PREVALENCE, CLINICAL EPIDEMIOLOGY AND ASSESSMENT OF THE KNOWLEDGE, PERCEPTION AND PRACTICES OF LYMPHATIC FILARIASIS AMONGST SELECTED COMMUNITIES IN KOTANGORA, NIGER STATE

ABSTRACT

Lymphatic   filariasis   caused   by   mosquito   borne   filarial   nematode,   Wuchereria brancrofti, is a debilitating Neglected Tropical Disease of major public health importance. This study was carried out to determine the status of Filariasis among five (5) selected communities include Rugan gandu/Tudun Fulani, Sabon garin mangu/ matachibu, Sabon garin Madara, Tashan badukke and Dogon fili in Kotongora Local Government Area, Niger State. In this study, standard parasitological techniques, rapid assessment method and structured questionnaire were employed. The result of this study showed that out of the 1015 blood samples collected and examined for the presence of filariasis using Filariasis Test Strip (FTS), 111(10.94 %) were positive. The prevalence of infection varies among the communities with Rugan gandu/Tudun Fulani having the highest infection rate (17.37 %) followed by Sabon garin mangu/ matachibu (14.51 %) while Tashan Baduke had the least infection rate of (4.52 %). In relation to age group 56-65 years had the highest rate of infection (22.5 %) followed by the age group 66-75 years (21.43 %) while the age group 46-55 years had the least infection rate (7.44 %). Among the respondents infected with the disease, 17(60.71 %) believed that stepping on charm is the cause of the disease, while 104(37.68 %) of the unaffected respondents believed that fever is the cause. Majority of the infected respondents, 24(85.71 %), believed that avoiding mosquito bites is the most accurate preventive measure. The disease is therefore, endemic in Kotongora Local Government Area, Niger State with high chances of prevalence, intensity and clinical symptoms increasing overtime. There is therefore, urgent need to implement control measures with the aim of halting the transmission of this disease.

CHAPTER ONE

1.0       INTRODUCTION

1.1       Background to the Study

Lymphatic filariasis, commonly known as elephantiasis which is a disease caused by microscopic, thread-like nematode worms of the family Filariodea.  It is a parasitic neglected tropical disease (NTD) targeted for global elimination by the year 2020 as part of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) World Health Organization (WHO, 2017). Infection occur when filarid parasite are transmitted to human as definitive host through infected mosquitoes bite in tropical and sub-tropical region of the world,center for disease control and prevention (CDC, 2013). Infection acquired in children usually cause hidden damage to the lymphatic system.

There are three different filarial species that can cause lymphatic filariasis in humans. Most of the infections worldwide are caused by Wuchereria bancrofti. In Asia, the disease can also be caused by Brugia malayi and Brugia timori (CDC, 2019). The parasitic filarid nematode worm Wuchereria bancrofti is one of the species of organism that cause such disease called lymphatic filariasis in Africa with high risk endemic in Nigeria  (WHO,  2010).  Anopheles  and  Culex  mosquitoes  are  the  main  vector  that transmit Wuchereria bancrofti causing the disease in Africa (WHO, 2010; WHO, 2014).

One-sixth of the world’s populations, mostly in developing countries are infected with one or more of this Neglected Tropical Disease (Amal and Anthony, 2017). Currently 856 million people in 52 countries are living in areas that require preventive chemotherapy to stop the spread of the infection. The global baseline  estimates of people affected by lymphantic filariasis were 25million men with hydrocele and over 15 million people with lymphoedema. At least 36 million people remain with the chronic disease manifestation (WHO, 2018).

The painful and disfiguring visible manifestation of the disease, lymphoedema, elephantiasis and scrotal swelling occur later in life and can lead to permanent disability as such infected people are not only physically disable but suffer mental, social and financial lost contributing to stigma and poverty (WHO, 2018).

Lymphatic filariasis is the second leading cause of permanent and long-term disability in the world, inflicting serious public health and socio-economic problem in endemic communities and the disease is usually seen among the poorest of the poor, in the priorities of most of the countries where it is prevalent for many years having a very low public health rating. People living for a long time in tropical or sub-tropical areas where the disease is common are at the greatest risk for infection and about 30 % of people at risk reside in the African region while 65 % of those at risk reside in South- East  Asia  Region,  with  the  remainder  in  other  parts  of  the  world  (WHO,  2010, Terranella et al., 2006, Nilmini et al., 2018).

The visible manifestations of the disease are severe and disfiguring, it has been reported that one third of infected individuals present with overt clinical manifestations such as lymphoedema and elephantiasis of the limbs, or genitals, hydrocoele, chyluria, or recurrent   infections   associated   with   damaged   lymphatic   vessel   lives   in   Africa (Sherchand et al., 2003). According to Person et al., (2006) acute attacks of adenolymphangitis (ADL) are characterized by fever, chills, local warmth and inflammation of the inguinal node. Patients are usually weak for 4-7 days while the attack lasts and the swelling later becomes permanent in the form of lymphoedema of lower extremities and at times there is dysfunction of the genital lymphatic that leads to hydrocoeles (WHO, 2010).

The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in the year 2000 with the aim of interrupting transmission, reducing morbidity and preventing disability. Interruption of transmission is possible through mass drug administration (MDA),  using once-yearly treatment  with  a single dose of  albendazole plus  either ivermectin or diethylcarbamazine (DEC) for 4-6 years (WHO, 2010). Such programs are  under  way  in  more  than  66  countries  in  reducing  transmission  of  the  filarial parasites and decreasing the risk of infection for people living in or visiting these communities (CDC, 2019).

Nigeria has the heaviest burden of lymphatic filariasis (LF) in sub-Saharan Africa, which is caused by the parasite Wuchereria bancrofti and transmitted by Anopheles mosquitoes which is believed to be the third most endemic country in the world after India and Indonesia with the prevalent of Lymphatic filariasis (Eigege et al., 2003; Tara et al., 2018). Studies in Nigeria have reported prevalence rates ranging from 6% – 47 % (Eigege et al., 2002; Anosike et al., 2005; Nwoke et al., 2006; Omudu and Okafor 2007; Udoidung et al., 2008,). About 106 million people in Nigeria are at risk of the disease (Federal Ministry of Health (FMoH), 2013).

Elkana et al. (2017) posits that various clinical manifestations of lymphatic filariasis range  from:  itching,  elephantiasis,  hydrocoele,  and  lymphoedema  of  breast  are  at varying rates. Lymphatic filariasis (LF) has a major social and economic impact with an estimated annual loss of $1 billion and impairing economic activity up to 88 %. Hydrocoele, lymphoedema and elephantiasis are the overt, chronic disabling consequences observed in patients with these damaging parasitic infections of the lymphatic vessels (WHO, 2016).

Though according to Yisa K, Saka, director of Neglected Tropical Disease programmed with Nigeria Federal Ministry of Health together with Carter center (2017), reported that, lymphatic filariasis as a public health problem in Plateau and Nasarawa states of Nigeria has been eliminated completely with a significant achievement and the states are placed under surveillance. Success in these two states not only protects the 7 million people who live there, but it also sets a pattern for similar success throughout the rest of Nigeria, as well as in other highly endemic countries (Carter center (2017).

The main vectors of lymphatic filariasis in Nigeria are mosquitoes of the An. gambiae (principally An. gambiae s.s. and An. arabiensis) and Anopheles funestus complexes (Lenhart et al., 2007; Sinka et al., 2010). Lymphatic filariasis is prevalent in all states and geopolitical zones of Nigeria before the success of the two states and a total of 241 lymphoedema and 205 hydrocele cases have been reported from mapping surveys conducted  in  the  country  (Okorie  et  al.,  2011).  Programs  to  eliminate  lymphatic filariasis are under way in more than 66 countries. These programs are at eradicating transmission of the filarial parasites and reducing the risk of infection amongst people living in or visiting these communities, targeted for elimination and the national programme  is  scaling  up  mass  drug  administration  (MDA)  across  the  country  to interrupt transmission, (Brant et al., 2018; CDC, 2018).

1.2       Statement of Research Problem

Lymphatic filariasis as one of the Neglected Tropical Disease cause a serious burden with various clinical manifestations such as itching, elephantiasis, hydrocoele, and lymphoedema of breast at varying rates, it also has a major social and economic impact with an estimated annual loss of $1 billion and impairing economic activity up to 88 % (WHO, 2019). Most of the clinical sign and symptoms such as swollen legs, scrotal itching and thickening of the skin seen in the other part of the region in the country were observed in the communities of Kontagora L.G.A and has become a serious burden of pains  and  disfiguring visible  manifestation  of the disease  resulting to  a permanent disability not only physical disable but also suffer mental, social and financial loss contributing to stigma and poverty.

The National Lymphatic Filariasis Elimination Programme (NLFEP) has set 2015 to eliminate  such  disease  in  the  country  and  success  of  this  programme  depends  on identifying as well treating endemic communities. Unfortunately, information on the distribution and nature of the disease from many parts of the country is lacking (Dogara et al., 2012, WHO, 2019). Upon the concerted control efforts by the government and international bodies yet, lymphatic filariasis is still a disease of public health concern in Nigeria resulting too many factors such as prevention of marriage, personal discomfort, special infidelity, spouse dissertation and also affect work and income; at times there is dysfunction of the genital lymphatic that leads to hydrocoele among the people of the Most of the community problem in strategies the elimination of the disease is the range of people’s knowledge, practice and perceptions towards the disease in the community, One of the rapid assessment procedures in assessing the burden and the effectiveness of a Lymphatic Filariasis elimination program is the Focus group discussion of knowledge, attitude and practices of a community;

1.3       Justification for the Study

Lymphatic filariasis is caused by infection with filarial worm that are transmitted by mosquito’s bites. There has been wide estimate globally of millions of people infected which such disease and a lot also has been disfigured and disabled by complication caused by LF such as swelling of the lower extremities such as the leg (elephantiasis) or scrotum (hydrocoele). Nigeria has the heaviest burden of lymphatic filariasis (LF) in sub-Saharan Africa, caused by the parasite Wuchereria bancrofti and transmitted by Anopheles mosquitoes which is believed to be the third most endemic country in the world after India and Indonesia with the prevalent of Lymphatic filariasis (Tara et al., 2018).The global programme to eliminate lymphatic filariasis (GPELF) was lunch in response to the call proposed at the 50th world Health assembly aimed at interrupting the disease  transmission  through  Mass  Drug  Administration  and  to  control  illness  and suffering in affected persons by 2020. The goal of the (GPELF) is to ensure that the counties where the disease is endemic would have been transmission free or would have entered post-intervention mass drugs administration (MDA) surveillance by 2020. Nigeria as a country with highest estimate of the disease in Africa caused by lymphatic filariasis is yet to be on the tracks to discontinue MDA as planned. This issue remains regarding the achievement of the stated goal and how to effectively monitor the disease in the post-control and post elimination phase. In accordance with the vision 2020, the knowledge, practice and perception of the individual in a giving community towards the disease caused by lymphatic filariasis is needed to be taken into consideration so as to reduce the spread, burden or probably eliminate the disease as stated by World Health Organization vision 2020 (WHO, 2019).

1.4       Aim of the study

The aim of this study is to assess the clinical epidemiology of lymphatic filariasis knowledge, practices and the perceptions amongst five selected communities of Kontagora Local Government Area, Niger state.

1.5       Objectives of the study

The objectives of the study are:

i.       prevalence of lymphatic filariasis amongst people of Kontagora communities.

ii.      The  morbidity  levels  of  lymphatic  filariasis  amongst  people  of  Kontagora communities.

iii.      effect of community knowledge, practice and perception on the distribution of lymphatic filariasis (LF) amongst people of Kontagora Local Government Area of Niger State.

₦8,000.00 – DOWNLOAD FULL PROJECT DOWNLOAD FULL PROJECT Added to cart

---

---

---

---

Related Project Topics :