Lymphatic Filariasis in Southwestern Nigerian Rural Communities: A Cross-sectional Survey of the Knowledge, Awareness, and Predisposing Factors

Sociodemographic characteristics as predictors of knowledge regarding mode of transmission of Lymphatic Filariasis among population of Nepal

INTRODUCTION

The majority of the districts of Nepal (63 out of 77) were detected as prevalent of Lymphatic Filariasis (LF), with an average prevalence of 13 percent ranging from less than one to 39 percent in Nepal. Despite people's ignorance about the LF, the government has a target to eliminate LF by 2020. The study aimed to assess the association between sociodemographic characteristics and knowledge of the mode of transmission of LF.

MATERIALS AND METHODS

The study used a cross-sectional design. Secondary data from Nepal Demographic and Health Survey 2016 were analysed. Altogether, 11040 participants participated in the study. Sociodemographic characteristics were the independent variables, whereas household heads' knowledge of LF transmission was the dependent variable. Descriptive, bivariate, and multivariate analyses were performed to assess the association between sociodemographic characteristics and knowledge of the mode of transmission.

RESULTS

Findings showed that only 28 percent of household-heads correctly identified the mode of transmission of Lymphatic Filariasis in the study. Household head's age, sex, wealth status, place of residence in terms of areas, geo-belt and province, migration history, and household assets such as bed nets, Radio, TV were significantly associated with the knowledge of the mode of transmission of Lymphatic Filariasis. Variables: wealth status, sex, residence, eco-belts, possessing bed nets, and Radio appeared as significant predictors for knowledge of the mode of transmission of Lymphatic Filariasis. The richest to the poorest people had lower odds ranging from 0.22 to 0.53 for knowing the mode of transmission of Lymphatic Filariasis compared to the richest people (p = 0.001).

CONCLUSION

The study identified the population groups with a low level of knowledge of modes of transmission of Lymphatic Filariasis. Thus, it can be inferred from the study that relevant programs need to focus on women, people residing in the mountains and Terai, and those belonging to the middle and poor wealth index. The study also emphasizes that information, education, and communication materials can effectively impart knowledge of Lymphatic Filariasis.

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

BACKGROUND

There is a dearth of experience in and evidence for cost-effective integrated community-based management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria.

METHODS/PRINCIPAL FINDINGS

This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria. The survey was completed by 353 community members (61.8% female) and 15 health care workers (100.0% female). A total of 52 individuals participated in six FGDs. Of the community members, 236 (66.9%) had heard or seen a case of leprosy; 324 (91.8%) and 131 (37.5%) had heard or seen a case of Buruli ulcer and lymphatic filariasis, respectively. Again, 213 (60.3%) of the respondents reported that the diseases were caused by witchcraft or curse. As regards prevention, 241 (68.3%) suggested avoiding handshake with affected persons. Up to 223 (63.2%) of respondents strongly agreed to the seriousness of skin NTDs in their community. Meanwhile, 272 (77.1%) of the respondents believed that the transmission of these skin NTDs can be prevented. Furthermore, 324 (91.7%) desired active community engagement for control of skin NTDs. Regarding community care seeking practices, 197 (55.8%) would first visit the health centre/hospital, followed by 91 (25.8%) traditional healer/herbalist and 35 (9.9%) pharmacy/patent medicine vendor if they develop a skin NTD. Overall, 332 (94.1%) of respondents expressed interest in being taught self-care practices for skin NTDs. Out of 15 healthcare workers, 13 (86.7%) were able to correctly diagnose two of these skin NTDs and 10 (66.7%) would encourage patients to practice self-care. Prominent themes in the FGDs were belief in witchcraft and herbal remedies; as well as the occurrence of physical, social and economic distress.

CONCLUSIONS

Our study helped quantify the information gaps that need to be addressed in order to create demand for integrated skin NTDs services in an endemic setting in Nigeria. Individual, structural and socioeconomic challenges to access and delivery of services were identified. Community and health care workers' empowerment and engagement through outreach and regular training, respectively may alleviate these challenges.