Assessment of Knowledge, Attitudes and Practices of Indigenous Population about Onchocerciasis in Endemic Communities of Kogi West, Kogi State, Nigeria

Onchocerciasis is a parasitic disease caused by the filarial worm, Onchocerca volvulus. Despite more than twenty years of ivermectin mass administration in Kogi State for the control of Onchocerciasis, existence of pathological indices such as ocular and skin burden in endemic foci of Kogi West are observed.This study therefore assessed the community’s Knowledge, Attitudes and Practices (KAP) about onchocerciasis in selected communities of Kabba, Ijumu, Mopa-muro and Yagba-east Local Government Area of Kogi. A crosssectional questionnaire survey which involved 1399 respondents were carried out to assess the Knowledge, attitudes and practices of the people. Data obtained were presented in frequency tables, percentages and binary logistic regression carried out using SPSS version 21. The demographic data revealed more males 62.0% (n = 868) than females 36.7% (n = 513), age group (35–44year) accounted for 34.5% (n = 482),farming constituted the dominant occupation at 53.3% (n = 745), 46.0%, (n = 644) of the respondents had achieved secondary school education while 38.9%, (n = 544) had no formal education, 22.9%, (n = 320)had lived in their respective communities for 20–30 years, followed closely by shorter-term residents with 0–10 years of residency (20.8%, n = 291).The survey revealed poor knowledge, cultural practices, attitudes of respondents onaetiology, disease transmission dynamics, adherence to preventive measures and ivermectin compliance.Majority of respondents, 76.1% (n = 1064) reported to have never heard of Onchocerciasis, 76.5%, (n = 1070) possessed no knowledge regarding the causative agent, 20.6% (n = 288) correctly recognized a parasite as the causative agent, 1.6% (n = 22) and 1.2% (n = 17) attributed the disease to viral and bacterial origins respectively. 69.7% (n = 975) of respondents are unaware how transmission occurs, only 21.8% (n = 305) accurately identified the bites of blackflies (Simulium spp.) as the vector pathway. Assessments of the clinical manifestations of onchocerciasis revealed76.5% (n = 1070)are unaware of its symptoms. Perceptions regarding the preventability of onchocerciasis varied widely; 55.4%, (n = 775) were unsure whether the disease could be prevented, 23.4% (n = 328) reported no knowledge of prevention, 17.1% (n = 239) affirmed that the disease is preventable.62.7% (n = 877)viewed the disease as a “very serious” condition, 69.6% (n = 974) of respondents believed that they and their family members were not at risk of contracting the disease, 83.1%, (n = 1163) expressed explicit willingness to participate in mass treatment programs, social stigmatization emerged as a near-universal concern within the surveyed communities;92.4% (n = 1293) reported individuals suffering from onchocerciasis face social stigma.66.9% (n = 936) of respondents stated that superstitious beliefs were viewed as the primary cause of onchocerciasis within their respective communities.More than half of the participants, 57.3% (n = 801), reported that they had never taken the medication. Conversely, 32.5% (n = 455) affirmed a history of drug utilization, 50.0% (n = 700), expressed explicit trust in the community drug distributors, 11.2% (n = 157) reported a distinct lack of trust, and 30.7% (n = 429) remained undecided on the matter. 38.7% (n = 542) of respondents affirmed that traditional beliefs actively competed with the acceptance of modern orthodox medicine. The limited understanding on the aetiology, transmission and prevention of Onchocerciasis among residents, poor practices of stigmatization, communal superstitious beliefs, traditional medicine preference and household poor ivermectin compliance might be responsible for the persistence of the disease in these communities and might therefore leads to raising risk of disease transmission. Strategic public health education that takes into consideration local language input, community attitudes and culture of the indigenous people becomes mandatory in order to eliminate this disease in these high risk communities.