title: Exploring Consumer Perceptions and Economic Burden of Onchocerciasis on Households in Enugu State, South-East Nigeria.
abstract: BACKGROUND
  Onchocerciasis or river blindness constitutes a major burden to households especially in resource-poor settings, causing a significant reduction in household productivity. There has been renewed interest from policy makers to reduce the burden of Neglected Tropical Diseases (NTDs) such as onchocerciasis on individuals and households. This paper provides new information on the patient's perceptions of onchocerciasis and its economic burden on households in South-eastern Nigeria. The information will be useful to health providers and policy makers for evidence-informed resource allocation decisions.
  
  
  METHODS
  Information was generated from a cross-sectional household survey conducted in Achi community, Oji River Local Government Area (LGA) of Enugu State, Southeast Nigeria. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 747 households were visited randomly and data were collected using pre-tested interviewer administered questionnaire from 370 respondents. The respondents' knowledge of the cause of symptoms of the disease, costs incurred for seeking treatment and productivity losses were elicited. Data were analyzed using tabulations and inferential statistics. A socio-economic status (SES) index was used to disaggregate some key variables by SES quintiles for equity analysis.
  
  
  RESULTS
  Many people had more than one type of manifestation of onchocerciasis. However, more than half of the respondents (57%) had no knowledge of the cause of their symptoms. Male respondents had significantly more knowledge of the cause of symptoms than females (P = 0.04) but knowledge did not differ across SES (P = 0.82). The average monthly treatment cost per respondent was US$ 14.0. Drug cost (US$10) made up about 72% of total treatment cost. The per capita productivity loss among patients was US$16 and it was higher in the poorest (Q1) (US$20) and the third SES quintiles (Q3) (US$21). The average monthly productivity loss among caregivers was US$3.5.
  
  
  CONCLUSIONS
  Onchocerciasis still constitutes considerable economic burden on patients due to the high cost of treatment and productivity loss. Prioritizing domestic resource allocation for the treatment of onchocerciasis is important for significant and sustained reduction in the burden of the disease. In addition, focused health promotion interventions such as health education campaigns should be scaled up in onchocerciasis-endemic communities.
authors.affiliation: Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria.
authors.forename: Ogochukwu
authors.initials: O
authors.lastname: Ibe
authors.affiliation: Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria.|Department of Health Administration and Management, Faculty of Health Sciences, University of Nigeria, Enugu, Nigeria.
authors.forename: Obinna
authors.initials: O
authors.lastname: Onwujekwe
authors.affiliation: Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Uzochukwu
authors.affiliation: Department of Community Medicine, Enugu State College of Science and Technology, Enugu, Nigeria.
authors.forename: Miriam
authors.initials: M
authors.lastname: Ajuba
authors.affiliation: Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria.
authors.forename: Paul
authors.initials: P
authors.lastname: Okonkwo
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D009855:Onchocerciasis / Q000191:economics* / Q000453:epidemiology* / Q000473:pathology; D011897:Random Allocation; D011795:Surveys and Questionnaires