ABSTRACT
This study was carried out to determine the implications of
Onchocerciasis on the health conditions and socio-economic
activities in Oji River LG.A. The type of data used to obtain the
information were questionnaires. Data was analyzed using
chi-square, frequency distribution and percentages. Chi-square
test and analysis of variance test were used to test the
hypotheses. The study reveals that ochocerciasis is endemic in
Oji River L.G.A and its incidence level is high. The level of
incidence varies in different village, occupation income and
educational levels. The intensity of the infectious bites of the
vector and occupational group mostly affected are the farmers
because of the nearness of the houses of most of the farmers to
streams and water bodies. The pathological effects of
onchocerciasis include visual impairment, rashes, palpable
nodules, leopards skins, groins and blindness. There is no
significant difference in the incidence of onchocerciasis in the
two communities of the study area. Onchocerciasis infection is
not related to income, education, health and occupation of the
inhabitants. The work recommends that a long term planning
programme involving the distribution of anti-parasitic drugs
and nodulectomy should be adopted by the government for the
effective control of the onchocerciasis in the area. Farmlands
close to the identified breeding sites need to be left uncultivated
until measures are taken to flush out parasite from the
breeding sites.
vii
TABLE OF CONTENTS
Title page……………………………………………………………………i
Certification ……………………………………………………………iii
Dedication ……………………………………………………………..iv
Acknowledgment …………………………………..………………….v
Abstract …………………………………………………………………vi
Table of contents …………………………………………..…..vii-viii
CHAPTER ONE: INTRODUCTION
1.0 Background Of The Study …………………………………1-2
1.1 Statement of Problem ………………………………………2-4
1.2 Research Questions…………………………..………………..4
1.3 Aim and Objectives of the Study …………..……….….4-5
1.4 Research Hypotheses ………………………………….……..5
1.5 Conceptual Framework ……………………………………5-9
1.6 Significant of the Study …………………………..……..9-10
1.7 Limitations of the Study ………………………..……..……10
1.8 Scope of the Study ……………………………..……….10-11
1.9 Study Area …………………………………………………11-18
CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.1 Onchocerciasis and its Health Impact……….………19-20
2.2 Origin of Onchocerciasis……………………..…..…… 21-22
2.3 Geographical Distribution of Onchocerciasis ……..22-26
2.4 Onchocerciasis and its Economic Impact ………….27-28
2.5 Onchocerciasis and its Social Impact ……..………..28-30
viii
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research Design………………………….………………31-32
3.2 Data Needs……………………………………..………………33
3.3 Sources of Data Collection ………………………..…..33-34
3.4 Data Collection ……………….………..………………..34-35
3.4.1 Study Population………….…………………..…….………..35
3.4.2 Sampling Techniques …………………….……………35-36
3.4.3 Determination of sample size ……………..…………36-37
3.5 Statistical Tools Used for the Analysis…….………37-39
CHAPTER FOUR: DATA PRESENTATION AND DISCUSSION
OF FINDINGS
4.1 Data Presentation ……………………………..…………40-49
4.2 Tests and Hypotheses …………………..………..…….49-51
4.3 Discussion and Findings………………………..……….52-58
CHAPTER FIVE: SUMMARY AND CONDITIONS
5.1 Summary …………………………………………..………59-61
5.2 Conclusion of the study …………………….…….……….62
5.3 Recommendation …………………………………………62-64
References
Appendices
1
CHAPTER ONE
INTRODUCTION
1.0 BACKGROUND OF THE STUDY
Onchocerciasis is an infection caused by the Onchocerca
volvulus worm which is spread to humans through the bite of an
infected blackfly. It is a leading cause of blindness in some
countries and is believed to infect over 17 million people
worldwide (World Health Organization, 2008). Infection can cause
dermatitis with severe itching, eye disease including blindness,
and the formation of nodules in the skin.
In recent decades, Onchocerciasis has struck 18 million
people worldwide, and accounts for nearly a tenth of all cases of
blindness (World Health Organization, 2008). The vast majority of
cases of river blindness are in Sub-Sahara Africa, where nearly
30 countries have been affected (World Health Organization,
2008). Onchocerciasis is a major public health problem in many
parts of the world. All reported cases result from emigration of
individuals from endemic areas. (Crosskey, 1998)
The presence of Onchocerciasis has been reported in Africa.
These observations were confirmed in 1917 and 1920 by
2
researchers. Then in 1995 an estimated 270,000 people were
blind and another 500,000 had severe visual impairment as a
result of the disease (World Health Organization, 2007). The
disease is found in east central and West Africa. In West Africa
regions where the disease has reached hyperendemic
proportions, over 100,000 persons were blind or had their eye
sight seriously impared (World Health Organization, 2006). In
Nigeria alone over 50% of identified hospital cases of filarial
infection were cases of Onchocerciasis is endemic in Oji River
Local Government Area.
In Achi, a town in Oji River Local Government Area of
Enugu state, 68% prevalence rate with a density of 24.9%
microfilaria per mg of skin was reported (Nwoke, 1990).
This study emphasizes the implications of Onchocerciasis
on the health conditions and socio-economic life in Oji River
Local Government Area of Enugu State.
1.1 Statement of Problem
The high incidence of serious visual impairment and
blindness, skin rashes, lesions and intense itching and
depigmentation of the skin of many inhabitants of Oji River L.G.A
attracted the interest of the researcher. In Oji Local Government
Area of Enugu State, there is a high incidence of serious visual
3
impairment and blindness. In severe cases the patients are
infected with Onchocerca volvolus which manifest under skin as
nodules (Ochocercoma) hanging and enlarged groins. This
condition has affected most of the indigenes, particularly
farmers, who have to abandon their fertile farmlands due to
severe illness or visual impairment, which in very extreme cases
lead to blindness. The socio-economic fabric of the area is
affected as many of the inhabitants, including youths, and
adults, resort to begging.
In Oji River, onchocerciasis can be considered as an
occupational disease. Most of the risk areas are Achi and
Ugwuoba who are exposed to the bites of black flies while going
about their daily chores where black flies breed, or are common.
The occupational group includes farmers, fishermen, cattle
herdsmen or people who live near rivers, which are the breeding
sites. The majority are aware of the disease which they
recognized once their body starts itching or muscular skeletal
pains develops, while some attributed chronic itching, nodules,
bad vision and leopard skin to blakfly bite. In the southern part
of Nigeria, ochocerciasis occurs in areas where savannah and
forest regions merge. Therefore, in view of these, the researcher
decided to embark on this study. The implications of
4
onchocerciasis on the health conditions and socio-economic
activities in Oji River L.G.A of Enugu State, Nigeria.
1.2 Research Questions
1. What percentage of the population are affected by
onchocerciasis?
2. What is the impact of the incidence of onchocerciasis on the
health of the inhabitants?
3. What is the relationship between the incidence of
onchocerciasis and sex, age, and education?
4. How does the incidence of onchocerciasis affect the income
level of household?
5. How does the incidence of onchocerciasis related to the type
of occupation in the study area?
1.3 Aims and Objectives
The aim of the study is to investigate the implications of
onchocerciasis on the Health conditions and Socio-economic
activities in Oji River L.G.A of Enugu State. In doing this, the
following form the objectives of the study which are to:
1. determine the percentage of the inhabitants affected by
incidence of the onchocerciasis in the study area.
2. determine the health impact of the incidence of
onchocerciasis in the two communities of the study area.
5
3. determine the relationship between income, occupation,
education and the infected population.
4. identify how the incidence of onchocerciasis affect the
income levels (earnings) of people in Oji River L.G.A.
5. establish the relation to type of occupation of the
inhabitants.
1.4 Research Hypotheses
The study tested the following hypotheses
1. Ho: There is no significant difference in the incidence of
onchocerciasis infection between Achi and Ugwuoba.
2. Ho: The incidence of onchocerciasis is not related to (1)
Gender (2) Age (3) Level of education (4) Income levels of
household and occupation.
1.5 Conceptual Framework
This work is based on the concept of sustainable
livelihoods. In the 80s and 90s the concept of “sustainability”
found their way into all discussions concerning the present and
future exploitation of our resource, economic development in
general and many other topics. As Wolf (1995) said that the word
“sustainability” does not mean very much and its meaning is very
vague and uncertain until it is attached to an object. As such
sustainability is defined in different ways depending on the
6
origin, point of view etc of the person using the concept. The
concept begins to take shape only when it is used in connection
with an object or something concrete. He therefore argues that
the first thing to do is to establish in what area or for what object
sustainability is to be achieved. This is because the concept is
used increasingly in conjunction with a specific object, e.g.
sustainable resource use, sustainable agriculture, sustainable
growth rates or sustainable development among others etc.
Kuhmen (1992) argues that sustainability means
fundamental survival, keeping the community alive. To achieve
this, the main requirement is sufficient food through agriculture
with the help of increased means of production and greater
efficiency in production. Attempts are made to meet the demand
e.g. O.F.N, Green Revolution etc. in Nigeria. Conservation of the
productive basis is seldom or at best considered second. He then
argues that sustainability means ecologically acceptable
production whereby everything removed is then replaced so as
not to harm the ecological system.
The implication of this is that both the life of man and the
resources he depend on must be adequately sustained. This
means sustainable livelihood.
7
For the large number of people resident in the developing
world, their basic needs. In terms of both development and
conservation are immediate and local. Survival in the short term
is their primary concern and for this they depend largely on the
resources of the surrounding area. For approximately 65 percent
of the people living in the developing world, these needs are rural
based (United Nations Development Programme, 1993). Providing
sustainable rural livelihoods, not just for the present population
but for many billions more, is therefore an urgent need, as the
populations will have to be supported by what is often a very
fragile and difficult environment. For adequate and decent
livelihoods that are sustainable, much depends on policies which
affect agriculture (Chambers et al., 1989). Within rural areas
agriculture plays roles in securing livelihoods at the household
level. As Rigg (1997) has suggested, there is more to rural life
than agriculture. Farming is only one option for securing basic
needs for food and cash in rural areas.
The people of Oji River Local Government Area is faced with
the problem of the blackfly. The blackfly is causing them the
disease known as onchocerciasis.
Onchocerciasis is an eye and skin disease causing skin rashes,
swelling, inflammation, lesions and intense itching. The skin
8
wastes away and loses its elasticity giving the appearance early
ageing (Vagima, 2008). People with onchocerciasis have several
hundred nodules on their skin. They cause discomfort that are
usually painful. Effect of onchocerciasis include the inability of
young children to grow and yet they look old. Affected
individuals look ugly and miserable, sickly and always suffer
from repeated chest infection (Reyment, 2001). He opined that
onchocerciasis is an important factor for eplilepsy and dwarfism
in certain areas. According to Ubachukwu (2006), onchocerciasis
is usually a serous threat to public health. He noted that
mortality among the blind may be four times as high as among
on-blind persons of the same age in the same community. As a
result of debilitation and blindness, the infected person is unable
to maintain any type of productive activity males sterility can be
caused by an invasion of reproductive organs of microfilariae.
Onchocerciasis disability impacts subsistence farming
communities causing them to switch to less productive, but lessintensive,
crop and livestock activities. The incidence of acute
onchocerciasis reaches its peak during the rainy season, the time
of peak agricultural cultivation thus compounding productivity
loss. Women with onchocerciasis are unable to participate in
market trading the major form of economic activity available to
9
women. Onchocerciasis is one of the reasons for desertion. This
has far-reaching effects on the agricultural production and
economy of the people by forcing them to desert rich fertile and
production lands in favour of upland, watershed areas,
consequently resulting in overpopulation of less productive areas,
with the attendant over cropping. The pattern of village
aboundment in Oji River correlates strongly with the geographic
pattern of onchocerciasis and blindness. These call for a need for
sustainable management. It is to this effect that this work is
based on the concept of livelihood.
1.6 Significance of the Study
This study is both theoretically and practically significant.
On the practical aspect, it will go a long way in guiding all
stakeholders, particularly the joint planning committee and the
community members. It will help to promote the adoption of sage
hygienic practices within the communities in order to limit the
occurrence and effect of insect vector and to assist in
empowering the communities for behaviour changes through
participatory approaches and also analyzing the health need of
the population.
On the theoretical level, the researcher makes a significant
contribution to the existing knowledge which include, (NGOS,
WHO/APOC, Joint monitoring programmes and community
10
members for the control) and preventions of the insect vector
causing the disease in the area and for the promotion of
environmental hygiene and health.
1.7 Limitations of the Study
1. Inferences were drawn using only the sample size.
2. The study lasted for only four months. There is need to
extend this type of research for at least one year to get full
effect of the disease on the people.
3. The inferences drawn in this work were based only on
questionnaire. Medical and laboratory analyses were not
included.
1.8 Scope of the Study
This study is limited to two communities in Oji River Local
Government Area in Enugu State. They are Achi and Ugwuoba. It
is strictly aimed at investigating the implications of
onchocerciasis on the health conditions and socio-economic
activities in Oji River L.G.A of Enugu State, the impact of
onchocerciasis on health, social, income, to investigate the
incidence of onchocerciasis infection in relation to gender, age,
level of education, income of households and occupation types.
The methodology adopted in collecting data include research
questionnaire, field observation and oral interviews with selected
11
households heads. The time frame for the work is four months (it
is horizontal).
1.9 Study area
1.9.1 Location
The study area is located at the Oji River Local Government
Area (L.G.A). It is located that about longitude 600E and latitude
600W bounded by the River Mamu which forms the boundary
between Enugu State and Anambra State to the west. It is
bounded by Udi and Awgu areas. (Fig 1)
1.9.2 Physical Characteristics
1.9.3 Climate
The study area falls within the humid tropical rainforest
belt of southeastern Nigeria. It has two seasons: the rainy season
and dry season. The rainy season which is characterized by
heavy thunderstorms lasts from April to October. The dry season
lasts from November to March, and is characterized by chilly
harmattan. The rainy season is marked by double maxima of
rainfall. The first peak occurs in July and the second in
September. The mean annual rainfall is about 2000mm. In 3
months. The heavy rainfall and storm result in flooding. The
turbulent run-off results in leaching, sheet erosion and
eventually to gully erosion (Ogbukagu, 1984).
12
During the dry season, humidity is low and clouds are
absent. Temperature is high during the day and low during the
night. This causes high evapotranspiration rate, which
contributes minimally to the lowering of water table. Harmattan
occurs between the months of November and February. During
its prevalence, visibility is poor mostly at nights and early in the
morning. This is as a result of suspended dust particle in the
atmosphere. There is noticeable drop in rainfall during the
month of August. This is popularly known as “August break”. It
is caused mainly by deflection of the moisture laden westerly
trade wind by the cold canary current. However, due to changes
in weather, the August break sometimes occurs in July or early
September.
The climatic conditions of this area which are characterized
by heavy rainfall, high temperature, strong wind and relative
humidity, all combine to bring about physio-chemical weathering
(Egoboka, 1983). From all indication it is climate of this area that
favour the breeding of blackflies that cause onchocerciasis.
1.9.4 Vegetation
Removal of natural vegetation cover from a forest area during
construction work can lower the infiltration capacity to a point
where rain intensity becomes higher. In Oji River Area, most of
13
the vegetation have been replaced by buildings, roads, and
compounds with bare and paved surfaces due to urbanization
there by thereby making the infiltration capacity to be decrease.
The high annual mean temperature and high relative humidity
favours luxuriant plant re-growth, which ideally produce climax
vegetation of the rainforest zone and the vegetation is guinea.
These favour the breeding of black flies that cause the
onchocerciasis.
1.9.5 Geology
The study area falls within the Anambra Basin of
southeastern Nigeria. The sediments found in the basin are
mainly sandstone, shale, mudstone siltstone and sometimes
limestone sequences.
In the study area, the sediments cut across two geologic
ages and periods, from upper Maestritehtian to Palacocene.
Three geological formation outcrop in the study area. They
are Ajali Sandstone, Nsukka Formation and Imo Shale. Ajali
Sandstone and Nsukka Formations are of upper Cretaceous
(Reyment, 1980) while the Imo Shale Formation is Tertiary.
Ajali sandstone covers the entire Achi town. It is well exposed
around Ozom River near Oji River police station. The formation is
poorly sorted, friable, massive, cross-bedded and white in colour.
14
Nsukka Formation lies on top of Ajali Sandstone and covers a
considerable extent in the study area. The places covered by
Nsukka formation are Oji River urban, Inyi, Awlaw and part of
Akpugoeze. A good exposure of the formation was observed in
Obune-Inyi. The outcrop in this place is almost entirely
sandstone. Siltstone is also present, outcrop of coal exists in
places where the sandstone has been removed by erosion,
especially in the stream valleys. The sandstone is massive
medium to very coarse grained, pebby, gravely and indurate. The
upper part of the sandstone has been affected. By weathering
and erosion, it is brown to rustic brown and sometimes reddish
colour which shows ferruginization (Egboka, 1983)
Imo shale (Palaeocene) is the youngest of the formation and
lies conformably on top of Nsukka formation. It covers the entire
southern part of the study area. The towns within the area are
Ugwuoba, Obinofia Ndiuno, Ndikelionwu, Ufuma and part of
Akpugoeze. The formation has shale and sandstone (Ebenebe
sandstone) units. The shale number is laminated, friable dark
and grey in colour with the Ebenebe sandstone lying on top of
the shale units. The top of the sandstone has been greatly
weathered and ferruginized. It is loose unconsolidated and
massive. It is unsorted fine to coarse-grained sandstone. The
15
colour is light brown, dull and sometime dirty white. The study
area is endowed with a number of resources of economic
importance. These resources are coal deposit, hydrocarbon, clay
deposit, sandstone deposit and forest vegetable. Some of the
resources are exploited locally by the villagers. The study area is
mostly rocky bedded with rapid and falls supporting breeding of
Simulium damnosum.
1.9.6 Topography
The topography of the study area emanates from the
undulating area of Udi Hills and falling to the west to join the
lower Anambra system near it’s junction with the Niger (Egboka
and Orajiaka, 1988).
The study area is generally marketed by low lands. The highest
elevation above mean sea level in the area measure 1000ft (above
300m) and it is located at Nachi. The prominent features in the
area are the Enugu Escarpment and the Ebenebe Sandstone
Ridge. The Ebenebe Sandstone which trends NW-SE passes
through Ugwuoba in the study area (Egboka and Orajiaka, 1988).
Erosion is active in the area, and this has combined to modify
the landscape. Gully erosion is common in the area covered by
Ajali Sandstone and Ebenebe sandstone. And this has
continuous effect on residential and agricultural land. The
16
evolution of the entire landscape in the study area corresponds
with two geologic cycles, namely, the transgression in the
Turonian stage (upper Cretaceous) and the transgression in the
early stage of the Tertiary. The topography of the study area
supports breeding of simulium damnosum. (Simpson, 2006). Oji
River is located on a depressed environment. A critical study of
the topographical map of Oji River shows that due to blocked
absence of drainage and soil type, the flood water accumulates.
This favours the breeding of black flies that causes
onchocerciasis.
1.9.7 Drainage
Oji River Local Government Area has poor drainage system.
The study area has aboundant surface water and groundwater
resources. Several rivers, streams and springs served the
inhabitants all their needs. Almost the whole place in the study
area are characterized by effluent seepages originating at
sandstone and shale boundaries and where the water table is
exposed by erosion. In the rainy season infiltration, and run-off
are high, water table is shallower. As a result, there are quite a
number of seepages during the wet season and most of the driedup
channels now contain water thus increasing the water supply
17
in the area. The surface water divide coincides with the Awka-
Orlu upland which falls steeply eastward into the Mamu plains.
Groundwater divide exists in the study area. This feature is
responsible for most of the numerous seepages running out from
road units and erosional features in the area under study. Achi
area is covered by a thick body of highly porous, friable and
unconsolidated Ajali sandstone. Because of the character of the
formation, infilteration and perculation are very high with the
result that only very few surface water exist. Poor drainage favour
the breeding of black flies that cause the onchocerciasis.
1.9.8 Human Characteristics
1.9.9 Population and Health
The population of the study area is 136, 587, which was
estimated in 2007 census counting, total number of female is
80,000, which was estimated in the national population census
in 2007. Total number of male is 56, 587 (National population
Commission, 2007). They have poor health condition. There is
no pipe borne water. Some of the households have no latrine.
There is absence of storm sewers and as such, the road surface
serves as a means of run off consequence. In the few places
where the drains are in existence, they are open and are being
used for refuse disposal. At other places they are poorly
18
managed. They wash and dump their refuse everywhere. These
favour the breeding of black flies that cause the onchocerciasis.
1.10 Occupation
The inhabitants of Oji River Local Government Area
environs are mainly farmers, which is the major traditional
occupation in the area. The typical agricultural produce includes:
cassava, yam, maize, vegetables, mangoes, oranges, plantain,
palm oil and ground nuts. Farming as an occupation plays a
predominat role in the exposure of people to the infection of the
disease. Farmers were said to have experienced the vector bite
during farming time.
1.11 Settlement Patterns
It is not well planned as people put up their buildings
indiscriminately. Urban floods results when towns and cities are
planned without due consideration to the hydrology and
topography of the area. The cause of flooding is as a result of
thoughtlessness and carelessness of the contractors to erect
building on flood courses. These favour the breeding of black flies
that cause the onchocerciasis.
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