Onchocerciasis: The potential of patient education in the control of a tropical disease

Onchocerciasis control programmes have usually focused on vector control measures which involve large scale, expensive aerial spraying of breeding sites along major rivers. The commonly used treatment, diethylcarbamazine citrate, requires continuous treatment three or four times a year, giving onchocerciasis the profile of a chronic disease. This profile, plus the severe itching provoked by the drug, create compliance problems which a patient education approach at village level might solve. In this study an experimental group of 32 patients received free drugs in two 3-week treatment blocks along with group counseling, development of coping skills, social support and individual counseling as needed. The 28 control patients received only free drugs and an orientation on how to take these. The experimental group demonstrated consistently better appointment keeping and medication consumption. They also complained less during the initial week of each treatment block when drug side effects would normally be more noticeable. The results imply that onchocerciasis control programmes that include a treatment component should also include patient education interventions at the primary care level.