The community-based treatment of onchocerciasis in Shao, Kwara State, Nigeria.

Community acceptance of and compliance with annual ivermectin treatment in Shao, a sub-urban community in Kwara State, Nigeria, were remarkably high. Of 890 subjects from 204 randomly selected households, 832 (93.5%) had taken ivermectin at least once during the six-year treatment period. An average community acceptance rate (ACAR) of 88.77% (range 85.4 - 91.9%) was recorded during this period; a community compliance rate (CCR) of 74.76% was recorded. Overt refusals, covert refusals and those excluded from treatment were low and insignificant (p > 0.05). The mean compliance age was 37.47 +/- 16.52 years. Of the subjects studied, 40.67% reported adverse reactions to ivermectin during the first round of treatment (Tx1); this number decreased significantly (p < 0.05) to 15.43% during the sixth round of treatment (Tx6). Though considerable adverse reactions were reported in the community, these did not seem to have negatively affected acceptance of and compliance with annual ivermectin treatment; in some cases, the adverse reactions were believed by the villagers to demonstrate the efficacy and effectiveness of the drug. The community showed great awareness of the disease, its treatment with ivermectin and the distribution of the drug. On the basis of the high acceptance and compliance rates, it was concluded that Shao will benefit greatly from the current African Program for Onchocerciasis Control Strategy: Community-Directed Treatment with Ivermectin (CDTI) using Community-Directed Distributors (CDDs).