Socio-Cultural Practices and Attitudinal Behaviour in the Control of Lymphatic Filariasis in Endemic Communities of Ondo State, Nigeria

Abstract

Background: Lymphatic filariasis (LF) is a parasitic disease caused by nematode worms- Wuchereria bancrofti, Brugia malayi and Brugia timori. These parasites are transmitted through bites from mosquitoes, most especially species of Culex, Anopheles and sometimes Aedes. Lymphatic Filariasis is a Neglected Tropical Disease (NTD) mainly affecting humans. It specifically causes damage to the lymphatic system, leading to disfiguration of the skin, tissue build-up in affected body parts, abnormal swellings, and skin thickening and roughness. Aim: This study investigated the socio-cultural practices and attitudinal behaviour in the control of the disease among residents of endemic communities in Ondo State, Nigeria. Study Design: A quantitative cross-sectional study was carried out using a structured questionnaire. Place and Duration of Study: The study was carried out in communities of Akoko South West Local Government Area of Ondo State, Nigeria. Methodology: A standardized questionnaire was adapted, and a scale of measurement was developed                    to evaluate the perception, habits, knowledge, attitude and practices of inhabitants in some rural and semi-urban areas of endemic communities in Akoko South West of Ondo State, Nigeria, towards Lymphatic filariasis. Results: Out of 180 respondents of both genders, including children, 47.8% claimed ignorance about LF infection, while 52.2% had prior information and mentioned having seen people infected with LF. Only 13.3% of the respondents believed the disease was transmitted by mosquitoes, while others could not tell. Moreover, 30.6% of the people patronized traditional healers (herbalists) as they claimed the disease was spiritually inclined. Although the majority of the population that were fairly educated (77.2%) had good knowledge of the disease while 22.8% had very poor knowledge about LF. The KAP of participants toward LF infection is significantly implicated in the method of vector (mosquito) control within the communities (ꭕ2 =9.211, P=0.027, P≤0.05). Predisposition to Lymphatic Filariasis infection was higher (51.3%) among users of long-lasting insecticide-treated nets (LLINs), as opposed to indoor residual spraying (IRS), which was very effective (0.0%). Only 20% were not aware of mass administration of medicines in the community(s); however, out of the majority (80%) involved in MAM practices, only 47.8% were committed to regular and conscious usage of treatment. According to occupation, farmers were more predisposed to LF infection (39.4%), followed by traders (34.5%) and Artisans (23%) when compared to the civil servants (3%). On duration of stay, exposure was higher among residents who were born in the communities or never left (72.7%) than the migrants (27.3%). Conclusion: Indoor residual spraying (IRS) may be a better alternative over LLINs (long-lasting insecticide-treated nets) for Lymphatic filariasis vector control, especially in the rural and endemic communities. In addition, prior knowledge of disease and access to MAM may not prevent Lymphatic filariasis infection in some areas due to behavioural attitude of residents towards regular and conscious treatment approach. These findings therefore reveal shortfalls in MAM responsiveness of community inhabitants, compliance and ineffective vector control methods.