Effects of Direct Costs of River Blindness Illness and Perceived Benefits of Community-directed Treatment with Ivermectin in Rural Households of Benue State, Nigeria

The study assessed households’ direct cost of Onchocerciasis illness and the perceived benefits of community-directed treatment with ivermectin in Benue State, Nigeria. A survey method was used and primary data were collected using structured questionnaires. The survey covered a period of six (6) months between June, 2019 and December, 2019. The population of the study consisted of households affected with Onchocerciasis in Benue State, Nigeria. Random sampling technique was used in selecting a sample size of 200 respondents from three Local Government Areas of Benue State. Descriptive statistics, Cost of illness approach, household expenditure model and multiple regression models were used to analyze the data. The descriptive statistics showed that majority (63.7%) of the respondents were males and married (66.7%) with average age of 48.8 years and average household size of 10 persons. The average farm size was 4.0 hectares with an annual farm income of N167, 266.16. The most perceived symptoms of onchocerciasis by the respondents were severe itching (29%), skin rashes (25.5%) and swelling (17.3%). Ivermectin was cited as the most effective treatment for onchocerciasis as 57.0% of the respondents attested to its effectiveness. The average cost of onchocerciasis illness was N77, 923.84. The direct cost of illness was estimated at N34, 503.20 per household which is high enough to stretch the already tight expenditure budgets of the poor rural households. The household expenditure model revealed negative and statistically significant relationship between onchocerciasis (health shock) and food expenditure (P<0.05), education expenditure (P<0.01) and housing expenditure (P<0.1). The study revealed a positive relationship between health consumption of affected households and household income, borrowing, sale of assets, de-saving and sale of food reserves. The study identified social and health benefits of community-directed treatment with ivermectin (CDTI). The social benefits include: Ability to work better (70.7%), acceptance by peers (52.3%) and respect in the community (47.7%) while the health benefits to the respondents were improved vision (69.4%), reduced itching (65.1%) and deworming (61.1%).The factors associated with perceived benefits of CDTI in the study area are age (P=0.029), marital status (p<0.012), length of stay in the onchocerciasis endemic community (p<0.001) and individual susceptibility to onchocerciasis infection (p<0.0001). The study recommends continuing sensitization of members of the public on the consequences of Onchocerciasis and the importance of Mectizan as curative drug. This will improve the overall health status, enhance the social interactions and increase the economic productivity of the households of North-Central Nigeria, as well as ensure food security and the development of the nation at large.