CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study
Leukemia is a malignant disorder of the blood and bone marrow characterized by uncontrolled proliferation of abnormal white blood cells that interfere with normal hematopoietic function. These abnormal cells suppress the production of red blood cells and platelets, thereby compromising immunity and oxygen transport within the body. According to Mansukhani et al. (2023), leukemia is broadly classified into acute and chronic forms, as well as lymphoblastic and myeloid subtypes, depending on the rate of progression and the cell lineage involved. Acute leukemia progresses rapidly and requires urgent intervention, while chronic leukemia advances more slowly. Medically recognized risk factors include genetic mutations, exposure to ionizing radiation, prolonged contact with benzene and related chemicals, prior chemotherapy, cigarette smoking, and family history of blood cancers. Adeniji et al. (2020) emphasize that understanding these clinical characteristics and risk determinants forms the basis for public awareness and preventive health education initiatives.
Globally, leukemia contributes significantly to the burden of cancer morbidity and mortality. Recent epidemiological estimates indicate rising incidence rates in several regions, partly due to improved diagnostic capacity and population growth. Noel et al. (2025) report that leukemia accounts for a considerable proportion of hematological malignancies worldwide, affecting both adults and children. Although advances in targeted therapies and bone marrow transplantation have improved survival rates in high income countries, disparities remain evident. Emokpae and Brown (2021) note that survival outcomes are closely linked to early detection and timely access to specialized care. Consequently, public knowledge about early symptoms such as persistent fatigue, unexplained bruising, recurrent infections, and weight loss plays a critical role in facilitating prompt diagnosis. These global patterns underscore the importance of awareness as a central element in cancer control strategies.
Within the African continent, the epidemiology of leukemia is shaped by socioeconomic, infrastructural, and healthcare system factors. Babah et al. (2024) observe that many African countries face constraints in diagnostic facilities, oncology workforce capacity, and treatment accessibility. Late presentation and limited screening initiatives influence clinical outcomes across several communities. Iorfa et al. (2020) further highlight that awareness of hematological cancers remains relatively low compared to more publicized malignancies such as breast and cervical cancer. In Nigeria, national cancer control efforts have increasingly emphasized awareness creation and early detection programs. Ayamolowo et al. (2024) indicate that public understanding of cancer symptoms and risk factors varies according to educational attainment, socioeconomic status, and exposure to health information campaigns. Patterns of health seeking behavior and reliance on informal care sources also influence cancer literacy within different regions of the country.
Moreover, cultural beliefs, stigma, and misconceptions continue to shape attitudes toward cancer in Nigerian communities. Akokuwebe and Idemudia (2022) explain that illness interpretations are often intertwined with spiritual or supernatural explanations, which may affect perception of disease causation and treatment pathways. Nkwunonwo et al. (2020) add that cancer related stigma can discourage open discussion and limit proactive health communication. In urban settings such as Lagos State, rapid population growth and environmental exposure patterns may further influence health awareness levels. Ajah, located within Eti Osa Local Government Area of Lagos State, has experienced significant residential and commercial expansion in recent years. Gbadebo et al. (2025) note that urbanization can both enhance access to health information and widen disparities in knowledge depending on social determinants.
Given the demographic composition and socioeconomic diversity of women residing in Ajah, assessing their knowledge and awareness of leukemia and its risk factors becomes essential for localized health planning. Aigbedion et al. (2025) stress that women often serve as primary caregivers and health decision makers within households, making their awareness level particularly influential in community health outcomes. Alagbe et al. (2025) affirm that targeted assessment of community specific awareness provides evidence for structured educational interventions. Therefore, this study is motivated by the need to generate empirical evidence on the level of knowledge and awareness of leukemia and its associated risks among women in Ajah, Lagos State, in order to inform tailored public health education and cancer prevention strategies.
1.2 Statement Of The Problem

Despite growing global emphasis on cancer awareness and early detection, attention to leukemia within community level health education remains comparatively limited. Mansukhani et al. (2023) note that hematological malignancies often receive less public visibility than breast or cervical cancers, which benefit from structured screening campaigns. In Nigeria, awareness initiatives have largely concentrated on reproductive related cancers, with less structured engagement on blood cancers. Ayamolowo et al. (2024) observe that public health messaging significantly shapes disease recognition patterns within communities. Consequently, women residing in Ajah, Lagos State may possess uneven or insufficient knowledge regarding the nature, symptoms, and risk factors of leukemia. This gap in awareness potentially affects how early warning signs are interpreted and acted upon at the household and community levels.
Inadequate knowledge of leukemia symptoms such as persistent fatigue, unexplained weight loss, recurrent infections, easy bruising, or abnormal bleeding may contribute to delayed health seeking behavior. Adeniji et al. (2020) emphasize that early symptom recognition plays a decisive role in improving cancer outcomes. However, Noel et al. (2025) highlight that misinterpretation of non specific symptoms often results in late clinical presentation. In sociocultural contexts where illness is sometimes attributed to non biomedical causes, perception of disease risk may be further shaped by belief systems and stigma. Akokuwebe and Idemudia (2022) as well as Nkwunonwo et al. (2020) explain that cultural interpretations of illness and fear associated with cancer diagnosis can limit open discussion and proactive screening behavior. These dynamics may reduce timely consultation with qualified medical professionals and constrain preventive health practices among women.

Furthermore, empirical investigation into leukemia awareness within localized Nigerian communities remains sparse. While broader studies on cancer literacy have been conducted, limited attention has been directed toward assessing specific knowledge of leukemia and its associated risk determinants among women in rapidly urbanizing settings. Babah et al. (2024) and Iorfa et al. (2020) underscore the importance of disaggregated community based data in shaping context specific health interventions. Ajah has experienced significant population growth and infrastructural expansion in recent years, as noted by Gbadebo et al. (2025), yet corresponding data on leukemia awareness within this population remain under documented. Aigbedion et al. (2025) argue that women’s health literacy significantly influences broader family health decisions.

The absence of localized empirical evidence constrains the capacity of public health planners to design targeted awareness campaigns tailored to the sociocultural and educational profile of women in Ajah. Alagbe et al. (2025) affirm that effective health promotion strategies depend on accurate baseline assessment of knowledge levels. Therefore, a systematic evaluation of women’s knowledge and awareness of leukemia and its risks in Ajah is essential to generate evidence for informed and strategic public health programming.
1.3 Objectives of the Study
The main objective of this study is to examine the knowledge and awareness of leukaemia and its risks among the women in Ajah, Lagos State. Specifically, the study seeks to; 
1. Assess the level of knowledge of leukaemia among women residing in Ajah.

2. To determine the level of awareness of the risk factors associated with leukaemia among women in Ajah, Lagos State.

3. To identify the sources of information through which women in Ajah obtain knowledge about leukaemia.

4. To examine the association between socio-demographic characteristics and knowledge of leukaemia among women in Ajah.
1.4 Research Questions
1. What is the level of knowledge of leukaemia among women residing in Ajah?

2. What is the level of awareness of the risk factors associated with leukaemia among women in Ajah, Lagos State?

3. What are the sources of information through which women in Ajah obtain knowledge about leukaemia?

4. What is the association between socio-demographic characteristics and knowledge of leukaemia among women in Ajah?
1.5 Significance of the Study
Women residing in Ajah, Lagos State will be primary beneficiaries of this study. The findings will provide insight into their current level of knowledge and awareness of leukaemia, its symptoms, and associated risk factors. Increased understanding can strengthen their capacity to recognize early warning signs such as persistent fatigue, unexplained bruising, recurrent infections, and abnormal bleeding. Enhanced awareness may also encourage timely medical consultation and informed health decision making. Access to evidence based information can reduce misconceptions and improve preventive health practices within households.
Healthcare providers, including nurses, community health workers, and physicians, will benefit from the study through a clearer understanding of existing knowledge gaps among women in the community. This evidence can support the design of targeted health education programs, screening advocacy initiatives, and community outreach campaigns. Findings may guide the development of culturally appropriate communication strategies aimed at improving cancer literacy and encouraging early detection practices.
Public health planners and policymakers in Lagos State will also benefit from the study. Empirical data generated from Ajah can inform strategic planning, resource allocation, and cancer awareness interventions within the local government area. The study may contribute to broader cancer control programs by providing localized evidence necessary for tailoring public health messaging to specific demographic groups. Non governmental organizations involved in cancer advocacy may also draw upon the findings to strengthen awareness campaigns and community engagement activities.
Academic researchers and students in public health, nursing, and medical sciences will benefit from the study as it contributes to existing literature on cancer awareness in Nigeria. The findings can serve as a reference point for further studies on hematological malignancies, community health education, and health seeking behavior. Future research may build upon the methodological framework and results to conduct comparative or longitudinal assessments in other communities.
1.6 Scope of the Study
The scope of this study is empirically focused on assessing the level of knowledge and awareness of leukaemia and its associated risk factors among women residing in Ajah, Lagos State. The study will examine the sources through which these women obtain information about leukaemia, including formal health channels and informal community networks, and analyze how socio-demographic characteristics such as age, education, and occupation influence their knowledge levels. The geographic scope is limited to the Ajah community within Lagos State, allowing for a localized and context-specific understanding of awareness patterns. The content is strictly centered on evaluating knowledge, awareness, and information sources related to leukaemia, providing insights that can inform targeted health education and cancer prevention interventions within this community.

1.7 Definition of Terms
Knowledge: Knowledge refers to the level of accurate information and understanding that women in Ajah possess about leukaemia, including its causes, symptoms, risk factors, and treatment options.
Awareness: Awareness denotes the degree of consciousness or familiarity with the existence of leukaemia as a medical condition and its potential health implications.

Leukaemia: Leukaemia is defined as a malignant disorder of the blood and bone marrow characterized by abnormal proliferation of white blood cells.

Risk Factors: Risk Factors refer to conditions or exposures such as genetic predisposition, radiation, chemical exposure, smoking, prior chemotherapy, or family history that increase the likelihood of developing leukaemia.

Women: Women refers to adult female residents living in Ajah, Lagos State, within the defined age range selected for the study.

Health Seeking Behavior: Health Seeking Behavior denotes actions taken by individuals in response to perceived symptoms or health concerns, including consultation with qualified medical professionals.

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