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Gender and ethnic differences in onchocercal skin disease in Oyo State, Nigeria
W R Brieger1, O O Ososanya, O O Kale
1African Regional Health Education Centre, College of Medicine, University of Ibadan, Nigeria.
Abstract:
During preparation for a study on the effects of ivermectin treatment on onchocercal skin disease in the Ifeloju Local Government Area of Oyo State, Nigeria, 1032 adults aged 20 years and older were examined for skin lesions and palpable nodules. It was found that for 4 types of skin lesions, acute papular onchodermatitis (APOD), chronic papular onchodermatitis (CPOD), lichenified onchodermatitis (LOD) and depigmentation (leopard skin), as well as for subcutaneous nodules, females had a significantly higher prevalence than males. Although the area is inhabited primarily by the Yoruba people, the study also included some of the cattle-herding Fulani ethnic group. The reactive skin lesions, APOD, CPOD and LOD, were found to be more common among the Fulani, although there were no significant differences in leopard skin and nodules between both groups. While there is need for further research on both immunological and behavioural factors that may lead to these differences in disease. The need to achieve equity in health programming by ensuring that women and ethnic minorities receive full disease control services is of more immediate concern.
Insights
Onchocercal skin disease is more prevalent in Nigerian women and the Fulani ethnic group. Further research and equitable health programming are needed to address these disparities in onchocerciasis control.
Area of Science:
- Dermatology
- Public Health
- Epidemiology
Background:
- Onchocerciasis, a parasitic disease, causes significant skin manifestations.
- Skin lesions and nodules are common symptoms of onchocerciasis.
- Understanding disease prevalence across different demographics is crucial for effective control.
Purpose of the Study:
- To determine the prevalence of onchocercal skin disease and nodules in adults in Oyo State, Nigeria.
- To investigate potential differences in disease prevalence between genders and ethnic groups.
- To inform public health strategies for onchocerciasis control.
Main Methods:
- A cross-sectional study involving 1032 adults aged 20 years and older.
- Examination for four types of skin lesions: acute papular onchodermatitis (APOD), chronic papular onchodermatitis (CPOD), lichenified onchodermatitis (LOD), and depigmentation (leopard skin).
- Assessment for subcutaneous nodules and analysis of prevalence by gender and ethnicity (Yoruba and Fulani).
Main Results:
- Females exhibited a significantly higher prevalence of all four skin lesion types and subcutaneous nodules compared to males.
- Reactive skin lesions (APOD, CPOD, LOD) were more common in the Fulani ethnic group than the Yoruba.
- No significant differences in the prevalence of leopard skin or nodules were observed between the Fulani and Yoruba groups.
Conclusions:
- Gender and ethnicity are associated with differential prevalence of onchocercal skin disease manifestations.
- Immunological and behavioral factors may contribute to observed disparities.
- There is an urgent need for equitable health programming to ensure women and ethnic minorities receive comprehensive onchocerciasis control services.