An evaluation of the knowledge, attitude and perception of Ekpan, a rural community in Edo State of Nigeria, towards onchocerciasis after 3 years of ivermectin distribution was undertaken. The structured questionnaire administered to the respondents focused on specific aspects of knowledge, attitude and perception related to the disease, its mode of transmission and control activities in the village. Results from the survey showed that 133 (68.6%) had fair knowledge of the disease. All subjects knew the bite of the blackflies was followed by itching but none knew that bites were accompanied by Onchocerca volvulus
transmission. Level of education influenced knowledge of the disease and the relationship was statistically significant (P<0.05). Knowledge of the clinical manifestation was however poor. Majority of the respondents (83.0%) perceived the disease to be due to other causes other than Onchocerca volvulus. Knowledge of the side effects of ivermectin treatment was good while knowledge of those excluded from treatment was generally fair. Their attitude to ivermectin distribution was strongly influenced by adverse reactions to the drug, leading either to outright rejection or discontinuation of the treatment after initial acceptance. The most prevalent reactions were swelling of leg/feet (22.2%), followed by itching (17.5%) and weakness (9.8%). The respondents perceived the different clinical manifestation of onchocerciasis to be specific disease entities. Onchocercal nodules were believed to be blood clots; leopard skin was thought to be healed scars of wounds and cuts accidentally acquired in the course of farming while hanging groin was regarded as hernia. In conclusion, ignorance of the cause of the disease negatively influenced their attitude and perception. Therefore, for maximum impact on morbidity and transmission to be achieved with ivermectin treatment, knowledge of the disease and control activities should be imparted to the residents. Such health education should of necessity take into consideration community attitude and culture, which promote health-seeking behaviour.
Key Words: Knowledge, attitudes, perception, onchocerciasis, ivermectin
Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 235-241