Lymphatic Filariasis in Southwest, Nigeria: A Cross-sectional Study on Prevalence, Morbidities and Socio-economic Impact in Four Endemic Areas of Ondo State

Abstract

Background: Lymphatic Filariasis (LF), commonly called Elephantiasis, is a painful and infectious disease with extreme disabilities, social and economic burden, majorly caused by the parasite-Wuchereria bancrofti, responsible for 90% cases worldwide and transmitted by blood-sucking Culex, Aedes and Anopheles mosquitoes in rural and semi-urban areas. In Akoko and Ondo State, Nigeria, there are no data on the endemicity of Lymphatic filariasis. Therefore, this study assessed the prevalence, associated morbidities and socio-economic impact of Lymphatic filariasis. Methodology: A cross-sectional study design in four endemic areas of Akoko south-west Local Government Areas of Ondo state, Nigeria. Questionnaire data was used to evaluate specifics of LF impact on quality of life, financial burden, access to education, psychological and social involvement (LFSQQ). Nocturnal intravenous blood was collected from subjects across villages and settlements including children, between 11pm and 1am due to parasite's circadian clock and analyzed for parasite’s microfilariae by microscopy of thick blood films. Physical morbidities on limbs, breast and scrotum were examined and documented as lymphoedema, limb elephantiasis and hydrocoele. Results: Overall prevalence of Lymphatic filariasis was 22.1%, with associated morbidities of 42.4%. Hydrocoele of scrotum (66.7%), lymphoedema and limb elephantiasis were endemic in the study area. LF affected population with economic burden (P=0.01; P<0.05) was 84.8%; involving school-aged children, youth, men and women. The socioeconomic impact of LF was expressed as 16.1% as measured using LFSQQ. Hydrocoele impacted higher burden (P=0.001 P<0.05) on the affected, including children of ages 3-14years. Significant statistical relationship existed between infection and study communities (P=0.007, P<0.05), as Ugbegun and Supare were highly infected. Moreover, infection was predominant across all age-groups, although higher among males and elderly of ages 55 and above. Conclusion: The social, economic and public health impact of Lymphatic filariasis is enormous, preventing smooth education of school-aged children, deprive victims of livelihood, relationships and comfort. Hence, prompt diagnosis and immediate management of associated morbidities and disabilities through health intervention initiatives such as hydrocelectomy is advocated, with properly monitored and timely administration of preventive chemotherapy (MAM) especially in rural and endemic communities.