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Onchocerciasis Amongst Children Of An Endemic Community In Edo State, Nigeria

MS Aisien, EE Adeyemi, VA Wagbatsoma

 

Abstract

Onchocerciasis among 278 children (0-15yrs) of Ekpan village, a hyperendemic community in Uhunmwode Local Government Area of Edo State, Nigeria was investigated using the prevalence of nodules as index. The overall prevalence of palpable nodules was 26.3%. Nodule prevalence increased with age and the association was found to be statistically significant (P<0.001). More males than females presented with onchocercal nodules; and the difference was also found to be statistically significant (P<0.05). Majority of the nodules found were located on the head, followed by the abdomen. Of the 186 children eligible to take ivermectin, only 124 (66.7%) actually took the drug. The efficacy of ivermectin against onchocerciasis is demonstrated in the observation that those who took the drug presented with fewer nodules. Therefore, a timely introduction of eligible children (>5yrs) to the treatment programme is advocated.

Keywords: Onchocerciasis, children, Nigeria, nodules, prevalence, ivermectin

African Journal of Clinical and Experimental Microbiology Vol. 9 (2) 2008 pp. 97-102

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Knowledge, Attitude And Perceptions Of Onchocerciasis In A Hyper-Endemic Community Of Edo State, Nigeria

VA Wagbatsoma, MSO Aisien

 

Abstract

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

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ONCHOCERCIASIS – A PUBLIC HEALTH PERSPECTIVE

AO Oluwasola, DO Oluwasola, KO Osungbade

 

Abstract

Onchocerciasis is a chronic parasitic disease with a wide range of cutaneous and ocular manifestations. It is caused by the tissue nematode, Onchocerca volvulus, and it is transmitted by the bite of a female black fly, Simulium damnosum. Onchocerciasis is a serious public health and socio-economic problem with 95% of all cases being found in Africa south of the Sahara. The WHO Expert Committee has estimated that over 80 million people are at the risk of infection worldwide, some 18 million infected, and 1 million people visually impaired of which some 340,000 are blind. Nigeria is highly endemic for this disease, to the extent that 40% of all cases worldwide are believed to occur in the country. The prevalence of blindness in villages near to fast flowing rivers may reach 15%, often, affecting males (of working age, perhaps 30-40 years old) more frequently than females. In spite of these ravaging consequences of this disease however, remarkable successes have been achieved by the control effort of the Onchocerciasis Control Programme (OCP), which uses chemical and biological larvicides with low environmental impact to kill black fly larvae flies. Other methods of effecting Onchocerciasis control include: (i) Reducing the number of bites by the Simulium fly on man; (ii) Killing the microfilariae with microfilaricides; and (iii) Killing the adult worms. The social and economic consequences of the disease in Nigeria and other African countries are huge, with considerable human suffering. It thus demands unrelenting intensive and concerted effort at the international, national and community levels, making optimal use of the identified modes of control for effective control of this disease which has serious public health and economic consequences.

Key Words: Onchocerciasis, Public Health, Control

Afr. J. Clin. Exper. Microbiol. 2004; 5(2): 165 – 172.