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 hematologic processes. In childhood, the most common forms are acute lymphoblastic leukemia and acute myeloid leukemia, both of which progress rapidly and require prompt medical intervention (Lim et al., 2023). These abnormal cells crowd out healthy red blood cells, platelets, and functional white cells, thereby impairing oxygen transport, clotting mechanisms, and immune response. Consequently, affected children may present with anemia, recurrent infections, bleeding tendencies, growth retardation, and general weakness that significantly compromise early childhood development (Abayomi et al., 2020). Given that children aged one to five years are in critical stages of physical and cognitive growth, understanding the nature and health implications of leukemia provides an essential conceptual basis for examining perceptions regarding its prevalence, risk factors, and prevention within community settings.
Globally, childhood leukemia remains one of the most common pediatric cancers, accounting for a substantial proportion of cancer diagnoses among children under five years (Iuliano et al., 2020). Survival rates in high income countries have improved markedly due to advances in early diagnosis, standardized treatment protocols, and supportive care. However, disparities persist between high income and low and middle income countries, where limited diagnostic facilities and treatment access contribute to poorer outcomes (Mhelembe et al., 2025; Usang et al., 2025). In Africa, the burden of childhood cancers is compounded by underreporting, delayed presentation, and restricted availability of pediatric oncology services (Olumide et al., 2025). These continental patterns underscore the importance of community awareness and accurate perception of disease occurrence and prevention as components of comprehensive cancer control.
Within Nigeria, hospital based cancer registries indicate that leukemia constitutes a significant fraction of childhood malignancies (Kayode et al., 2023). Access to pediatric oncology centers remains concentrated in major urban areas, while many communities experience limited specialized services and delayed referrals (Adepoju et al., 2023). Parental awareness of childhood cancers varies according to educational level, socioeconomic status, and exposure to health information through media or healthcare workers (Osibogun et al., 2021; Razaq-Shuaib, 2025). Immunization practices, environmental exposures, and general preventive child health education also shape how caregivers interpret illness and respond to early warning signs (Lawal et al., 2020). Consequently, perception of prevalence and risk influences decisions regarding timely healthcare utilization.
Cultural and social interpretations of childhood illness further shape community responses. In many Nigerian settings, persistent fever, pallor, or unexplained bruising may initially be attributed to common infections or spiritual causes rather than malignancy (Foláyan et al., 2022). Stigma associated with cancer and reliance on traditional remedies can influence health seeking pathways and perceptions of preventability (Afolabi et al., 2020). These sociocultural dynamics are particularly salient in densely populated communities where informal information networks guide health related beliefs (Momoh et al., 2022). Understanding perceived prevalence and causation within such contexts is essential for culturally sensitive health communication.
Previous empirical studies reveal varying levels of parental knowledge concerning leukemia risk factors, including genetic predisposition, exposure to environmental toxins, ionizing radiation, infections, and certain maternal factors during pregnancy (Nnawuihe et al., 2025; Adeleke et al., 2025). Some caregivers demonstrate awareness of the importance of early detection and preventive health services, while others express uncertainty regarding modifiable and non modifiable risk determinants (Olaniyan et al., 2021; Alagbe et al., 2025). Perceptions regarding prevalence may also be influenced by personal experiences and community narratives (Oyibo et al., 2021).
In Ikotu, Lagos State, assessing how caregivers perceive the prevalence, risk factors, and prevention of leukemia among children aged one to five years is particularly relevant given the community’s evolving urban dynamics and healthcare landscape. Context specific evidence can inform targeted awareness campaigns, strengthen early recognition of symptoms, and promote timely healthcare engagement (Omidiji et al., 2025). The motivation for this study arises from the need to generate localized empirical insights that support effective community based cancer prevention and control strategies aimed at protecting young children in Ikotu.
1.2 Statement Of The Problem

The problem of this study focuses on the limited understanding of the perceived prevalence, risk factors, and prevention of leukemia among children aged 1 to 5 years in Ikotu, Lagos State. Although global advances in pediatric oncology have improved detection and survival rates, leukemia continues to contribute significantly to childhood cancer mortality, especially in low resource settings where access to timely diagnosis and treatment is constrained (Mhelembe et al., 2025; Usang et al., 2025). In these contexts, community awareness and perceptions play a critical role in early healthcare seeking and preventive practices.
Parents and caregivers in Ikotu may hold varying and sometimes inaccurate perceptions regarding how common leukemia is among young children. There is often limited knowledge of recognized risk factors such as genetic predisposition, exposure to environmental toxins, maternal factors, and infections (Olumide et al., 2025; Adepoju et al., 2023). Misinterpretation of early warning signs, including persistent fever, unexplained bruising, pallor, weight loss, or frequent infections, can delay medical consultation, thereby reducing the likelihood of early detection and successful treatment outcomes (Oyibo et al., 2021; Foláyan et al., 2022).
Cultural beliefs, misconceptions, and restricted exposure to structured health education further contribute to inaccurate or incomplete understanding of childhood leukemia. In some cases, reliance on traditional remedies, fear of cancer diagnosis, and community stigma may shape caregivers’ perceptions of causation and preventive measures, affecting the timeliness of healthcare seeking behaviors (Afolabi et al., 2020; Momoh et al., 2022). The social interpretation of symptoms and preventive practices may therefore influence both recognition and response to early signs of leukemia among children in the community.
Empirical evidence specifically examining caregivers’ perceptions of leukemia in Ikotu is limited. Most studies on childhood leukemia in Nigeria focus on clinical epidemiology or hospital-based patient outcomes rather than community-based understanding of risk and prevention (Lim et al., 2023; Olaniyan et al., 2021). The absence of localized data constrains the design and implementation of targeted health education initiatives and community interventions aimed at improving awareness, promoting preventive practices, and ensuring timely medical attention for affected children.

Consequently, the central problem of this study is the insufficient context-specific evidence regarding caregivers’ perceptions of the prevalence, risk factors, and preventive strategies for childhood leukemia in Ikotu. This gap limits the capacity of public health practitioners and policymakers to develop effective community-based interventions and educational programs that enhance early recognition, encourage preventive behaviors, and ultimately improve pediatric health outcomes in the area (Nnawuihe et al., 2025; Omidiji et al., 2025; Adeleke et al., 2025).

1.3 Objectives of the Study
The main objective of this study is to examine the assessment of the perceived prevalence, risk factors and prevention of leukaemia among children age 1-5 years in Ikotu, Lagos State. Specifically, the study seeks to; 
1. To assess the perceived prevalence of leukaemia among children aged 1–5 years in Ikotu, Lagos State.

2. To identify the perceived risk factors associated with leukaemia among children aged 1–5 years in Ikotu, Lagos State.

3. To evaluate the level of awareness of early signs and symptoms of leukaemia among caregivers of children aged 1–5 years in the study area.

4. To assess knowledge of preventive measures against leukaemia among caregivers in Ikotu, Lagos State.
1.4 Research Questions
1. What is the perceived prevalence of leukaemia among children aged 1–5 years in Ikotu, Lagos State?

2. What are the perceived risk factors associated with leukaemia among children aged 1–5 years in Ikotu, Lagos State?

3. What is the level of awareness of early signs and symptoms of leukaemia among caregivers of children aged 1–5 years in the study area?

What is the knowledge of preventive measures against leukaemia among caregivers in Ikotu, Lagos State?
1.5 Significance of the Study
The findings of this study will benefit parents and caregivers of children aged 1 to 5 years in Ikotu, Lagos State, by providing them with evidence-based information regarding the prevalence, risk factors, and preventive measures associated with childhood leukemia. Increased awareness and understanding can improve early recognition of symptoms such as persistent fever, pallor, unexplained bruising, and frequent infections, encouraging timely healthcare-seeking behavior. This knowledge can also empower caregivers to adopt preventive practices and make informed decisions regarding their children’s health, reducing delays in diagnosis and improving treatment outcomes (Adepoju et al., 2023; Olumide et al., 2025).
Healthcare professionals and community health educators will also benefit from the study, as the findings will highlight areas where public knowledge is lacking and identify common misconceptions held by caregivers. This information can guide the design and implementation of targeted health education programs, awareness campaigns, and community interventions aimed at improving leukemia literacy, promoting early detection, and enhancing preventive care among young children (Foláyan et al., 2022; Oyibo et al., 2021).
Policymakers and public health authorities will find the study valuable for planning evidence-informed interventions and allocating resources for childhood cancer prevention. Localized data on caregivers’ perceptions of leukemia prevalence and risk factors will provide a foundation for developing community-specific health policies, integrating pediatric cancer education into primary healthcare services, and strengthening public health initiatives for early diagnosis and intervention (Afolabi et al., 2020; Lim et al., 2023).
1.6 Scope of the Study
The study is empirically designed to assess the perceived prevalence of leukaemia among children aged 1 to 5 years in Ikotu, Lagos State, and to identify caregivers’ perceptions of associated risk factors within the community. It further evaluates the level of awareness of early signs and symptoms such as persistent fever, pallor, unexplained bruising, and recurrent infections, as well as caregivers’ knowledge of preventive measures related to childhood leukaemia. The research relies on primary data obtained from parents and other caregivers responsible for children within the specified age bracket. The content scope is limited to perception of prevalence, risk factors, awareness of symptoms, and preventive knowledge, while the geographic scope is confined to Ikotu in Lagos State, thereby generating context specific findings relevant for local child health education and community based intervention strategies.

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