Onchocerciasis among Women in a Rural Guinea Savannah Ecotype of Nigeria: Social Implications for Control.

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Objectives: The objective of the current study was investigations on the social factors affecting the control of onchocerciasis among women in an endemic savannah community.
Methods: A randomized sampling of households with women above 18 years of age was conducted in a mesoendemic rural community in the Guinea savannah woodland of northern Nigeria. Two hundred and eighty women were selected randomly from fifty households. Structured questionnaires were administered to the women to solicit their socio-demographic indices. Interviews were conducted as a second exploratory approach.
Results: The investigation helped these women to change their erroneous beliefs about onchocerciasis. They now perceive the disease as a grave social problem demanding urgent attention. Thirty women (14.4%) were infected with onchocercal symptoms ranging from onchodermatitis, nodules and blindness. There was an increasing prevalence of onchocerciasis with advancing age I.e women 51 years of age and above were mainly affected 17 (51%). Health care utilization was low; only one person (3.33%) had ever sought medical help. Farming was the main occupational risk. There was little knowledge regarding onchocerciasis, 60% of the women did not know the cause and most of the others cited act of God 7 (23.3%) and a sign of aging 5 (16.6%). There was however impressive knowledge of black flies and their habits. All the women were illiterate Muslims. Most of the affected women were involved in the polygamous relationship (43.3%). Health education led all of them to believe they needed treatment. Fear of neglect by husbands was the main reason for their desire for seeking treatment.
Conclusion: Targeted health education, making use of visual aids should be directed at illiterate women in endemic areas of onchocerciasis. The social implication of neglect by husbands was observed as a predisposing factor that can enable future compliance to ivermectin treatment of onchocerciasis.