Sociodemographic characteristics of the study population
The study population (n = 512) was predominately males with respectively 63% males and 37% females. Fifty-five percent of the participants were male, heads of households, 32.0% were spouses and the remaining 13.0% were daughters/sons, nieces/nephews, brothers/sisters, and other relatives of the head of the households.
The participants (n = 512) were 12 to 89 years old with average age of 43 ± 16 years. Their duration of stay in their respective communities varied from < 1 year to 89 years with an average year of living in the village of 35 ± 19 years. About 89% of the participants were living in their communities more than 10 years, and 82.5% of them did not travel out of their respective communities.
Regarding the education level of the participants (n = 509) no answer was obtained from four of them and 12.4% did not attend any form of schooling. Adult schooling was attended by 2.4%, primary school by 36.1%, secondary by 38.7% and university by 9.6% (Table 2).
Table 2
Sociodemographic Characteristics of the study population (n = 512)
Variable | Number | Percent | | Variable | Number | Percent |
Gender (n = 512) | | Schooling (n = 510) | | |
Male | 321 | 62.7 | | Yes | 434 | 85.1 |
Female | 191 | 37.3 | | No | 65 | 12.7 |
Marital status (n = 504) | | | | No answer | 11 | 2.2 |
Married | 424 | 84.1 | | Education Level (n = 509) | | |
Single | 73 | 14.5 | | Secondary School | 197 | 38.7 |
Widow | 4 | 0.8 | | Primary School | 184 | 36.1 |
Divorced | 3 | 0.6 | | None | 63 | 12.4 |
Age (n = 509) | | | | University | 49 | 9.6 |
Mean (SD) | 42.8 | 15.7 | | Adult Schooling | 12 | 2.4 |
Min – Max | 12 | 89 | | No Answer | 4 | 0.8 |
Residence in the village (n = 505) | | | | Main source of income (n = 500) | | |
Mean (SD) | 35.3 | 19.4 | | No Income | 140 | 28.0 |
Less than 10 years | 58 | 11.5 | | Daily/Irregular Income | 139 | 27.8 |
10 years and above | 447 | 88.5 | | Farming | 125 | 25.0 |
Travel out of the community (n = 498) | | | | Commerce/Self-employed | 62 | 12.4 |
Yes | 85 | 17.1 | | Regular Salary | 34 | 6.8 |
No | 411 | 82.5 | | Knowledge of Onchocerciasis local name (n = 493) | | |
No answer | 2 | 0.4 | | Yes | 470 | 95.3 |
Onchocerciasis Local name (n = 476) | | | | No | 18 | 3.7 |
Filaria | 441 | 92.7 | | No Answer | 5 | 1.0 |
Kuntaib | 28 | 6.0 | | Identifying the Vector (n = 430) | | |
Night blindness | 3 | 0.6 | | Black fly | 333 | 77.4 |
River Blindness | 2 | 0.4 | | Mosquito | 52 | 12.1 |
Ama Aljoor | 1 | 0.2 | | Fly | 20 | 4.7 |
Kurtaib | 1 | 0.2 | | Other | 25 | 5.8 |
Knowledge of the drug distributed (n = 512) | | | | Onchocerciasis Vector Local name (n = 360) | | |
Yes | 369 | 72.1 | | Kuntaib | 281 | 78.0 |
No | 143 | 27.9 | | Kurtaib | 76 | 21.1 |
Ivermectin distribution ongoing (n = 486) | | | | Filaria | 2 | 0.6 |
Yes | 13 | 2.7 | | Small insect | 1 | 0.3 |
No | 473 | 97.3 | | | | |
| | | | | | |
Unemployment was reported by 0.6% of the participants and 25.9% of the study participants were housewives. The main occupations in Abu-Hamed were laborer (25.3%), farmers (24.7%), and trading/commerce (12.1%). Teachers, drivers and students represented respectively 2.9%, 2.5% and 2.3% respectively. The remaining 4.3% include health professionals (1.9%), security personnel (0.8%), self-employed (0.8%) and a fisher (0.2%).
Regarding the main source of income, out of the 500 respondents, 28.0% did not have income. They were either housewives, students or unemployed. Daily or irregular income was recorded for 27.8%. They were mainly labors. Farming was the main source of revenue for 25.0%, commerce/trade or self-employment represent 12.4%. Regular monthly salary was the main source of income for 6.8%; they were either teachers, health professionals, or security forces.
Health issues and social impact related to onchocerciasis
The participants raised a common compliant in the additional notes section of the questionnaire about the vector biting and nuisance particularly during the winter season when they usually harvesting their farms and crops (Wheat, Okra, and the Egyptian beans) the main source of income in Abu Hamed area.
Most (97.0%, 495/510) of the study population had heard about onchocerciasis, and only 2.8% participants did not hear about the disease. Onchocerciasis is known in Abu-Hamed by several local names which were provided by 95% of the participants (n = 493). Onchocerciasis or river blindness is locally named as Ama Aljoor, Night blindness, Kurtaib, Filaria, and Kuntaib. The vector transmitting Onchocerciasis (the Simulium hamedense) was identified as black fly by 77.4% of the participants. Surprisingly, the local name of the vector is the same of the disease but not reported in the same proportion (Table 2).
Only 61 participants identified the name of the drug used as Mectizan or Ivermectin®. However, 369 participants reported to know the drug and they described it well in terms of presentation and dose administrated by community-distributors. Also, 97.3% of the participants (n = 486) reported that ivermectin mass distribution was halted (by the end of project) in their respective communities. The remaining 2.7% who reported continuation of ivermectin distribution had not provided any reason justifying the continuation of the distribution.
Regarding the impact of Onchocerciasis elimination in Abu-Hamed, 90% of the study population (n = 512) did not have any complain after the elimination apart from the vector biting and nuisance; persisting itching was reported by 7.2%. Other complains were less than 3.5% and were mainly about the need for developmental project to increase the employability of the locals (Table 3).
Table 3
Health issues and social impact parameters
Variable | Frequency | Percent | Variable | Frequency | Percent |
Complain since distribution of the drug was halted (n = 512) | Knowledge of people currently complaining about Onchocerciasis symptoms (n = 506) |
No complain | 461 | 90.0 | No | 453 | 89.5 |
Itching | 37 | 7.2 | Yes | 53 | 10.5 |
Irritation | 13 | 2.5 | Change in the work performance of participants (n = 377) |
Other | 1 | 0.3 | Stable | 228 | 60.5 |
Receiving guests in the twelve past months (n = 373) | Increased | 113 | 30.0 |
More often | 167 | 44.8 | Poor | 36 | 9.5 |
Less often | 128 | 34.3 | Change in the revenue of participants (n = 371) |
Regularly | 78 | 20.9 | Stable | 226 | 60.9 |
Opinion regarding halt of ivermectin distribution (n = 482) | Decrease | 73 | 19.7 |
Distribution to continue because of health benefits | 377 | 78.2 | Increase | 72 | 19.4 |
Programme reached objectives and as halted | 96 | 19.9 | Receiving guests in the twelve past months (n = 373) |
Distribution to continue because of Programme failed | 9 | 1.9 | More often | 167 | 44.8 |
Change in school attendance (n = 19) | Less often | 128 | 34.3 |
Increase | 10 | 52.6 | Regularly | 78 | 20.9 |
Decrease | 7 | 36.8 | Social events in the last twelve months (n = 162) |
Stable | 2 | 10.6 | Birth | 93 | 57.4 |
Change in school performance (n = 20) | | Marriage | 59 | 36.4 |
Good or better | 12 | 60.0 | Divorce | 9 | 5.6 |
Fair or worse | 8 | 40.0 | Separate | 1 | 0.6 |
Changes in the performance of children attending school had not been noticed by 91.9% of the study population (n = 307), only 19 people (6.2%) noted changes and 1.9% did not know (Table 3). For those who noted changes, school attendance (n = 19) increased for 52.6%, for 10.6% the attendance was stable and it decreased for 36.8%. The participants (n = 20) rate school performance as excellent (30%) or good (30%); it was fair and poor respectively for 25.0% and 15.0%.
In the last past twelve months, the work performance of the participants (n = 377) remained stable for 60.5%, it increased for 30% and was poor for 9.5%. On the other hand, the revenue of the participants (n = 371) remained stable for 60.9%; and increased for 19.4%. The remaining 19.7% reported a decrease of their revenue.
Socialization was measured as the frequency of receiving guests and/or getting involved in social events in the last twelve months. Also, 44.8% of the participants (n = 373) received guest sometimes, 34.3% less often and 20.9% regularly. In the past twelve months, the social events the most frequent reported by participants (n = 162) was birth (57.4%), followed up by marriage (36.4%). Divorce and separation were reported respectively 5.6% and 0.6%.
Participants were requested to share their opinion regarding stopping ivermectin mass distribution (n = 482). Additionally, 78.2% thought the distribution should continue because of the health benefits of the drug such as deworming and preventing other skin infections. Only 21.8% was in favor of stopping ivermectin distribution. Out of 105 participants, 91.4% justified the halt of the distribution because of the program objectives were achieved, and failure of the program may justify the decision for the 8.6%.
The 89.5% of participants (n = 506) reported that currently at their knowledge no one complains about Onchocerciasis and the remaining 10.5% know people complaining currently about the disease (persistent itching).
In the overall, the social impact of Onchocerciasis elimination in the ten communities surveyed can be estimated with a general public satisfaction reported from most of the study participants (90%).