the popular Ushongo hills from which the LGA derives its names (Wikipedia, 2020). Farming is the main occupation of the people of Ushongo LGA. The crops such as citrus fruits, grains, mangoes, and tubers like potatoes, yams are grown in large quantities by the farmers. The LGA was also lockdown and consequently restriction of movement as well as a social gathering as a result of COVID-19 pandemic in Benue state. To objectively carry out the study, the researcher, therefore, adopted the survey design method to elicit information from the respondents with the use of the instrument and key informants for interview. The data were quantitatively analysed using SPSS and qualitatively analysed using the ethnographic method. The fishbowl method was used to select three council wards in the area. They are, Mbagba (45 respondents), Mbayegh (62 respondent) and Lessel Township (58 respondents). Only those respondents that are willing to participate in the study were considered. In this case, 165 respondents were purposively selected and accepted to participate in the study. The respondents were reached in their various homes and social gathering. The data shows that female constituted 50% (82) of the respondents, while male counterpart constituted 49.7% (82). This implies that more female participated in the study. The data on the age range of the respondents indicates that 26.1% (43) participated in the study belong to the age range of below 18 years, 39.4% (65)were between the age range of 18 to 36, and 34.5% (57) was 37 years and above. This implies that mature respondents took part in the study, and the information provided is reliable. The data on the occupation of the respondents' shows that majority of the respondents were farmers 58% (97) and 21.2% (35) were businessmen and women. In addition, the row data shows that majority of the respondents 69.5% (113) have formal education and 31.5% (52) have not received formal education. This implies that more educated respondents took part in the study and the information they provided are considered to be reliable for the study. The data presented indicates that all the respondents were aware of the deadly COVID-19 disease in Ushongo local government area of Benue state, Nigeria. The table also shows that majority of the people 59.4% (98) were aware of the COVID-19 preventive guidelines/ measures. This implies that COVID-19 preventive measures were known by the majority of the people in the area.

Source: Field work, June, 2020
The data in respect to the knowledge on the keeping physical distance and avoiding social gathering as a way of preventing COVID 19 shows that majority56.4% (93) of the respondents were known about this preventive guideline, while 43.6% did not have knowledge of this preventive measure. The data shows that despite the knowledge on the maintaining social distance and avoiding the social and political gathering majority of the respondents 67.3(111) did not stop attending a social and political gathering like burial, wedding, and sporting event.
The data indicate that majority of the respondents72.7% (120 were aware of regular washing of hands with running water and soap can o curtain COVID-19. The data revealed that despite being aware of this preventive method, the application is at a minimal level. This is because the majority of respondents 83.6 %(138) did not wash their hands regularly as directed, while only a few of the respondents 16.3 % stick to the guideline. In addition, majority of the respondents 86.7(143) did not have access to running water. The result of the study revealed that majority of the respondents 93.9(155) did not apply or have alcohol-based sanitizer, only a few respondents 6.1% (10) in the area have access and apply alcohol-based sanitizer. The result shows that 90.9% (150) of the respondents do not normally wash their hands up to the elbow as required, only 9.9%( 15) of the respondents agreed to be washing their hands up to the elbow. The data on the accessibility and availability of running water and alcohol-based sanitizer indicated that majority of the respondents 97.0% ( 160) have no access to running water and hand sanitizer, while only a few of the respondents 3.0% ( 5) have access to the running water and hand sanitizer.
The data on the usage of face mask as COVID-19 preventive measure indicates that majority of the respondents 55.6 %( 95) did not have a face mask, only 44.4% (70) have and use the face mask. The data shows that majority of the respondents 97.0% (160) have not been changing their face mask after use, only a few of the respondents3.0 % (5) have been changed their face mask after use. The data shows that 97.6 %( 161) of the respondents did not have more than a face mask, 2.4% of the respondents have more than one face mask. Also, the data shows that 93.9 % (155) of respondents did not wear it often, 6.1% (10) wear it often any time they are going out of their compound. The result revealed that majority of the respondents 96.4 % (159) were not been washing their face mask after every usage, only few 3.6% (6) agreed to have been washing it after every use. The result revealed that 98.8% (163) of the respondents did not know that they are not supposed to touch the forefront of the face mask, only few 1.2 % (2) known about this guideline. In addition, the row data indicated that majority of the respondents 94.5(156) said they were not taught on how to properly wear a face mask, only a few of the respondents 5.5% (9) said they were taught on how to wear a face mask. The data revealed that 52.1(86) wear the face mask to cover both the mouth and the nose, while 47.9 (79) were not wearing the face mask to cover both the mouth and the nose. Data shows that majority of the respondents 65.2 %( 106) share their face mask with their relative, 34.8% (59) were not sharing face mask with their relative.
In an interview with one of the key informants in Mbayegh district area of Ushongo LGA and health personnel in charge of primary health care said that: In this area, the people are aware of the deadly COVID-19 pandemic, regrettably, they don't believe it exists. The think COVID-19 is not real and of course the disease of the rich and top politicians. This single reason influences the inability to strictly adhere to the preventive guidelines and proper usage. For example (with a laugh in dismay), many people don't wear a face mask. The few that wear it share with their relative, hardly wash it and wear it wrongly. People in the area hardly wash their hands with running water, the few that wash their hands as a precaution, use stagnant water in a container and mostly without soap. Many of them clean their hands with alcohol "Okogoro" in place of alcohol-based sanitizer. In addition, despite the prohibition of social gathering, it has been completely ignored by the people. Every social event such as burial, marriage ceremonies, religious activities football matches among others continues as usual. I, therefore, call for more campaign on the proper usage and adherence to COVID-19 preventive measures.
Another key informant in Mbagba district area and head of primary health care Atekombo also opine the: My brother, hmm, the people here are also heard of the existence of COVID-19, but believe it is the disease of the rich and political manipulation to stead government money. As such many don't wear a face mask, even the few that wore it rarely washed it. It is very funny that the few that wear face mask use it with other members of the family. Some people locally produce their face mask with a funny look to cover only their mouth. In fact, some drunker drink more beer and Ogogoro (hot alcoholic drink) saying that it kills the virus. All social and economic activities like burial, market etc continues as normal as before. People still shake and hug others as normal as before. Effort should be intensified to educate people of this deadly disease.

Another respondent and the medical doctor in charge of General hospital Lessel, the headquarter of Ushongo
LGA in an interview alluded that: The people of this place are not properly using the COVID-19 preventive measures. This is because many of them don't wear a face mask, though few wear it. It is pitiable that the few that wear it don't even wash it and it always looks so dirty. Again, the concept of washing hands with running water is misunderstood to flowing water in a stream or river; in this case, many people that wash their hands as a preventive measure use stagnant water (water in a container). To worsen it all, the prohibition of social or physical distance is not applicable here. All social activities continue as during pre-COVID-19 era. People shake their hands normally and jokily saying COVID-19 is for rich people. In fact, the way people are applying face mask looks so funny and the way of washing their hands with stagnant water will actually worsen the situation. In addition, people are not adhering to the guidelines at all, at all, and this is worrisome. Another worrisome perception of many people in the area is that COVID-19 is mere political propaganda aimed at stealing government money. I have, therefore, advised that more efforts should be made in educating people on the proper usage of the guidelines and strict adherence to it. As you know my brother, there is a saying that it is better to prevent than to cure. I tell you, if proper care is not taken, the community transmission of this deadly disease will flush out the entire populace. The table shows the other COVID-19 preventive guidelines and its application. The data indicates that the majority of the respondents 78.1% (129) still shake hands and hug their relative, only 21.9 (36) use to obey the instruction. The data also shows that 84.8 % (140) said they did not sneeze at their elbow, only 15.2% (25) of the respondents sneeze at their elbow. The data indicate that 97.5 % (161) of the respondents do not use in disinfecting their door handle, bedside regularly, only 2.5 (4) said they use to disinfect their door, bedside regularly. The data also shows that the 3 feet distance were not maintaining in the area. This is because the majority 95.8% (158) attested to it and very few 4.2 % maintain the 3 feet distance.

Discussion of the Findings:
The finding of the study revealed that majority of the people in the area are aware of the existence of COVID-19 as a deadly disease, despite being aware of the disease, the majority believe it is political propaganda and manoeuvre aimed at continuing embezzlement of national money.
Another finding of the study is that the people in the area were not observing the social and physical distance at all. As shown in the table as well as in an interview with key informants, the social activities such as marriage ceremony, burial, market among others continue as normal as pre-COVID-19 era. The shaking of hands continues normally and people were not applying the three feet distance with others. It was observed during the survey that the people even make fun when they shake their hands. They shake hands and with a saying that "Zenda Bo-uange" meaning send away deadly disease (refer to . This is indeed worrisome at this time.
Furthermore, the study revealed that many people were not practising regular washing of hands as a precaution measure for the disease. Those that wash their hands for this purpose use stagnant water in a container as clearly presented in the qualitative and quantitative survey. The study revealed that people refer to running water as the water in the stream and river. The few that understand the meaning of running water hardly use it and have no access to it.
The study found that many people heard that the use of face mask can prevent COVID-19, but the majority of the people hardly adhere to its usage. It was found that the few that were using it wrongly apply it. Many of this category wore the face mask to cover only their mouth, they use it with their relative, and it looks so dirty meaning they hardly wash it. It was found in the study that the majority of the people did not have alcohol base sanitizer for cleaning of hands. This is attributed to lack of accessibility and availability of the product.

Conclusion/ Recommendations:-
The COVID-19, which possesses no accepted therapy, it is actually incredibly necessary to stop the spreading in society. The bottom lines in stopping the escalation in the society are actually hands cleanliness, social distancing, use of face mask and in fact, obeying the guidelines stipulated by the WHO and NCDC. Regrettably, these guidelines are not properly and wrongly applied or practiced by many people in the area. The non-application and to worsen it most is the wrong application of these preventive measures by the people of Ushongo LGA of Benue State, Nigeria. These wrong practices do not in any way augur well in the prevention of this inferno the COVID-19 pandemic. If urgent steps are not taken, the deadly disease can sweep the area. Base on the findings of the study, the following recommendation were made: More awareness should be carrying out-educate them that COVID-19 is real and it is not political propaganda. This change of perception by the people will go a long in the proper usage and adherence to the preventive measures. This should be done with the help of stakeholders, government and community health personnel in the area.
Government should make available these preventive facilities such as face mask, alcohol-based hands sanitizer, running water among others in nooks and cronies of the area. By providing these preventive measures, there should be in place the law that could compel people to properly and strictly adhere to the directive while interacting with others.
Tiv people like singing and dancing, therefore, the government WHO and stakeholders should embark on the massive campaign by employing local creative singers to create COVID-19 native songs addressing the preventive measures, strict adherence and proper application of the guidelines.