Socioeconomic consequences of blinding onchocerciasis in west Africa

Onchocerciasis or river blindness, a major cause of irreversible blindness among adults, has been the focus of international disease control efforts for over 20 years in West Africa. This paper employs the international classification of impairment, disability and handicap (ICIDH) to interpret results from a field study to assess the socioeconomic consequences of onchocerciasis in Guinea in 1987. In a sample of 136 blind, 94 visually impaired and 89 well-sighted persons, decreasing visual acuity is strongly associated with mobility, occupational and marital handicaps. Individual, household and disease correlates were explored. The implications of these findings for the ICIDH concept of handicap are discussed with particular emphasis on the need to extend analysis beyond the individual when assessing the socioeconomic consequences of disabling disease.