{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:33:35Z","timestamp":1791941615124,"version":"4.3.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1020","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered \u2018private\u2019), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A \u2018quick-win\u2019 was identified whereby the CDTI chain could be utilised to deliver other health interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/pgmj.2010.100248","type":"journal-article","created":{"date-parts":[[2010,10,22]],"date-time":"2010-10-22T06:36:08Z","timestamp":1287729368000},"page":"573-577","source":"Crossref","is-referenced-by-count":18,"title":["Onchocerciasis in Anambra State, Southeast Nigeria: clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI)"],"prefix":"10.1093","volume":"86","author":[{"given":"Evaristus C","family":"Mbanefo","sequence":"first","affiliation":[{"name":"Public Health Parasitology Unit, Department of Parasitology and Entomology, Nnamdi Azikiwe University , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine I","family":"Eneanya","sequence":"additional","affiliation":[{"name":"Public Health Parasitology Unit, Department of Parasitology and Entomology, Nnamdi Azikiwe University , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obioma C","family":"Nwaorgu","sequence":"additional","affiliation":[{"name":"Public Health Parasitology Unit, Department of Parasitology and Entomology, Nnamdi Azikiwe University , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M","family":"Oguoma","sequence":"additional","affiliation":[{"name":"Public Health Parasitology Unit, Department of Parasitology and Entomology, Nnamdi Azikiwe University , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses O","family":"Otiji","sequence":"additional","affiliation":[{"name":"Ministry of Health, Enugu State , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernice A","family":"Ogolo","sequence":"additional","affiliation":[{"name":"Nnamdi Azikiwe University Teaching Hospital (Trauma Centre) , Oba , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,10,21]]},"reference":[{"key":"2023041909022455100_b1","article-title":"The Importance of Onchocercal Skin Diseases","author":"World Health Organization","year":"1995","journal-title":"Document TDR\/ONCHO\/95.1"},{"key":"2023041909022455100_b2","article-title":"Expert Committee on the Epidemiology of Onchocerciasis","author":"World Health Organization","year":"1976","journal-title":"WHO Technical Report Series No. 597"},{"key":"2023041909022455100_b3","article-title":"Community Directed Treatment with Ivermectin: Sustainability and Ownership","author":"World Health Organization\/African Programme for Onchocerciasis Control"},{"key":"2023041909022455100_b4","first-page":"16","article-title":"Onchocerciasis in Imo State, Nigeria 1: the prevalence and distribution in the Imo River Basin, Nigeria","volume":"27","author":"Dozie","year":"2006","journal-title":"Nig J Parasitol"},{"key":"2023041909022455100_b5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1475-2883-6-15","article-title":"Epidemiology and psycho-social aspects of onchocercal skin diseases in northeastern Nigeria","volume":"6","author":"Okoye","year":"2007","journal-title":"Filaria J"},{"key":"2023041909022455100_b6","first-page":"322","article-title":"Detrimental Effects of Onchocerciasis on marriage and breast-feeding","volume":"46","author":"Amazigo","year":"1994","journal-title":"Trop Geogr Med"},{"key":"2023041909022455100_b7","first-page":"11","article-title":"Social and Psychological Aspects of Onchocercal Skin Disease in Nkwelle-Ezunaka, Anambra State","volume":"22","author":"Eneanya","year":"2001","journal-title":"Nigeria. 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