Primary motives for demand of ivermectin drug in mass distribution programmes to control onchocerciasis

BACKGROUND: Onchocerciasis is a disease with a spectrum of manifestations suffered by different infected people. Based on individual perceptions and manifestations presented, demand for the drug Ivermectin was due to different motives and priorities during mass distribution programmes. SUBJECTS AND METHOD: This study presents findings from a sample of 594 persons out of a total of 35,763 treated individuals who voluntarily demanded Ivermectin treatment during a community-based Ivermectin distribution exercise. The distribution, which took place in 2008, was mass distribution of the microfilaricide to control onchocerciasis in endemic communities of Ezinihitte in the Imo River Basin of Nigeria. The subjects who were selected by quota sampling procedure on the basis of community and gender, were asked to rank-order six plausible reasons for seeking treatment in terms of their order of importance in motivating them to demand Ivermectin. RESULTS: “To gain treatment and prevention of Skin Problems” and “Desire to be De-wormed” ranked first and second respectively. “To gain promotion of general wellbeing” and “To improve state of vision and prevent blindness” ranked third and fourth respectively. In the fifth and sixth rank-order positions were “To prevent hanging groin” and “to prevent/relieve enlargement of the scrotum or clitoris” in that order. A test of hypothesis to determine if there was significant agreement among treated persons on the rank order of importance of their reasons for demanding Ivermectin gave a Kendall's Coefficient of Concordance of W = 0.62, p <.001. CONCLUSION: The findings are interpreted within the framework of the major postulations of the health belief model with consideration to perceptions of severity of the conditions and belief that submitting to treatment will abate the perceived risk of the conditions. The role of endemicity of specific manifestations of onchocerciasis in lay assessment of risk of this disease is also discussed.