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A Content Analysis of Monkey pox outbreak Coverage/reportage in three selected Newspapers in Nigeria
By Olalekan Moses Olayemi
Senior Librarian
Library and Information Technology Department,
Nigerian Institute of Medical Research, PMB 2013,
Lagos, Nigeria.

+234- 0809-515-01 99
[email protected]
The media play a crucial role in engaging and educating the masses on health issues, especially health related information during diseases outbreak or epidemics. This study focused on the content analysis of monkey pox outbreak coverage in three selected newspapers in Nigeria namely; the Guardian, the Punch and the Vanguard newspaper. Content analysis was the designed adopted for the study. The issues of monkey pox reporting were searched manually from page to page of each Newspaper understudied during the outbreak period covering from 20th September (Two days before official reporting of the first suspect cases) was reported to 25th November, 2017. The findings of the study revealed that the Guardian newspaper has the most frequently reported issues on monkey pox, followed by the Punch andthe Vanguard respectively. The result also shows that straight news story was the most reported story type/ forms with 63(63.6%) on the diseases, and the placement pattern of reports in the selected newspapers were mostly found inside the page of the newspapers with the few been in the front page mostly as headlines. Based on the findings of the study, it was recommended that newspapers should endeavor to always place topical diseases outbreak on the front page and back page of their publication in order to grasp the attention of readers and those who only glance through headlines of newspaper.

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Keywords: Content analysis, monkey pox, diseases, outbreak, newspapers, Nigeria
Introduction
Over the time, Nigeria like many developing countries have been ravaged by different outbreak of diseases that has affected human lives and their communities, and recently these outbreaks have become incessant, hence causing panic and worry among its citizens. Within the spate of about three years, Nigeria has witnessed different diseases outbreak ranging from; Ebola in 2014, Stevens-Johnson Syndrome in 2016, Lassa feverin 2016, Cholera in 2017, cerebrospinal meningitis in 2017 (Kazeem, 2017: Musa, et al. 2015: Odebode, 2016; Mofolorunsho, 2016: WHO, 2017), and now monkey pox. Like many disease outbreak in the country, they have poses a lot of threat to the country’s security health system and citizens at large which have affect the socio-economic of the people and survival.

The media has played a major role by reporting and documenting the trends of thesediseases outbreak.In fact, the media are significant sources of health-related information and have been shaping the way we think about and discuss health issues. The more coverage a topic receives in the news media, the more likely it is to be a concern of the public (Institute of Medicine, 2003). The unfolding news coverage of these outbreak by media has provides a good platform for raising important health issues and making them more visible to the public eye.This they have done by gaining the attention of specific of the individual, public, community leaders and traditional rulers, religious leaders, opinion leaders, including politicians, governmental agency, and corporate executives, among others. Hence, the media holds a very powerful capacity to set a social issue for mass audience and discourse as well as crucial role to society, serving as the watchdog of the society, and providing constant stream of health information and socialization to the public through television, radio and newspaper (Inuwa, 2007).

According to Adelakun et.al (2013) cited in Ogbonna (2016) the roles of media in health issues include: “staging health related programme such as health talk, inform and explain to the populace new government policies on health, collaborate with health organizations (governmental and non-governmental) to assist people in solving health related problems, report epidemics before it spread, andreport the findings of health researchers to help in health decision making”. Among the channel used by mass media, newspapers are among the most commonly read periodicals that are available and accessible to the vast majority of people in the country, since the media (Newspaper) is relied on for the reportage of accurate and trustable information on topical issues; it is believed that mass media has important role to play whenever there is epidemic (Ejima, 2014; Oluwadun ; Obono, 2013). The media plays a vital role in information dissemination and enlightenment particularly in cases of disease outbreak occurring at alarming proportions like Nigeria; hence their contribution cannot be under-estimated. This present study therefore, intends to investigate the coverage of monkey pox outbreak in some selected Nigerian Newspaper.

The Nigerian Newspaper: Historical Overview
Newspaper has become a medium of communication to people. According to Gul ; Islam (2013) the evolution of newspaper started round 15th century from Corantos-paper printed in Northern Germany. It could also have been aided by the invention of printing machine by Johannes Guttenberg in Germany. Nigerian Newspapers prints have a long history and can be traced back to the European missionaries who brought Christianity. In 1859 Henry Townsend founded and released Iweiroyin fun Ara Egbaati Yoruba (The newspaper for Egba and Yoruba people) in Abeokuta, Ogun State. The Newspaper was been published bi-weekly in both Yoruba and English language. Later in 1863 it was followed by Anglo- African, the Lagos Times in 1880, the Eagle 1887, and the Chronicle in 1908 among other at that period (Igbeka ; Ola, 2010). This initiative coupled with the struggle for Nigerian political independence led many nationalist to established newspaper outfit as channel for promoting national consciousness and the liberation of the country from the colonialist. Nnamdi Azikwe established West African Pilot in 1937; the Northern Nigerian Government established a Hausa language Newspaper tagged Gaskiya Ta Fi Kwabo in 1939; Obafemi Awolowo had the Nigerian Tribune in 1946. As at today, there are many Newspapers outfit in Nigeria, some of which are: the Vanguard, the Daily trust, the Guardian, the Punch, the Mirror, the Nation, the Leadership, Thisdays, Tribune, Newswatch etc owned either by the government, private companies or individuals. Newspapers are no more new or scarce; it has become source of information for the general public across different profession and languages, keeping the public informed about happenings in the health, politics, cultural, entertainment and general global issue, facts and truth for decision making.

Monkey Pox: Brief Historical Outbreak in Nigeria
Monkeypox is a rare infectious viral zoonotic disease (i.e. a viral disease transmitted from animals to humans) that occurs sporadically, primarily in remote villages of Central and West Africa, near tropical rainforests. It is caused by the Monkeypox virus which belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (the cause of smallpox), vaccinia virus (used in the vaccine for smallpox eradication), and cowpox virus (used in earlier smallpox vaccine). The Monkey pox virus can cause an ill-health with the following symptoms; fever, a generalized vesicular skin rash, and painful jaw swelling. In earlier outbreaks, it was said to have led to death in about 1-10% of infected cases. Although report asserted that, “there is no specific medicine to treat the disease, but when intensive supportive care is provided most patients recover fully” (Nigeria Centre for Disease Control, 2017).

Historically, Monkey pox was first discovered in 1958 when two outbreaks of a pox like disease occurred in colonies of monkeys reserved for research, thus the name ‘monkey pox. The first human case of monkey pox was recorded in 1970 in the Democratic Republic of Congo when there was exerted effort to eliminate smallpox. Since then, monkey pox has been reported in humans in many other Central and Western African countries. The 2003 outbreak in the United States is the only time Monkey pox disease in humans was recorded outside Africa. In Nigeria, the last time that cases of Monkeypox were reported was in the early 1970s, until the recent outbreak of 2017(Ministry of Health, 2017: Nigeria Centre for Disease Control (NCDC) 2017).
The first case of the monkey outbreak in 2017 was first discovered / announced at Bayelsa State in Southern part of the country. According to federal ministry of health “On the 22nd of September 2017, the Nigeria centre for disease control (NCDC) received a report of a suspected case of monkey pox virus disease from the Niger Delta University teaching hospital (NDUTH), Okolobiri, Bayelsa State” (Federal Ministry of Health, 2017), with suspected cases later reported and confirmed in some other States; Bayelsa, Rivers, Ekiti, Enugu, AkwaIbom, Lagos, Ogun and Cross River states. As at the 19th of October 2017, 74 suspected cases of monkey pox were confirmed and reported from 11 States, including the federal capital territory (FCT) (Nigeria Centre for Disease Control, 2017). The unfortunate thing about monkey pox is that “there is no cure for the diseases” and “no specific medicine to treat the diseases, but intensive supportive care can helps patients to recover fully” (Ogundipe, 2017: World health organization, 2018).

Theoretical framework
Agenda setting theory
This study is anchored on agenda setting theory. According to Orr (n.d) agenda setting theory was first introduced by Maxwell McCombs and Donald Shaw in 1972. This theory states “that the news plays an integral part in the shaping of political realities. The amount of time spent on an issue and the information relayed in a news story, along with the story’s position, determines how much a reader learns and the amount of importance placed on the issue”. The common assumption of agenda setting is that the ability of the media to influence the visibility of events in the public. Hence, the concept of agenda setting in our society is for the press to selectively choose what we see or hear in the media without any form of bias (Sanchez, 2002). The theory explains the relationship between the rate at which media report a story, and the extent that people think that such story is important. It is believed that how a person acts at a particular time is determined mainly by what issue the individual believes is important (Uwom & Oloyede, 2014).

In this context, agenda-setting theory deal with newspaper’s capability to influence the perception of their readers and what they regard as the most significant issue of the day. This obviously states the value the media (Newspaper) places on particular information or news may be determine by the attention and the placement of such news within the newspaper pages. Attention to health news, stories, analysis and interview have been increasing in importance during the last few decades, and accordingly, media reports has become a pivot for bringing a desired orientation and changes in behavior in the public sphere (Collinson & Heffernan, 2014).

Mass media (Newspaper) is one of the channels used to inform individuals concerning diseases within a population or community. Diseases outbreak have been a common incidence and phenomenon in many developing countries that always required urgent response healthcare and the media, which if not quickly ‘nip in bud’ could lead to panic and loss of lives. It has become public concern once diseases outbreak are reported by the media and subsequently given attention. Therefore, the best way during such an outbreak by the media is to communicate scientific knowledge that reaches the target group ensuring that they will fully understand the information and consequently react to it (Calderón, 2016). This would subsequently determine likened it to power of the newspaper to set the agenda of public discussion which decides what people will talk and think about.

Methodology
Content analysis is the study design used for this study. In the context of the this study, content analysis requires systematically watching or reading with an analytical and critical eye, going beyond what is presented and looking for deeper meanings and messages to which media consumers are exposed (Kort-Butler, 2016 ). Content analysis is useful for examining trends and patterns in documents and newspaper publications. The purpose of content analysis is to organize and elicit meaning from the data collected and to draw realistic conclusions from it.Content analysis has been adopted by different authors (Ejima, 2014:Ogbonna, 2016: Uwom & Oloyede, 2014) in conducting a similar study.

Three(3) Nigerian popular Newspapers were purposely selected for the study, they were: The Guardian, The Punch and Vanguard Newspapers. These newspapers were selected because of their popularity, high frequency of publication, report current issues affecting the nation and they are sold at affordable prices. Also, they are easily accessible; they appeal to the audience and have a wide range of topics ranging from politics, health, entertainment, business and sport. These newspapers have both print and online editions published on a daily basis (Oluwadun & Obono, 2013).

The issues of monkey pox reporting were searched manually from page to page of each newspaper selected for the study during the outbreak period covering from 20th September (Two days before official reporting of the first suspect cases) was reported to25th November, 2017 when the cases of reportage fizzle out or no longer reported till the period of coverage. The coded data was analyzed using simple frequency counts, percentages and charts. The population for this study is 201 editions of the three selected newspapers covering 67 days, which is the scope of study.

Literature Review
Literature reviewed shows that various studies have been conducted on different the coverage of mass media and roles they played during diseases or epidemic outbreak. Yan, Tang & Wu, (2016) studied the effect of mass media report on A/H1N1 influenza epidemic in the Shaanxi province of China, they compared the number of hospital visits with the number and duration of news reports about the epidemic. Their findings reveal that more news reports coverage ‘resulted in fewer hospital visits and vice versa’. This indicates that media coverage is a powerful tool to help halt the spread of disease during an epidemic.

Mboera & Rumisha (2004) studied the role of mass media in disease outbreak reporting in the United Republic of Tanzania. Ninety-nine outbreak episodes were reported in four local dailies collected, compiled and analyzed. The finding revealed that the cholera disease received the highest coverage which was frequently reported from the 3 districts in Dar es Salaam Region. While other epidemic-prone diseases like meningitis and rabies received very little coverage.

Egbo (2012) investigated newspaper coverage of sexual violence against women and children in selected Nigerian newspapers. The result of the study revealed that the newspapers do not give prominence to sexual violence stories due prominence as well as not adequately placing available stories on the front pages. Igbinoba & Ekeanyanwu (2010) examined the Nigerian print media coverage of sexuality issues. The findings show that the Nigerian print media did not give adequate coverage to sexuality issues for the period under study although most of the stories reported were of high quality. Furthermore, the reported stories were not given the prominence they deserve. It was recommended therefore that the media should demystify the concept of human sexuality and enhance the right sexual attitude amongst individuals in the society by ensuring that majority of the stories on sexuality issues are sourced from specialists so as to enhance the quality of information disseminated to the public on the subject matter.

Uwom & Oloyede (2014) examine newspaper contents with a view to ascertain whether or not adequate coverage is given to health issues in Nigerian newspapers. The Guardian and The Punch newspapers were chosen for the study. A total of 554 health reports were found and analyzed on the selected health issues. The single disease that garnered the most media attention was HIV/AIDS, and the most reported genre was straight news story. The newspapers didnot give prominence to health issues.

Smith & Smith (2016) studied the media coverage of the Ebola virus disease in four widely circulated Nigerian newspapers. The most common topic was Ebola cases in Nigeria (17.5%) followed by discrimination due to Ebola (10.8%) and least of all the use of salt and or Kola for the cure of Ebola (5.2%). In same vein, Ogbonna (2016) carried out an overview of the agenda-setting role of the Nigerian press on the Ebola virus disease outbreak in Nigeria with a focus on Punch newspaper. The findings of the study revealed that Ebola virus disease was given significant coverage and that the problem received prominence in terms of story type, but not in the aspect of page placement.
Ejima (2014) investigated the contribution of mass media in Nigeria to public health education in the country. The result of the study indicates that the physical dimension of health was given greater attention in the contributions by the Newspapers under review. More so, three of the newspapers, the Daily trust, Punch and Vanguard gave adequate coverage to issues on general health, nutrition, maternal and child health (MCH), and social/emotional/mental health.

From the above literature reviewed, it can be seen that scholars acknowledge the media, especiallythe role newspaper plays in educating and enlightening the public during diseases outbreak. However, it can be observe that despite the reoccurrence of monkey pox outbreak in Africa and other countries, there is a dearth of study that focus on content analysis of newspaper reportage about the menace. The objective of this study is to help fill this gap and unveil the coverage of monkey pox outbreak issues interms of stories, prominence, and level of coverage, placement pattern and space allocated to the disease outbreak in some selected newspaper in Nigeria.

Research objectives
The objective of this is to investigate the content analysis of monkey pox outbreak coverage in three selected newspapers in Nigeria. The specific objectives of the study are:
To find out the ratethe newspapers selected reports monkey pox issues during the study coverage;
To find out which story type/forms reporting has the highest frequency of coverage on monkey pox outbreak by the selected newspapers;
To find out the prominence of placement pattern given to monkey pox outbreak issues in the selected Nigerian Newspaper;
To find out the space allocated to monkey pox outbreak issues
Research question
How frequent did the selected newspapers report monkey pox issues?
Which story type/forms of reporting has the highest frequency of coverage on monkey pox outbreak by the selected newspapers?
Where were the prominences of placement pattern given to monkey pox outbreak issues in the selected newspaper?
What were the sizes of the space allocated to monkeypox outbreak issues in the selected newspapers?
Significance of the study
In Nigeria, there are pockets of diseases outbreak. However, the roles the media reporting this menaceseems not have been adequately covered and appreciated. This study intends to fill the gaps.The findings of this study would further provide an insight into monkey pox reportage in Nigerian newspaper. More so, it would add to the existing literature for academician, researchers and scholars on monkey pox reportage by the media hence may encourage new directions for research on the issue. Finally, the recommendations of the study would benefits the mass media (reporters) on the roles they can further play during diseases outbreak which can in turn help ameliorate future occurrence.

Results
Table 1. Showing total number of story per newspaper
Newspaper Frequency (Percent)
The Guardian 39(39.4%)
The Punch 31(31.3%)
The Vanguard 29(29.3%)
Total 99 (100%)
Table 1 shows the number of monkey pox issues as reported by the various newspapers under study during the period covered. The Guardian newspaper top the list with 39(39.4%), the Punch 31(31.3%), the Vanguard 29(29.3%).

Table 2. Story type/ forms of report
THE
GUARDIAN THE
PUNCH THE VANGUARD COMBINED TOTAL
Frequency Frequency Frequency Frequency
Straight News 27(69.2%) 18(58.1%) 18(62.1% ) 63(63.6%)
Features (News analysis) 1(2.6%) 4(12.9%) 3(10.3% ) 8(8.1%)
Editorial/ Comment – 2(6.5%) 1(3.4%) 3(3.0%)
Opinion Article/ letter to editors 1(2.6%) 2(6.5%) – 3(3.0%)
Picture/ Photo News 8(20.5% ) 3(9.7%) 7(24.1%) 18(18.2%)
Cartoon / Joke 1(2.6 ) 1(3.2%) – 2(2.0%)
Interviews 1(2.6%) 1(3.2%) – 2(2.0%)
Total 39 31 29 99
Table 2 shows the story type/forms reported by the various newspapers. The data indicates that that most predominant story type/forms reported on monkey pox in the selected newspapers was the straight news format, which was as high as 63 (63.6%), this was followed by 18(18.2%) picture/photo news, 8(8.1%) features, 3.(3.0%) and 3.(3.0%) editorial/comment and opinion article/letter to editors respectively, while carton / joke and interviews were the least with 2(2.0%) and 2(2.0%) respectively.

Table 3. Placement pattern
THE GUARDIAN THE PUNCH THE VANGUARD COMBINED TOTAL
Frequency Frequency Frequency Frequency
Front page 2(5.1%) 2(6.5% ) 4(13.7%) 8(8.1% )
Back page – – – –
Inside page 32(82.1%) 29(93.5%) 23(79.3%) 84(84.5)
Dedicated health page 5(12.8%) – 2(6.9%) 7(7.1% )
Total 39 31 29 99
Table 3 indicates the placement pattern of reports in the selected newspapers. 84 (84.5%) of the reports in the selected newspapers were majorly found inside the page, followed by 8(8.1%) on front page mostly as headlines, and the least 7(7.1%) on a dedicated health page.
Table 4. Showing space allocated to monkey pox issues
THE GUARDIAN THE PUNCH THE VANGUARD COMBINED TOTAL
Frequency Frequency Frequency Frequency
Full page 7(20.0% ) 1(3.2%) 2(6.9%) 10(10.1%)
Half page 2(5.7%) 5(16.1%) 2(6.9%) 9(9.1%)
Combined two page – 3(10.3%) 3(3.0%)
More than half page 2(5.7%) 4(12.9%) 7(24.1%) 13(13.1%)
Less than half page 28(68.6%) 21(67.7%) 15(51.7%) 64(64.6%)
Total 39 31 29 99
Table 4 above shows that majority 64 (64.6%) of the stories were given less than half page space, followed by 13(13.1%) more than half page, 10(10.1%) full page, 9(9.1%) half page, and 3(10.3%) combined two page only by Vanguard newspaper.

Discussion of findings
This study investigated content analysis of monkey pox outbreak coverage in three selected newspapers in Nigeria namely; the Guardian, the Punch and the Vanguard newspaper.Three newspapers understudy were searched each day for the 67 days of the coverage, totaling to 201 editions. The findings of the study indicated that the Guardian newspaper was the most frequently reported issues on monkey pox followed by the Punch and Vanguard respectively. The result also shows that straight news story was the most reported story type/ forms with 63(63.6%) on the diseases. This is consistent with the findings of Uwom & Oloyede (2014) in a similar study, who found out that the most reported genre, was straight news story. Overtime, the media has been seen as one of the dominant potential leading sources of information on health issues hence the public has so much depend on them on daily basis for news reports. In fact many relied on the newspaper media for health related information as a credible source.

The finding of the study revealed that placement pattern of reports in the selected newspapers are mostly found inside the page of the newspapers with the few been front page mostly as headlines.This result indicates that the newspapers seem not to attach importance of placing such diseases outbreak in the front page and back page of their newspapers. It must be noted that, placement of issues of diseases outbreak have the tendency of attracting readers attention as well as those who often glance or adjudged content of news from the front page.This corroborated the analysis of Egbo (2012) who reported that prominence was not given to sexual violence as well as not adequately placing available stories on the front pages of the newspapers studied. The importance ofnews reportage and coverage such as diseases outbreak in the front page newspapers cannot be over-emphasized. Zubiaga (2013) buttressed that “the front page is the most important page of a newspaper. It is what passers-by will have chance to look at, and so it represents the showcase that might determine whether or not they will end up buying the newspaper”. Therefore, one can conclude that any news item not tactically placed risks being overlooked by an average reader who would only glance through the front or/ back page.

On the spaces allotted, the result shows that most of thenewspapers under study gaveless than half page to monkey outbreak reportage.Spaces allotted to an issue by newspapers is often said to be determined by the importance placed on such information. Wei, Wei, Western, Skinner & Lyle (2015) asserted that “news media, through their noted ‘agenda-setting’ role, signal the importance of an issue to the wider readership by increasing the frequency and detail of coverage and ensuring the issue receives a prominent position in the essentially fixed amount of space of the newspaper”. Furthermore, Yan et.al (2016) suggested that in order to mitigate emerging infectious diseases, media reports coverage should be focused on how to guide people’s behavioral changes, which are critical for limiting the spread of disease and death.

Conclusion
This study examined content analysis of monkey pox outbreak coverage in three selected newspapers in Nigeria. The study discoveredthat the newspapers selected for the study reported straight news on the outbreak of monkey pox than other related issues, this denote that the newspapers did not give much attention and sufficient information to other story type as far the outbreak was concerned. It is also affirmed from the findings that most of the newspaper studied allotted less than half page spaces to monkey pox issues during the outbreak. The newspaper media play a crucial role in engaging and educating the masses on health issues, especially in addressing diseasesoutbreaks. The media can be used as the primary catalysis of change or as a means to provide current and effective information on method of infections, precautions, preparedness, vaccination, and educationon health issues.

Recommendations
Based on the findings of this study, the following recommendations are made:
The media management should endevaour to give prominence to health issues especially outbreak of kind of diseases such monkey pox so as to bring them to the knowledge of public and educate them.

Newspapers should strive to always place topical diseases outbreak on the front page and back page of their publication in order to catch the attention of readers and those who only glance through headlines of newspaper.

Nigerian newspapers should not limit health issues to straight news only but should engage on other forms of report such as editorial comments and interview during diseases outbreak.

The media should publish more features or news analysis and editorials and not just straight news.

Acknowledgement
The author wish to acknowledge the permission of the Research and Bibliographic (Ghandi section), University of Lagos Library, Lagos and Nigerian Institute of Medical Research, Lagos for allowing me to have access to the Guardian, Punch and Vanguard newspapers of year 2017 in their archives.

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