What is it about?

Yellow fever is a vaccine-preventable acute viral disease that can rapidly spread and cause serious public health impact. Delay in seeking health care from health facilities is a potential risk of prolonged disease spread. Therefore, this study assessed the delay in health-seeking behaviour and implications for yellow fever outcomes in the 2019 outbreak in Nigeria. Furthermore, the study examined the factors associated with delayed yellow fever vaccine uptake. A retrospective study was conducted from January to December 2019 using 137 cases recorded in the WHO database. The data were analysed using descriptive (frequency and percentages) and the Chi-square test. The results were significant at p < 0.05. Results showed a low uptake of yellow fever vaccine (24.1%) among patients and a median total health-seeking delay of 7 [IQR 7, 9] days. The delay was more among the older age ≥40 years (12 [IQR 12, 29]), females (8 [IQR 8, 11], and rural inhabitants 7 [IQR7, 9], particularly in Izzi LGA (9 [IQR 9, 16] than the other subgroups. Patients' location or place of residence was significantly associated with the yellow fever vaccine uptake (p < 0.000*), and delay (p = 0.003*). Conclusively, the low vaccine uptake was due to the delay in health-seeking behaviour. Thus, the healthcare system in Nigeria needs to intensify mass participation in immunisation programmes. Interventions that promote behavioural change towards immunisation are required. Also, health promotion campaigns to educate rural people on desirable health-seeking behaviour are needed.

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Why is it important?

The study important because it provided evidence on the prevalence of yellow fever in an endemic region. It also provided evidence on why people delay in receiving immunization at a health facility in Nigerian communities.


The publication offers insights into an endemic disease in a state in south-east Nigeria. The findings can inform the government and public health experts' needed interventions to curb unprecedented transmission of YF during an outbreak. Such public health interventions can eliminate barriers to health-seeking among infected persons at health facilities in the state.

Samson Agbaje
University of Nigeria

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This page is a summary of: Delay in health‐seeking behaviour: Implication to yellow fever outcome in the 2019 outbreak in Nigeria, Health & Social Care in the Community, March 2021, Wiley, DOI: 10.1111/hsc.13329.
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