Length-weight relationship of fishes from Anambra ... - Zoo-unn.org

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Community participation in the control of parasitic diseases61Effective Drug Distributionusing Community DirectedDistributorsNodulectomy using PrimaryHealth Care PersonnelEnlightenment Campaignsusing CDDs and PHCpersonnelWorld Health Organization, Federal Ministry ofHealth, Non-governmental DevelopmentOrganizationsVector control using WHO / APOCProvision of Pipe-borne water and / orborehole.Figure 1: Schematic Representation of Strategies for controlling onchocerciasis inUzo-Uwani Local Government Area.3. Enlightenment campaign: The people ofUzo-Uwani Local Government Area are largelyignorant of the basic facts concerning thecausative agent, vector and commonmanifestations of onchocerciasis. Thisignorance leads to misconceptions of both thecause and symptoms of the disease. One ofthe misconceptions with serious implications isthat oncho-rashes are caused by poor hygieneand are contagious. This belief leads to socialdiscrimination against people with rashes andculminates in the late marriages and limitedchoice of marriage partners of infected people,especially girls (Ubachukwu, 2001b).The enlightenment campaignrecommended here will make use of theCommunity Directed Distributors (CDDs)selected from each community for ivermectindistribution in collaboration with the staff ofprimary health care (PHC) units e.g. healthcentres and/or health posts in each community.In the existing set up, WHO trains the CDDs onthe guidelines for ivermectin treatment. Thesepeople go back to their communities todistribute drugs. It is recommended that thereshould be further enlightenment on theparasite, vector, manifestations and effects ofonchocerciasis to enable these communitydistributors to enlighten their own people.Some of the areas of enlightenment suggestedinclude the aetiology of the disease,onchocerciasis, including what causes it(Onchocerca volvulus), the vector (Simuliumdamnosum) and the symptoms (itching, rashes,palpable nodules, visual impairment, leopardskin, lizard skin, hanging groin, scrotalelephantiasis, body pains etc). Also to beincluded here is where and how they get theinfection (mostly near rivers and in farms andthrough Simulium bites), the socio - economiceffects of onchocerciasis, the fact that themanifestations, especially rashes, are notcontagious. From the little enlightenmentcarried out during the studies, it is obvious thatthe communities are willing to learn. Finally,they should be encouraged to try and preventthe bites particularly during the peak bitingperiods through covering themselves properlywhile working outdoors, using insect repellentsor changing their working habits, taking theirbreak and leave from the farms during the peakbiting periods especially the evening peaks(between 5.00 and 6.00 p.m.) which are usuallyhigher (Ubachukwu & Anya, 2001).Another area of the enlightenmentshould be on the effective use of the choicedrug, ivermectin. The rules guiding the use ofthe drug and the consequences of not followingthe guidelines should be stressed to the CDDsduring their training before drug distribution.The effect of not taking the drug by the entirecommunity should also be stressed, for examplethe danger of serious visual impairment andblindness with their long-lasting implications onboth the young and old. Again, the rural peoplehave no recorded medical history and this hasled to a few tragic cases that discouraged manyin the affected communities from taking thedrug. It is recommended that the medical
UBACHUKWU, Patience Obiageli62history of each individual be traced andrecorded before the administration of the drug.Proper monitoring is also required.4. Vector control: Boakye (1999)reported some of the successful results ofvector control by World Health Organization(WHO) in the Onchocerciasis ControlProgramme (OCP) areas of West Africa. To beable to eradicate onchocerciasis in Uzo-UwaniLocal Government Area, it is recommended thatvector control be undertaken in addition toeffective distribution of ivermectin drug,nodulectomy and enlightenment campaigns.These strategies, if well co-ordinated will yieldthe desired result in this area and eliminateonchocerciasis as a public health and socioeconomicproblem in Uzo-Uwani LocalGovernment Area as has been reported in theOCP areas (WHO, 1996).5. Use of repellents: There is need todiscover an effective repellent that can be usedby the people while working outdoors especiallyat the peak biting periods of the Simulium flies.6. Provision of social amenities: Itwas observed in the course of this study thatall the communities in Uzo-Uwani LocalGovernment Area lack pipe-borne water andtherefore depend on streams and rivers as theirmajor source of water supply. Provision ofpipe-borne water/ boreholes would help toreduce the man - fly contact arising from goingto the river/stream to fetch water for drinkingand laundry.REFERENCESAKOGU, O. B., APAKE, E., EJERE, V. C.,OGUNGBEMI, K. and TONG, M. (2003).Evaluation of the Sustainability of theEkiti State CDTI Project. WHO/APOC,46 pp.AMAZIGO, U., NOMA, M., BOATIN, B. A.,ETYA’ALE, D. E., SEKETELI, A. andDADZIE, K. Y., (1998). Delivery Systemsand Cost Recovery in MectizanTreatment for Onchocerciasis. Annalsof Tropical Medicine and Parasitology,92 Supplementary Number 1: S23 -S31.BENTON, B. (1998). Economic Impact ofOnchocerciasis Control through theAfrican Programme for OnchocerciasisControl: An overview. Annals ofTropical Medicine and Parasitology, 92Supplementary Number 1: S33 - S39.BOAKYE, D. A. (1999). Insecticide Resistance inthe Simulium damnosum s. l. vectors ofHuman Onchocerciasis: Distributional,Cytotaxonomic and Genetic Studies.Post Doctoral Thesis, University ofLeiden, Netherlands.CROSSKEY, R. W. (1981). A Review ofSimulium damnosum s. l. and HumanOnchoceriasis in Nigeria with SpecialReference to Geographical Distributionand development of a Nigerian NationalControl Campaign. Tropenmedizin undParasitologie, 32(1): 2 - 16.DADZIE, K. Y., REMME, J. and DE SOEL, G.(1990). Epidemiological impact ofvector control II: changes in ocularonchocerciasis. Acta Leidensia,59(1&2): 127 -139.DE SOEL, G. and REMME, J. (1991).Onchocerciasis infection in children bornduring 14 years of Simulium control inWest Africa. Transactions of the RoyalSociety for Tropical Medicine andHygiene, 85: 385 - 390.DUKE, B. O. L. (1972). Onchocerciasis. BritishMedical Bulletin, 28: 66 - 71.EDUNGBOLA, L. D. 1991. OnchocerciasisControl in Nigeria. Parasitology Today,7: 97 - 99ETYA’ALE, D. E. (1998). Mectizan as a Stimulusfor development of novel partnerships:the international organization’sperspective. Annals of TropicalMedicine and Parasitology, 92Supplementary Number 1: S73 - S77.GARMS, R., WALSH, J. F. and DAVIES, J. B.(1979). Studies on the re-invasion ofthe Onchocerciasis Control Programmein the Volta River Basin by Simuliumdamnosum s. l. with emphasis on thesouth western areas. Tropenmedizinund Parasitologie, 30: 345 - 362.HOPKINS, A. D. (1998). Mectizan deliverysystems and cost recovery in theCentral African Republic. Annals ofTropical Medicine and Parasitology, 92Supplementary Number 1: S97 - S100.NWOKE, B. E. B. (1992). Ivermectin(Mectizan): The incredible drug againstHuman Onchocerciasis (Riverblindness). Medicare Journal, 5(1): 28– 30.REMME, J., DE SOEL, G., DADZIE, K. Y., ALLEY,E. S., BAKER, R. H. A., HABBEMA, J. D.F., ELAISIER, A. P., VAN
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