Description

This study investigated onchocerciasis awareness and treatment strategies in rural southeast Nigeria. Social Cognitive Theory was used as theoretical framework. The study design is mixed methods research. Questionnaire and In-depth Interview was the study data collection instruments. For the qualitative data of the study, a total of 24 In-depth Interviews were conducted. Almost all the respondents have heard of onchocerciasis disease and more than half are aware that black fly is the vector that transmits the disease into human. Over one third of people in rural southeast Nigeria utilize traditional medicine/herbs to treat onchocerciasis disease. The study also found statistical significant positive correlation between onchocerciasis awareness level and use of ivermectin as the disease best treatment method. Finally the study clearly shows that as onchocerciasis awareness level continue to increase; many people tend to adopt ivermectin as the disease best treatment method in rural southeast Nigeria.

Spearman-Rho Correlation Test

Using Spearman rho correlation test, the study found statistical significant positive correlation between respondent onchocerciasis awareness level and use of ivermectin as the disease best treatment method. This means that as onchocerciasis awareness continue to rise, people tend to adopt ivermectin as the disease best treatment method in rural southeast Nigeria.

Nine FGDs and 16 SSIs were conducted. There was a notable shift in perceptions and attitudes, as most community members no longer believed that epilepsy is contagious, while acknowledging that this condition can be treated in local health centers. Persons with epilepsy and their family experienced less epilepsy-related stigma and consulted less frequently traditional healers; the latter showed a growing willingness to collaborate with health professionals in the management of PWE.

The distribution of onchocerciasis is connected to the location of black flies which are normally found near fast running streams and waterways in the inter-tropical zones. Hence, huge percentage of the disease happens in Africa. It developed into the SCT in 1986 and posits that learning occurs in a social context with a dynamic and reciprocal interaction of the person, environment, and behaviour. The unique feature of SCT is the emphasis on social influence and its emphasis on external and internal social reinforcement. SCT considers the unique way in which individuals acquire and maintain behaviour, while also considering the social environment in which individuals perform the behaviour. The theory takes into account a person's past experiences, which factor into whether behavioural action will occur. These past experiences influence reinforcements, expectations, and expectancies, all of which shape whether a person will engage in a specific behaviour and the reasons why a person engages in that behaviour. The goal of SCT is to explain how people regulate their behaviour through control and reinforcement to achieve goal directed behaviour that can be maintained over time. The first five constructs (Reciprocal Determinism, Behavioural Capability, Observational Learning, Reinforcements and Expectations) were developed as part of the SLT; the construct of self-efficacy was added when the theory evolved into SCT.

Theory of Onchocerciasis Disease

This theory describes a dynamic, ongoing process in which personal factors, environmental factors, and human behavior all interact. The theory asserts that individual onchocerciasis disease awareness level not only improve based on their own experiences, but by observing the actions of others and the benefits of those actions. Therefore the choice of onchocerciasis disease treatment method that will be adopted by an individual is a product of rational evaluation of past implications of the disease and preventive methods.

The in-depth interviews were personally conducted by the researcher with the help of a research assistant who took notes. Interviewees’ responses were recorded with notebooks and audio tape recorders. The quantitative data was processed using the Statistical Package for Social Sciences (SPSS) and analyzed using descriptive and inferential statistics. For the qualitative data, QDA Miner software was used in the analysis of the interview transcripts. Analysis started by transcribing the IDI data verbatim. Deductive themes and sub-themes were used as categories and sub-categories.

To enquire if the respondents are aware how one can contract onchocerciasis disease, the respondents were asked to identify ways people contract the disease. Majority (50.8%) of the respondents revealed that it is through black fly bites, 16.6% said it is through contact with infected person, 21.3% said it is as a result of punishment from the gods, 5.2% said it is caused by poor dietary habits, 1.1% of the respondents said the cause is not known, while 5.1% said they don’t know. The respondents were further asked to rate awareness level of onchocerciasis in their community. To this end, almost half of the respondents 418 rated high onchocerciasis awareness in their community while only 8 respondents said it is low. This implies that many of the people are aware of onchocerciasis in their community.

Therefore, it can be concluded that those aged 18-45 years are more likely to use ivermectin and benocide to treat onchocerciasis disease than those aged between 46 years and above. This could be explained from the point of view that younger people are more susceptible to new ways of doing things due to education, globalization and technologies (phone, computer) that make information easily available and in the long run influence behavior. Though majority of the respondents favor the use of ivermectin as onchocerciasis disease best treatment method, it is observed that over one third of the people believe that traditional medicine/herbs are the disease best treatment methods.