Awareness and Preventive Practices for Diphtheria Among Caregivers of Children Aged 2-14 Years Old in Osogbo Local Government Area, Osun State, South -Western Nigeria

Background In 2023, the World Health Organization reported an alarming number of cases of diphtheria in Nigeria with overall risk of diphtheria assessed as high at the national level. While the outbreak's primary burden lies in northern Nigeria, the disease spread, with three confirmed cases identified in Osun State. The risk in Osun is substantial despite the low case count, as only 42.0% of children under 15 years are fully protected, leaving a highly susceptible 58.0% at risk. Critically, Osogbo serves as a major hub for interstate travel and commerce, creating an elevated risk for rapid disease introduction and transmission via the movement of people and goods. This threat is compounded by Osun state having high cases of zero dose children who are at risk of diphtheria. Understanding the local awareness and risk profile is essential for preemptive intervention. Therefore, this study aimed to assess the awareness, prevalence of risk factors, and level of adoption of preventive measures for Diphtheria among caregivers of children aged 2–14 years in Osogbo Local Government Area (LGA), Osun State in order to curb the disease’s transmission and aid the development of interventions. Method A cross-sectional study was conducted among 360 caregivers of children aged 2–14 years attending primary health care facilities in Osogbo LGA between January and March 2024. An interviewer-administered questionnaire was used to obtain data on socio-demographic characteristics, prevalence of risk factors, awareness and adoption of preventive practices for diphtheria. Descriptive statistics, bivariate analysis and logistic regression were performed using SPSS version 21. Awareness was measured on a six-point scale, with scores ≥ 4 classified as high awareness, while level of adoption of preventive practices was assessed on a 33-point scale, with scores ≥ 24 categorized as good. Results The mean (± SD) age of caregivers was 32.3 (± 6.3) years. Most children had received the pentavalent vaccine (80.6%), lived in households with 1–5 occupants (75.0%), and shared eating utensils (83.6%). However, only 63.6% had completed the full immunization schedule. Overall, 81.9% of caregivers demonstrated low awareness of diphtheria, while 87.8% reported good adoption of preventive practices. The highest level of caregiver education was significantly associated with awareness level (p = 0.010). Age (p = 0.032) and highest level of education (p = 0.003) were significantly associated with adoption of preventive practices in the bivariate analysis. Caregivers age (29–39 years) was identified as the independent predictor of adoption of preventive practices [AOR = 3.02, 95% CI: 1.34–6.83, p  = 0.008]. Conclusion Despite relatively high general vaccine uptake and good adoption of preventive practices (87.8%) awareness of diphtheria among caregivers in Osogbo LGA remains low. This reflects that people take the vaccines as recommended with low awareness of the specific antigens and what it prevents, hence the low awareness on diphtheria in this study. This is more so among caregivers < 30 years. Targeted community based health education, especially for younger caregivers is needed to improve awareness and support completion of immunization schedules. Addressing age-specific barriers, strengthening community-based health promotion strategies and integrating health literacy approaches into primary healthcare services are essential in promoting equitable adoption of infection-prevention measures to reduce diphtheria risks among vulnerable children in the region.