Published: 2021-11-24

Urban-rural difference in community willingness to isolate during COVID-19 pandemic in Benue State Nigeria 2021

Ubong Akpan Okon, Adebola Olayinka, Pamela Mwansa, Hope Mwansa, Rabi Usman


Background: Coronavirus disease 2019 is a highly infectious viral disease reported across more than 210 countries of the world. Isolation is a very critical component of COVID-19 public health responses were infected or exposed persons are separated from the unexposed individual for the purposing of protecting and preventing or containing disease spread. Our study assessed and compared community willingness to isolate during COVID-19 pandemic among urban and rural dwellers.

Methods: A multi-stage comparative cross-sectional study was used to assess respondents’ willingness to isolate between January and April 2021. Response was scored and each composite scores were converted to a percentage. The assessment was done using three questions with a maximum score of 15. A score of ≥80% of the maximum score was categorized as more willing to quarantine or isolate, score from 51% to 79% was categorized as slightly willing to quarantine or isolate while ≤50% was categorized as less willing to quarantine or isolate. Data was analysed using STATA SE 64 software and level of significance set at 5%. Categorical variables were summarised as frequency and percentages and presented in tables urban and rural comparisons were done with Chi square test and the corresponding p-values presented.

Results: One thousand three hundred and thirty-one respondents recruited into the study had a mean age of 33.7±12.83. Urban respondents aged 25-34 years were 36.64% (358) while rural respondents 31.94% (145) were aged 25-34 years (p=0.013). Most the respondents in both urban and rural communities were females 58.15% (574) and 55.73% (253) respectively. 549 (56.19%) of urban respondents were willing to be quarantined after contact with a suspected COVID-19 patient when compared with the rural respondent 292 (64.32%). Only 524 (53.63%) of urban respondents were willing to isolate after having had contact with a confirmed patient compared with the rural respondents 277 (61.01%). More than half of the respondents in urban and rural 629 (64.38%) and 303 (66.74%) respectively showed their willingness to isolate if confirmed to have COVID-19. Overall, 758 (77.58%) of the respondents were willing to go into isolation during COVID-19 pandemic when compared with rural communities 377 (83.04%) of respondents (p value =0.06).

Conclusions: Willingness to isolate during COVID-19 pandemic is higher among rural dwellers than the urban dwellers.


Benue state, COVID-19 Pandemic, Isolation, Willingness

Full Text:



Denis M, Vandeweerd V, Verbeeke R, Laudisoit A, Reid T, Hobbs E, Wynants L. information available to support the development of medical countermeasures and interventions against COVID-19. Covipendium. 2020;4:01-296.

Hauck G, Gelles K, Bravo V. Five months in: A timeline of how COVID-19 has unfolded in the US. 2020. Available from: https://www.usatoday. com/in-depth/news/nation/2020/04/21/coronavirus-updates-how-covid-19-unfolded-u-s-timeline/2990956001/. Accessed on 29 April 2021.

“First Case of Corona Virus Disease Confirmed in Nigeria”. Nigeria Centre for Disease Control. 2020. Available from: Accessed on 10 March 2020.

Maclean R, Dahir AL. Nigeria Responds to First Coronavirus Case in Sub-Saharan Africa. The New York Times. Available from: https://www.nytimes. com/2020/02/28/world/africa/nigeria-coronavirus. html. Accessed on 10 March 2020.

WHO. Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19); 2020. Available from: Accessed on 10 March 2020.

MOH. Coronavirus (COVID-19) latest updates; 2020. Available from: COVID19/Details/3926. Accessed on 29 April 2021.

World Health Organization. Global surveillance for human infection with coronavirus disease (COVID-19); 2020. Available from: publications-detail/global-surveillance-for-human-infection-with-novel-coronavirus-(2019-ncov). Accessed on 29 April 2021.

Kass NE. An Ethics Framework for Public Health. Am J Public Health. 2001;91:1776-82.

Rashid H, Ridda I, King C, Begun M, Tekin H, Wood JG, Booy R. Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic. Paediatr Respir Rev. 2015;16:119-26.

Flahault A, Vergu E, Coudeville L, Grais RF. Strategies for containing a global influenza pandemic. Vaccine. 2006;24:6751-5.

Haber MJ, Shay DK, Davis XM, Patel R, Jin X, Weintraub E, et al. Effectiveness of interventions to reduce contact rates during a simulated influenza pandemic. Emerg Infect Dis. 2007;13:581-9.

Smylie MA. Reducing racial isolation in large school districts: the comparative effectiveness of mandatory and voluntary desegregation strategies. Urban Educ. 1983;17:477-502.

Cook AR, Zhao X, Chen MIC, Finkelstein EA. Public preferences for interventions to prevent emerging infectious disease threats: a discrete choice experiment. BMJ Open. 2018;8:e017355.

Van D, McLaws ML, Crimmins J, MacIntyre CR, Seale H. University life and pandemic influenza: Attitudes and intended behaviour of staff and students towards pandemic (H1N1) 2009. BMC Public Health. 2010;10:130.

Zhang Q, Wang D. Assessing the role of voluntary self-isolation in the control of pandemic influenza using a household epidemic model. Int J Environ Res Public Health. 2015;12:9750-67.

Nicoll A. Personal (non-pharmaceutical) protective measures for reducing transmission of influenza- ECDC interim recommendations. Week Rel (1997-2007). 2006;11(41):3061.

Becker NG, Glass K, Li Z, Aldis GK. Controlling emerging infectious diseases like SARS. Math. Biosci. 2005;193:205-21.

Loustalot F, Silk BJ, Gaither A, Shim T, Lamias M, Dawood F, et al. Household transmission of 2009 pandemic influenza A (H1N1) and nonpharmaceutical interventions among households of high school students in San Antonio, Texas. Clin Infect Dis. 2011;52:146-53.

Teh B, Olsen K, Black J, Cheng AC, Aboltins C, Bull K, et al. Impact of swine influenza and quarantine measures on patients and households during the H1N1/09 pandemic. Scand J Infect Dis. 2012;44:289-96.

Kavanagh AM, Bentley RJ, Mason KE, McVernon J, Petrony S, Fielding J, et al. Sources, perceived usefulness and understanding of information disseminated to families who entered home quarantine during the H1N1 pandemic in Victoria, Australia: a cross-sectional study. BMC Infect Dis. 2011;11:2.

Mas FS, Jacobson HE, Olivarez A, Hsu CE, Juo HH. Communicating H1N1 risk to college students: a regional cross-sectional survey study. J Homel Secur Emerg Manag. 2012;9

Katz R, May L, Sanza M, Johnston L, Petinaux B. H1N1 preventive health behaviours in a university setting. J Am Coll Health. 2012;60:46-56.

Eastwood K, Durrheim D, Francis JL, d’Espaignet ET, Duncan S, Islam F, et al. Knowledge about pandemic influenza and compliance with containment measures among Australians. Bull World Health Organ. 2009;87:588-94.

Horney JA, Moore Z, Davis M, MacDonald PDM. Intent to receive pandemic influenza A (H1N1) vaccine, compliance with social distancing and sources of information in NC, 2009. PLoS One. 2010;5:e11226.

Eastwood K, Durrheim DN, Butler M, Jones A. Responses to pandemic (H1N1) 2009, Australia. Emerg Infect Dis. 2010;16:1211-6.

Zheng J, Zhang Y, Xu Y, Yang L, Lin C, Zhu L. Health literacy and demand for health education on novel coronavirus pneumonia epidemic among community residents in Fujian province: an online survey during epidemic outbreak. Chinese J Public Health. 2020;36(2):160-4.

Chen X, Chen H. Differences in preventive behaviours of covid-19 between urban and rural residents: lessons learned from a cross-sectional study in China. Int J Environ Res Public Health. 2020;17:4437.

Zahnd WE, Goldfarb J, Scaife SL, Francis ML. Rural-urban differences in behaviours to prevent skin cancer: an analysis of the Health Information National Trends Survey. J Am Acad Dermatol. 2010;62:950-6.

Doescher MP, Jackson JE. Trends in cervical and breast cancer screening practices among women in rural and urban areas of the United States. J Public Health Manag Pract. 2009;15:200-9.

Zimmerman RK, Santibanez TA, Janosky JE, Fine MJ, Raymund M, Wilson SA, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med. 2003;114:31-8.

Zhang J, Zhu L, Li S, Huang J, Ye Z, Wei Q, et al. Rural-urban disparities in knowledge, behaviours, and mental health during COVID-19 pandemic: a community-based cross-sectional survey. Medicine. 2021;100:13(e25207).

Haque T, Hossain KM, Bhuiyan MM, Ananna SA, Chowdhury SH, Islam MR, et al. Knowledge, attitude, and practices (KAP) towards COVID-19 and assessment of risks of infection by SARS-CoV-2 among the Bangladeshi population: An online cross-sectional survey. Research Square. 2020.

Qi Y, Chen L, Zhang L, Yang Y, Zhan S, Fu C. Public practice, attitude, and knowledge of novel coronavirus-infected pneumonia. J Trop Med. 2020;20(02):145-9.

Chen X, Hay JL, Waters EA, Kiviniemi MT, Biddle C, Schofield E, et al. Health literacy and use and trust in health information. J Health Commun. 2018;23(8):724-34.

Paige SR, Krieger JL, Stellefson ML. The influence of eHealth literacy on perceived trust in online health communication channels and sources. J Health Commun. 2017;22:53-65.

Ye Y, Wu R, Ge Y, Wang T, Yao X, Yang Y, Long C, Chen F, Tang S, Huang R. Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China. Infect Dis Poverty. 2021;10(1):1-4.

Park CL, Cho D, Moore PJ. How does education lead to healthier behaviours? Testing the mediational roles of perceived control, health literacy and social support. Psychol Health. 2018;33(11):1416-29.

Wolf MS, Serper M, Opsasnick L, O’Conor RM, Curtis L, Benavente JY, et al. Awareness, attitudes, and actions related to COVID-19 among adults with chronic conditions at the onset of the US outbreak a cross-sectional survey. Ann Intern Med. 2020;173(2):100-9.

Ramirez AS, Carmona KA. Beyond fatalism: information overload as a mechanism to understand health disparities. Soc Sci Med. 2018;219:11-8.

Zhong BL, Luo W, Li HM, Zhang QQ, Liu XG, Li WT, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. Int J Biol Sci. 2020;16(10):1745-52.

Witteveen D, Velthorst E. Economic hardship, and mental health complaints during COVID-19. Proc Nat Acad Sci USA. 2020;117(44):27277-84.

Atchison CJ, Bowman L, Vrinten C, Redd R, Pristerà P, Eaton JW, et al. Perceptions and behavioural responses of the public during the COVID-19 pandemic: a cross-sectional survey of UK adults. MedRxiv. 2020.

Calderon-Larranaga A, Dekhtyar S, Vetrano DL, Bellander T, Fratiglioni L. COVID-19: risk accumulation among biologically and socially vulnerable older populations. Age Res Rev. 2020;63:101149.