Journal of Tropical Diseases & Public Health

Prevalence, Knowledge and Perception of Lymphatic Filariasis in Yenagoa Local Government Area, Bayelsa State, Nigeria

Awiya B Henry^1*, Amawulu Ebenezer¹, Nduka Florence² and Chinwe Eze N^{2 1}Department of Biological Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
²Department of Animal and Environmental Biology, University of Port Harcourt, Choba, Rivers State, Nigeria
^*Correspondence: Awiya B Henry, Department of Biological Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria, Email:

Received: 06-Jun-2023, Manuscript No. JTD-23-21740 ; Editor assigned: 09-Jun-2023, Pre QC No. JTD-23-21740 (PQ); Reviewed: 26-Jun-2023, QC No. JTD-23-21740 ; Revised: 04-Jul-2023, Manuscript No. JTD-23-21740 (R); Published: 12-Jul-2023, DOI: 10.35241/2329-891X.23.11.387

Introduction

Lymphatic Filariasis (LF) is a debilitating Neglected Tropical Disease caused by the parasitic nematodes; Wuchereria bancrofti, Brugia timori and Brugia malayi [1]. The adult worm dwells in the lymphatic system inducing permanent disability in human with its disability adjusted life years trailing second highest behind malaria [2]. Report from the World Health Organization documented that over 856 million people across 52 nations of the world are susceptible to the disease, Nigeria alone has the prevalence of 22.1% which was fourth to India, Indonesia and Guinea Papua with the North-Central accounting for 8.2%, North-West region carries 7.8%, South-East with 7.1%, and South-South had 2.5% prevalence [3-5]. Although the mortality from this disease is quite low, factors accountable for the prevalence of the disease in both rural and urban areas may include poor hygienic conditions and overcrowding [6].

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) with the aim of reducing its serious economic and social burden was instituted in the year 2020 [7,8]. Lymphatic filariasis has been considered an urban disease [9]. However, literatures have shown that the parasite and vector have adapted to rural pocket [10]. Understanding the distribution, prevalence and cultural concepts of belief and perceptions of the disease are prerequisites to accomplishing the global elimination programmes [10]. Little of this information is documented in Bayelsa State. This research is therefore designed to provide reliable baseline data on the prevalence of lymphatic filariasis in selected urban and rural communities in Yenagoa Local Government Area, Bayelsa State. The result shall guide intervention activities in Yenagoa Local Government Area of Bayelsa State, South-south Nigeria.

Materials and Methods

Area of study

This study was carried out in Yenagoa Local Government Area, Bayelsa State. Yenagoa Local Government Area (4055’ 17.39 N and 6015’ 30.60E) is the municipal capital of Bayelsa State. The description of the study locations has been discussed extensively [11]. The study locations were Akenfa, Yenizue-gene, Tombia and Agbura during March-May, 2020.

Inclusion and exclusion criteria

Only participants within the age of ten years and above and who have resided within the communities for at least six months from the time of study were included in the study. Participants not residing within the study communities and less than ten years respectively were excluded.

Study population and sample size

The study was carried out in four randomly selected communities in Yenagoa Local Government Area, Bayelsa State based on accessibility and willingness to participate in the study. The sample population comprised as follows: Akenfa, Yenizue-gene Tombia and Agbura respectively. All participants who presented at the community health centers represent the sample. Sample size for this study was determined according to the formula in Cochran (1963) [11]. A total sample of 300 was obtained.

Ethical approval

Ethical clearance was obtained from the University of Port Harcourt Research Ethics Committee, Bayelsa State Ministry of Health Research Ethics Committee and the CDC of the various communities.

Sample collection and processing of blood for circulatory antigen

The blood samples were collected from consented individuals with the help of a nurse from the Primary Health Centers after when the importance of the study was explicitly elucidated to them. A self-designed questionnaire tagged: the knowledge, attitude and perception of lymphatic filariasis was also given to the consented individuals to fill. Duly filled questionnaires were retrieved and checked for correctness in a Microsoft excel. One millilitre (1 ml) of peripheral blood samples were collected from three hundred (300) participants using a fingerpick method into micropipette and duly labelled. A drop of the blood specimen was applied into the sample well filarial test kits (Filariasis IgG/IgM Cat: IFI-422, Version: 02; Encode Medical Engineering Co., China), followed by a drop of diluent buffer. The test kit was allowed to lie parallel on a plane surface. Results were then read in 15 minutes. A positive result was recorded when a coloured line appears in a control region (C) region T1. When coloured line appears in the control region (C) appears but no line appears in test line regions T1 or T2, the result was recorded as negative. An Invalid result was recorded when the Control line fails to appear in both C and T1 or T2.

Data analysis

Descriptive statistics such as frequency and percentage was used to show the frequency of occurrence of lymphatic positive cases among the participants. The relationship between variables was assessing using chi square at 0.05 level of confidence. These analyses were done using Statistical Package for the Social Sciences (SPSS) version 23.0.

Results

Socio-demographic data of study population

A total of 300 participants were sampled in four randomly selected communities in Yenagoa Local Government Area of Bayelsa State; 116 representing 38.7% were male and 184 (61.3%) were female. The age characteristics of the population were 10-20 (15.3%), 21- 30 (25.7%), 31-40 (27.3%), 41-50 (13.3%) 51-60 (10.7%) and 61 and above (7.7%). The educational qualifications were more of the secondary school level representing (39.3%) followed by non- formal education (22.7%), tertiary (20.3%) and the least was the primary education level (17.7%). The occupational characteristics of the study population in order of their increasing frequency are farming/fishing (18.3%), trading (23.0%), others (27.0%) and students (31.7%). More of the respondents were married (44.0%) and the least was separated (5.3%). The variations of the study population. Details of the demographic information of the study population are shown in Table 1.

Table 1: Socio-demographic data of study population

Overall prevalence of circulating filarial antigen in the study communities

Out of 300 participants examined for circulating filarial antigen, 3(1.0%) were positive. More infection (2.7%) was recorded in Agbura, followed by Yenizue-gene (0.9%). None showed positive in Tombia and Akenfa communities. Differences in the community variation of circulating filarial antigen was not significant (χ²=3.308; P>0.347; p>0.05). Higher prevalence (1.4%) of the circulating filarial antigen was recorded in rural settlement than in urban settlement (0.6%). Although the variation was not significant (χ²=0.487^a; P>0.485) (Table 2). More males 2(1.7%) than females 1(0.5%) Differences was not significant (χ²=1.002^a; P 0.317) (p>0.05). The prevalence decrease with increase in age with highest prevalence (2.6%) was recorded among age bracket 21-30, followed by age bracket 31-40 (1.2%). Differences in the age variation of the circulating filarial antigen (χ²=^s3.499^a; P 0.631) was not significant (p>0.05). Among the infected individuals, the highest prevalence (1.9%) was recorded among those with primary education; followed by non-formal education (1.5%) while the least (0.9%) was among secondary education. Differences (X² 1.217^a; P 0.749) was not significant (p>0.05). The highest prevalence was among the Farming/fishing occupation (3.6%), followed by trading (1.5%) (Table 3).

Table 2: Overall prevalence of circulating filarial antigen in the study communities

Table 3: Prevalence of Circulating Filarial Antigen by Socio-economic Status across Sex

Knowledge on Lymphatic Filariasis (LF) in the study location during March-May, 2020.

Detailed information on the knowledge of Lymphatic filariasis is shown in the Table 4. Out of the 300 individuals that participated in the study, 101 (33.7%) had knowledge of lymphatic filariasis while 199 (66.3%) had no knowledge of LF. Only 13 (4.3%) heard that lymphatic filariasis was transmitted by mosquito, 33 (11.0%) believed it was due to stepping on charms (juju), 42 (14.0%) believed it was due to inadequate personal hygiene, 17 (5.7%) stepping on dirty water while 190 (63.3%) had no knowledge on the mode of transmission of lymphatic filariasis. With regards to the socio- economic impact, 64 (21.3%) acknowledged that it was personally uncomfortable in public, 27 (9.0%) admitted that LF affects work and income, 17 (5.7%) believed that it affected sexual relationship with spouse while 192 (64.0%) had no idea on the socio-economic impacts of LF. Only 23 (7.7%) believed that lymphatic filariasis could be prevented and managed by sleeping under mosquito nets while 67 (22.3%) believed it could be prevented and managed by keeping the environment clean.

Table 4: Respondents Knowledge on Lymphatic Filariasis (LF)

Discussion

The prevalence of Circulating Filarial Antigen (CFA) in Yenagoa Local Government Area of Bayelsa State was 1% and was considered to be low. The low prevalence rate was comparable with 0.22% and 0.0% prevalence in two locations in Suriname and Trinidad respectively, 0.11% in Cameroun, 0.4% in Central Nigeria and (0.5%) prevalence in Rwanda [12-15]. However, the prevalence rate was two-fold lower than the 2.4% prevalence recorded in Ogun State, Nigeria and elsewhere in South-South region [4,5,14]. The low prevalence rate had been attributed to mass administration of filarial drugs. The low circulating filarial antigen in this present study may not be unconnected with the sample sizes.

This drift of prevalence rates across communities was also observed and has been reported elsewhere in Nigeria [16,17]. The higher prevalence of LF in Agbura in this study was attributed to the poor socio-economic status of the people. Poverty, poor environmental conditions, poor access to medical facilities and poor housing systems were prevalent in Agbura as a representative of the rural settlement. The poor housing system and the occupation of the people may have predisposed them to the bite of the insect vector mostly Culex quinquefasciatus. Yenizue-gene and Akenfa are communities within the urban areas. The low prevalence may be due to the improved housing and access to medical facilities. The overall prevalence of the filarial antigen in rural than in urban settlements agrees with Elkanah et al. but contrasts the observation that lymphatic filariasis are considered as an urban disease [16,9]. However, the prevalence in rural settlement is an affirmation that the disease which was once an urban disease have adapted to rural areas [1,4].

More males than females were infected. Similar reports have been recorded in Amassoma, Bayelsa State; in Zamfara State and in Ogun State [11,16,17]. However, in some other reports, females were more infected than males [18,19]. More infection in males in this present study is an indication that males are more predisposed to mosquito bites due to their high involvement in fishing and farming activities in the study area. Although, the biting rhythm of the mosquito and fishing activities were not compared in this present study, Ebenezer et al. [20], have reported that the peak biting period of mosquitoes correspond with the fishing activities in the coastal area in Bayelsa State. The insignificant differences between male and female infection in this present study implies that both male and female are engaged equally in activities that exposed them to the vector.

In this present study, prevalence decreases as age increases. This is in in accordance with Ebenezer et al. [11,13]. More infection among age (21-30) could be due to their more involvement in activities that may have predisposed them to the vector including farming and fishing. The age bracket>60 had no result of circulating filarial antigen. This result contrasts the report of Muawiyya et al. Who reported that age bracket 51-60 yrs had the highest prevalence. The differences in occupation related prevalence of circulating filarial antigen was not statistically significant among farming/fishing, traders and students [19].

The knowledge about lymphatic filariasis in the study communities was low. Some believed it was transmitted by stepping on charm (juju), inadequate personal hygiene and stepping on dirty water while only few of them acknowledged that lymphatic filariasis was transmitted from mosquito bites. The low knowledge about lymphatic filariasis in the present study contrasts the reports elsewhere who reported that majority of the participants were aware of lymphatic filariasis and recognized the disease mainly by its disfiguring manifestation [21]. None of the respondents also had any knowledge of MDA programs or drugs used in the treatment or prevention of lymphatic filariasis. Hence, it was not surprising that the respondents in the study were ignorant about lymphatic filariasis. Sensitization on Lymphatic Filariasis was also poor in the rural and urban areas of Bayelsa State, Nigeria. The perception on socio-economic impacts of lymphatic filariasis was observed to be high across the study communities. [5, 22-24].

Conclusion

The prevalence of circulating filarial antigen has been established in Yenagoa Local Government Area of Bayelsa State. Both the prevalence rate of circulating filarial antigen and knowledge of LF was low in the study area. The infection exists both in rural and urban communities, although the prevalence rate in rural settlements were higher than those in urban settlements. This may be due to her poor housing system, low level of health education, inadequate health care facilities and the occupation of the people which may have predisposed them to the bite of the insect vector mostly Culex quinquefasciatus. In the study area, both gender and age groups were infected with circulating filarial antigen.

Acknowledgement

We appreciate the assistance of the communities’ head for allowing the research to be done in their communities. We also appreciate all the volunteers during the blood collections.

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