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Studies on Epidemiology and Effects of Human Onchocerciasis On /15.04.0'2 1 ~BA STUDIES ON EPIDEMIOLOGY AND EFFE_CTS OF HUMAN ~ Qc}_ f1 ~ ONCHOCERCIASIS ON PRODUCTIVITY AND SOCIAL LIVES OF RURAL COMMUNITIES IN UZO-UW ANI LOCAL GOVERNMENT PG /Ph.D ./95/22232 A THESIS SUBMITTED TO THE DEPARTMENT OF ZOOLOGY, UNIVERSITY OF NIGERIA, NSUKKA, IN FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DOCTOR OF PHILOSOPHY DEGREE. CODESRIA-LIBRARYSUPERVISOR: PROF. A. 0. ANYA, FAS, NNOM DEPARTMENT OF ZOOLOGY, UNIVERSITY OF NIGERIA, NSUKKA. DECEMBER, 2000 ·- CERTIFICATION Mrs. Patience Obiageli Ubachukwu, a post-graduate student in the Department of Zoology;· ' ' University of Nigeria, Nsukka with registration number PG/Ph.D./95/22232 has satisfactorily completed the research work for the award of the degree of Doctor of Philosophy in Zoology with emphasis on­ Parasitology and Entomology. The work embodied in this thesis is originafand has npt been submitted· · in part or full for any other degree of this or any other university. Any other work referred to is duly acknowledged. Supervisor Ag. Head of Department Prof. A. O. Anya Dr, B. 0. Mgbeilka Department of Zoology, Department of Zoology, University of Nigeria, Nsukka. University of Nigeria Nsukka.. · ' ' CODESRIA-LIBRARY iii DEDICATION To all who wait for the appearing of the Lord, Jesus Christ. I CODESRIA-LIBRARY iv PREFACE The field studies described in this thesis were carried out in 16 rural communities that 11:ake up Uzo-Uwani Local government area of Enugu State, Nigeria, between October, 1997 and March, 2000, under the supervision of Prof. A. 0. Anya, FAS, NNOM. The work covered various aspects of the epidemiology of onchocerciasis including the prevalence of the disease in the area (Chapter 3) and local disease perception and treatment (Chapter 4). Other aspects of the disease such as the effects of the disease on the productivity and social lives of the people (Chapter 5), the effects of Mectizan treatment on the histology of the nodule (Chapter 6) and the daily biting patterns of the vector, Simulium flies, in different seasons of the year (Chapter 7) were also studied. Chapter 8 is the general discussion of the results. Recommendations based on the findings were made on how best to control onchocerciasis in the study area. P. 0. UBACHUKWU December, 2000 CODESRIA-LIBRARY 1. V ACKNOWLEDGEMENTS · I wish to express my profound gratitude to all who contributed in different capacities to make this work a success. I hereby acknowledge with thanks the Council for Development of Social Sciences Research in Africa (CODESRIA) Dakar, Senegal, for sponsoring the project under the 1997 Small Grants Programme for Thesis Writing. I am very grateful to my supervisor, Professor A. 0. Anya, for his fatherly direction, patience and valuable suggestions and criticisms throughout the period of the study. His encouragement to do further field work at a time I thought I had finished yielded great dividends. I wish to thank the traditional rulers of the 16 communities of Uzo-Uwani · local government area, the principals/head teachers, staff and students/pupils of the secondary and primary schools used for the studies and the entire people of Uzo-Uwani local government area for their co-operation during the field studies. My thanks also go to the field assistants used for the work. The staff of zonal Ministry of Health, especially Mr. Nwobu and the health superintendent of Ukpata healthCODESRIA-LIBRARY centre, deserve special mention for their co-operations. I thank the members of staff of West African Examinations Council (WAEC) and Examinations Development Centre (EDC), Enugu for supplying me with required school results. · vi I acknowledge with gratitude the Heads (Dr. N. M. Inyang, Dr. H. M. G. Ezenwaji and Dr. B. 0. Mgbenka) and members of staff of Department of Zoology during the period of the study for their contributions and encouragement. I specially acknowledge Dr. (Mrs.) U. 0. Amazigo who introduced me to onchocerciasis studies in friy final year as an undergraduate, Rev. (Prof.) E. U. Iheagwam who initiated this work and Professor F. C. Okafor who corrected some of the early manuscripts. I wish to thank my elder brother, Professor D. N. Ezeasor, of the Department of Veterinary Anatomy, University of Nigeria, for making his facilities available for the sectioning and staining of the nodules and for taking the microphotographs. I also acknowledge Mr. Aloka who helped in the sectioning and staining of the nodules and Mr Dim who helped to take the microphotographs .. I am very grateful to Professor B. E. B. Nwoke of Federal University of Technology, Owerri, for supplying me with literature materials and useful suggestions and encouragement. I acknowledgeCODESRIA-LIBRARY all my Christian brethren for their prayers and support. Finally, I wish to express my profound gratitude to my entire family for their understanding and patience especially my husband, Dr. A. A. Ubachukwu, for his support and encouragement in every way and for carrying the burden of the work with me throughout the study period. I ! ! vii To all others who contributed in one way or the other to make this work a sticcess, especially Dr. Eric Eboh of the Department of Agricultural Economics, Mrs. Uzoma Okoye of Department of Sociology and Anthropology, Dr. J. E. Eyo of Zoology Department and all staff of Divine Love Computers, I say a big thank you. May the good LORD reward you all in Jesus' Name - Amen. To GOD ALMIGHTY, who kept me alive and helped me to complete this work successfully, I owe my life. NSUKKA P. 0. UBACHUKWU 2000 CODESRIA-LIBRARY viii LIST OFT ABLES TABLE PAGE 3 .1 General Distribution of Onchocerciasis in Uzo-Uwani Local Government Area. 69 3.2 The Distribution Of Onchocerciasis in the Different Health Districts in Uzo-Uwani Local Government Area. 70 4.1 Names of Blackfly and Manifestations of Onchocerciasis in Uzo-Uwani Local Government Area. 105 6.1 Age-Sex Distribution And Location Of Excised Nodules in Mectizan-Treated Onchocerciasis Patients in Uzo-Uwani Local Government Area. 160 7.1 Summary of Fly Collections in Uzo-Uwani Local Govenunent Area during the Study Period. 178 7.2 Daily Biting Pattern in Early Raining Season. 179 7.3 Daily Biting Pattern in Late Raining Season. 180 7.4 Daily Biting Pattern in the Dry Season (without Harmattan). 181 7.5 DailyCODESRIA-LIBRARY Biting Pattern in the Dry Season with Harmattan. 182 ix LIST OF FIGURES FIGURE PAGE 2.1 Map of Uzo-Uwani Local Government Area Showing the Study Areas. 36 5.1 Performance against Onchocercal Manifestations. 138 7.1 Daily Biting Pattern of Blackfly (Simulium) in Uzo-Uwani Local Government Area of Enugu State, Nigeria. 183 7.2 Daily Biting Pattern of Blackfly (Simulium) in Uzo-Uwani Local Government Area of Enugu State, Nigeria, during Early Raining Season. 184 7.3 Daily Biting Pattern of Blackfly (Simulium) in Uzo-Uwani Local Government Area of Enugu State, Nigeria, during Late Raining Season. 185 7.4 Daily Biting Pattern of Blackfly (Simulium) in Uzo-Uwani Local Government Area of Em:tgu State, Nigeria, during the Dry Season (without Harmattan). 186 7.5 DailyCODESRIA-LIBRARY Biting Pattern of Blackfly (Simulium) in Uzo-Uwani Local Government Area of Enugu State, Nigeria, during the Dry Season with Harmattan. 187 9.1 Schematic Representation of Strategies for Controlling Onchocerciasis in Uzo-Uwani Local Government Ar~a. 227 ! i . \ X LIST OF PLATES PLATE PAGE 2.1 River Adada at Nkpologu. 38 2.2 River Adada at Ukpata. 39 2.3 River Obina at Adani. 40 2.4 River Obina at Asaba. 41 2.5 River Obina at Adani-Omor Road. 42 2.6 . River Duu at Umulokpa. 43 2.7 River Eshi at Ogurugu. 44 2.8 River Anambra at Ogurugu. 45 2.9 Awara Stream at Umulokpa. 46 2.10 Dammed Section of River Obina at Adani. 47 2.11 Interviewed Primary School Children from lgga. 50 2.12 Interviewed Elders from Nkume. 51 2.13 Interviewed Elders from Uvuru. 52 2.14 Interviewed Elders from Nkpologu: 53 2.15 InterviewedCODESRIA-LIBRARY Elders from Ogurugu. 54 2.16 Interviewed Elders from Asaba. 55 2.17 Interviewed Elders from Adani. 56 2.18 Interviewed Elders from Abbi. 57 2.19 Interviewed Elders from Nrobo. 58 .xi 3.1 The Legs of a 19-Year Old School Girl from Ukpata showing Leopard Skin. 72 3.2 The Legs of an Elderly Woman from Nkpologu showing Leopard Skin. 73 3.3 The Back of the Legs of a Middle-Aged Woman from Nkpologu showing a Nodule. 74 3.4 The Legs of an Elderly Man from Nkume showing Nodules. 75 3.5 The Legs of Men from Ukpata showing Leopard Skin. 76 3.6 The Legs of Women from Ukpata showing Leopard Skin. 77 3.7 The Legs of Men and Women from Adani showing Leopard Skin. 78 3.8 The Legs of Men from Asaba showing Leopard Skin. 79 3.9 The Legs of Men from Nkpologu showing Leopard Skin. 80 3.10 The Legs of Elders from Akpugo showing Leopard Skin. 81 3.11 The Legs of Men from Uvuru showing Leopard Skin. 82 3.12 The Legs of Men from Nimbo showing Leopard Skin. 83 3.13 The Legs of Men from Abbi showing Leopard Skin. 84 3.14 TheCODESRIA-LIBRARY Legs of Men from Ugbene-Ajima showing Leopard Skin. 85 3.15 The Legs of Men from Nrobo showing Leopard Skin. 86 3.16 A Man met Working in the Farms at Nkpologu Wearing only Trousers. 93 3.17 A Woman met Working in the Farms at Nkpologu Wearing xii Clothes that Cover the Trunk. 94 6.1 The External Appearance of Nodul~s. 161 6.2 A Section of Nodule showing Part of Outer and Inner Zones.
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