title: Onchocerciasis in the Democratic Republic of Congo: Survey of knowledge, attitude and perception in Bandundu province.
abstract: A community-directed treatment with ivermectin (CDTI) for fighting onchocerciasis was started in 2003 in the hyperendemic province of Bandundu, Democratic Republic of Congo (DRC); such initiative was supported by the African Programme for Onchocerciasis Control (APOC). As the APOC stopped at the end of 2015, there was an urgent need to assess the sustainability of an ivermectin treatment. A cross-sectional survey of knowledge, attitude and perception was conducted to determine the awareness level of local population regarding the disease. A multi-stage random sampling technique allowed the selection of 450 heads of households. Most respondents (96.9%) knew about onchocerciasis as a disease. The black-fly was viewed as the causing agent of onchocerciasis by 49.9% of respondents. The most commonly cited clinical manifestations were nodules (34.4%) and pruritus (31.1%), while blindness was the most frequently reported complication (90.7%). Approximately 55.1% of respondents had a good knowledge of onchocerciasis and CDTI. Overall, only 37% of participants had a favourable attitude and 46% a positive perception. Good knowledge was associated with school attendance (adjusted OR=1.9, 95%CI: 1.3-2.8, p=0.001), while education and continuation of treatment were related with good attitude (adjusted OR=9.7, 95%CI:4.8-19.5 and adjusted OR=19.8, 95%CI: 9.7-40.6, respectively, both with p<0.001). Good perception was associated with being at least 46 years old, non-Catholic and continuing the treatment (adjusted OR=3.2, 95%CI:1.2-9.1; adjusted OR=29.6, 95%CI:14.1-62.2 and adjusted OR=5.1, 95%CI:1.6-16.0 respectively, all with p<0.001). A good level of knowledge, attitude and perception is needed for a massive adherence of population to onchocerciasis control programmes. In the area of study (Moanza, DRC), good attitude and perception motivated the continuation of treatment in the population. In the future, different plans should focus on educational strategies to maintain a massive adherence and reduce onchocerciasis prevalence.
authors.affiliation: School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium. Electronic address: jcmakebof@yahoo.fr.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Makenga Bof
authors.affiliation: School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Dieudonne
authors.initials: D
authors.lastname: Mpunga
authors.affiliation: School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Emery N
authors.initials: EN
authors.lastname: Soa
authors.affiliation: National Program for Onchocerciasis Control, Kinshasa, Democratic Republic of Congo.
authors.forename: Fortunat
authors.initials: F
authors.lastname: Ntumba
authors.affiliation: National Program for Onchocerciasis Control, Kinshasa, Democratic Republic of Congo.
authors.forename: Didier
authors.initials: D
authors.lastname: Bakajika
authors.affiliation: Department of Dermatology, Watford General Hospital, Watford, Herts, UK.
authors.forename: Michele E
authors.initials: ME
authors.lastname: Murdoch
authors.affiliation: School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Coppieters
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D005260:Female; D005369:Filaricides / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000188:drug therapy; D011634:Public Health; D066252:Sociological Factors; D055815:Young Adult
chemical_list: D005369:Filaricides; D007559:Ivermectin
keywords: Attitude; DRC; Ivermectin; Kinshasa; Knowledge; Mont-Ngafula; Onchocerciasis; Perception