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

Main Article Content

F. O. Ogebe
Abah Daniel
P. A. Burbwa


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.

River blindness, ivermectin, perception, cost of illness, Nigeria.

Article Details

How to Cite
Ogebe, F. O., Daniel, A., & Burbwa, P. A. (2020). Effects of Direct Costs of River Blindness Illness and Perceived Benefits of Community-directed Treatment with Ivermectin in Rural Households of Benue State, Nigeria. Journal of Advances in Medicine and Medical Research, 32(1), 117-130. https://doi.org/10.9734/jammr/2020/v32i130359
Original Research Article


Vos T, Abajobir AA, Abbaafati C, Abbas KM, Abate KH, Abayan V. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017. [CrossRef]. 2016;390:1211-1259.

Uttah EC, Simonson PE, Pederson EM, Udonsi JK. Sporadic onchocerciasis in the lower Imo river Basin, Nigeria. African Journal of Applied Zoology and Environmental Biology. 2004;6:76–85.

Ubachukwu PO. Socio- economic impact of onchocerciasis with particular reference to females and children: A Review. Animal Research International Journal. 2006;3(2): 494–504.

Xu K, Evans D, Mald K, Zeramdini R, Klavus J, Murray C. Household catastrophic Health expenditure: A multi-country analysis. The Lancet. 2003;362.

Amazigo UO, Noma M, Boatin BA, Etya’ale DE, Seketeli A, Dadzie KY. Delivery systems and cost recovery in Mectizan treatment for onchocerciasis. Annals of Tropical Medicine and Parasitology. 1998; 92(Suppl.1):523-531.

Meredith SED, Cross C, Amazigo UV. Empowering communities in combating river blindness and the role of NGOs: Case studies from Cameroon, Mali, Nigeria and Uganda. Health Resource Policy and Systems. 2012;70:10-16.

National Bureau of Statistics, [NBS] Statistical Report, Abuja; 2004.

National Population Commission, [NPC] National Population Census Report, Abuja; 2006.

Hodgson TA, Meiners MR. Cost of illness methodology: A guide to current practices and procedures. Milbank Memorial Fund Quarterly. 1982;60(3):429–462.

Nnaji A, Ozo G. Prevalence of onchocerciasis in primary school children- The situation in Nike Enugu State of Nigeria. Orient Journal of Medicine. 2001; 13(1-2):82-84.

Jimoh A, Sofola O, Petu A, Okorosobo T. Quantifying the economic burden of malaria in Nigeria using the willingness to pay approach. Cost effectiveness resource allocation. Biomed. Central Ltd. 2007;5(6): 1–17.

Asante FA, Asenso-Okyere K. Economic Burden of Malaria in Ghana; 2003.

Awoniyi SOM, Amos TT, Omole MM. Rice famers productivity in Nigeria: How has malaria not helped International Food Policy Research Institute? Discussion Paper, Washington DC, 2006-1007; 2012.

Jiang YS, Braun J. The economic cost of illness and household coping strategies in Western rural China, Chinese Rural Economy. 2005;11:3-39.

Russell S. The Economic burden of illness for households in developing countries: A review of studies focusing on Malaria, Tuberculosis, Onchocerciasis and Human Immunodeficiency virus (Acquired Immuno-deficiency Syndrome). American Journal of Tropical Medicine and Hygiene. 2004;71(suppl. 2):147–155.

Oluwepo RA. Determining rural farms’ income: A Rural Nigeria Experience, Journal of Africa Studies Development. 2010;2(4):99-108.

Central Bank of Nigeria (CBN, 2017): Dollar to Naira Exchange Rate.

Ugwuja VC, Adesope OM, Odeyemi TJ, Matthews-Njoku EC, Olatunji SO, Ifeanyi-Obi CC, Nwakwasi R. Socioeconomic characteristics of farmers as correlates of fertilizer demand in Ekiti State, Southwest Nigeria: Implication for Agricultural Extension. Greener Journal of Agricultural Science. 2011;1(1):48-54.

Joseph N, Siewe F, Michael M, Deby M. Single versus multiple dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo. Journal of Tropical Medicine and International Health. 2011;20(10):28-42.

Mahal A, Karan A, Engelau M. The economic implications of non-communicable disease for India. World Bank: Washington, DC Google Scholar; 2010.

Hong W, Licheng Z, William H. Ill health and its potential influence on household consumption in rural China. Health Policy. 2006;78:167-177.

Beegle K, Weerdt JD, Dercon S. Adult mortality and consumption growth in the age of HIV/AIDS. Economic Development and Cultural Change. 2008;56:299-326.

Liu YL, Rao KQA, Hsiaq W. Medical expenditure and rural impoverishment in China. Journal of Health Population and Nutrition. 2003;21(3):216-22.

Lawrence G, Leafasia T, Seridan T, Hills S. Control of scabies, skin sores and haematuria in children in the Solomon Islands another role for ivermectin. Bulletin of the World Health Organization (WHO). 2005;83:34-42.