Knowledge and attitudes toward onchocerciasis in the Thyolo highlands of Malawi

In preparation for mass distribution of ivermectin to control onchocerciasis in the Thyolo highlands of Malawi a survey was conducted to determine knowledge and attitudes toward onchocerciasis which could assist in developing educational messages. Since onchocerciasis is not known by a specific name in the Thyolo highlands, information was sought about individual perceptions of common symptoms of infection. Itching, skin thickening, nodules, or depigmentation (leopard skin) were reported by 95% of those interviews. Effective treatment was often thought by the community to be available when actually it was not. Traditional healers were not thought to be an important source for treatment of lesions associated with onchocerciasis. None of those interviewed associated Simulium damnosum s.l. with any symptoms other those related to the actual bite. Based on the information gathered, various options for ivermectin educational messages are discussed.