Comorbidities of onchocerciasis and non-communicable diseases, and determinants of continued transmission in Bafut Health District, Cameroon.
Despite decades of mass Ivermectin distribution, onchocerciasis transmission persists in Cameroon. Comorbidities with non-communicable diseases (NCDs) and gaps in treatment uptake may contribute to the sustained transmission of this disease. This study assessed the prevalence of onchocerciasis, its comorbidity with selected NCDs, and determinants of continued transmission in Bafut Health District, Cameroon.
A community-based cross-sectional study with health facility-based recruitment was conducted from June to July 2024 among 282 adults aged 30 years or older who had resided in Bafut for at least 5 years. Data on sociodemographic, NCD history, onchocerciasis knowledge, and ivermectin uptake were collected using a structured questionnaire. Laboratory investigations included skin snip microscopy, nodule palpation, blood pressure measurement, and venous blood tests for diabetes and rheumatoid arthritis. The relationship between categorical variables was analysed using the Chi-square test and logistic regression at the 5% significance level.
Of the 282 participants examined, 43 (15.2%) had palpable nodules, 17 (6.0%) were positive on skin snip for Onchocerca volvulus, and 6 (2.1%) had both palpable nodules and positive skin snip results. Onchocerciasis infection showed significant associations with sex, age group, marital status, and educational level (p < 0.05). Hypertension (27.8%) and rheumatoid arthritis (25.9%) were the most common comorbidities among infected individuals. Ivermectin uptake was high, with 94.3% of participants reporting that they had ever taken ivermectin at least once during previous community-directed treatment with ivermectin (CDTI) rounds. In comparison, a small proportion (5.7%) declined due to illness or blurred vision. Participants with tertiary education had approximately five times higher odds of taking ivermectin compared to those with no formal education (aOR = 4.62, 95% CI: 1.18-18.12, p = 0.028). Similarly, individuals who had lived in the community for more than 10 years had five times higher odds of adhering to ivermectin treatment than recent residents (aOR = 5.03, 95% CI: 1.11-22.8, p = 0.036), primarily due to a refusal of ivermectin, mainly because of side effects. Nearly half of the participants (48.9%) demonstrated poor knowledge of onchocerciasis.
Onchocerciasis remains present in Bafut, with ongoing transmission. Infection was associated with socio-demographic and behavioral factors. Non-communicable diseases were observed; however, no causal relationship can be inferred. Strengthening ivermectin uptake and health education may improve control.
Not applicable.
A community-based cross-sectional study with health facility-based recruitment was conducted from June to July 2024 among 282 adults aged 30 years or older who had resided in Bafut for at least 5 years. Data on sociodemographic, NCD history, onchocerciasis knowledge, and ivermectin uptake were collected using a structured questionnaire. Laboratory investigations included skin snip microscopy, nodule palpation, blood pressure measurement, and venous blood tests for diabetes and rheumatoid arthritis. The relationship between categorical variables was analysed using the Chi-square test and logistic regression at the 5% significance level.
Of the 282 participants examined, 43 (15.2%) had palpable nodules, 17 (6.0%) were positive on skin snip for Onchocerca volvulus, and 6 (2.1%) had both palpable nodules and positive skin snip results. Onchocerciasis infection showed significant associations with sex, age group, marital status, and educational level (p < 0.05). Hypertension (27.8%) and rheumatoid arthritis (25.9%) were the most common comorbidities among infected individuals. Ivermectin uptake was high, with 94.3% of participants reporting that they had ever taken ivermectin at least once during previous community-directed treatment with ivermectin (CDTI) rounds. In comparison, a small proportion (5.7%) declined due to illness or blurred vision. Participants with tertiary education had approximately five times higher odds of taking ivermectin compared to those with no formal education (aOR = 4.62, 95% CI: 1.18-18.12, p = 0.028). Similarly, individuals who had lived in the community for more than 10 years had five times higher odds of adhering to ivermectin treatment than recent residents (aOR = 5.03, 95% CI: 1.11-22.8, p = 0.036), primarily due to a refusal of ivermectin, mainly because of side effects. Nearly half of the participants (48.9%) demonstrated poor knowledge of onchocerciasis.
Onchocerciasis remains present in Bafut, with ongoing transmission. Infection was associated with socio-demographic and behavioral factors. Non-communicable diseases were observed; however, no causal relationship can be inferred. Strengthening ivermectin uptake and health education may improve control.
Not applicable.
Authors
Ajonina-Ekoti Ajonina-Ekoti, Aghaeze Aghaeze, Ajonina Ajonina, Nkuo-Akenji Nkuo-Akenji
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