ARI Volume 2 Number 1.pdf - Zoo-unn.org

OKAFOR, Fabian Chukwuemenam and OMUDU, Edward Agbo 256begin to address some of these socio-culturalbeliefs when developing intervention strategiesrather than focusing only on the biologicalmechanism through which these diseases operate.SOME PARASITIC DISEASES WITH SEXUALREPERCUSSIONSOnchocerciasis: Onchocerciasis, or riverblindness is caused by a filarial parasiteOnchocerca volvulus and transmitted by the bitesof blackfly Simulium species. This disease is ratedas a leading cause of blindness and about 20million people are infected worldwide while onemillion of those infected are totally or partiallyblind (Edungbola and Parakoyi, 1991).Onchocerciasis can manifest in several dramaticand bizarre forms with an incredible adverseimpact on agriculture, demography and socioeconomicconditions. It causes extensive skindisfiguration with unbearable discomfort. However,its most dreadful and terminal complication isblindness.Besides blindness, hernias, leopard skin,hanging groins and elephantiasis have beenidentified as important complications ofonchocerciasis in areas where the disease isendemic (Edungbola et al., 1991). While theassociation between hanging groins and herniashas been reported (Williams and Williams, 1966) ithas been established that hernia is a definite andmajor complication of onchocerciais (Nelson 1958,Edungbola et al., 1991).The medical and socio-economicseriousness of these complications ofonchocerciasis such as hernias, elephantiasis,hanging groins are often associated with sexualdisability because of the severe enlargement oforgans and disfiguration. Scrotal elephantiasis andhernias constitute formidable psychological burdenfor infected individuals as a result of obvioussexual repercussions. Partner desertion andabandonment often characterize such situations.In addition to the sexual incapacitation, scrotalelephantiasis and hernias also lower theproductivity and wage earning capacity of thoseafflicted.Gender roles also influence theconsequences of these manifestations ofonchocerciasis (Hartigan,1999, Harnson, 1999).For example masculinity is often demonstratedthrough multiple sexual conquests and control ofresources. Men who develop scrotal elephantiasis,hernia or hanging groins find it very difficult, if notimpossible, to engage in sexual intercourse inaddition to lower productivity. Women, on theother hand depend more on their physicalappearance to enhance their prospects formarriage and sustaining a relationship with malepartners, developing any of these onchocercalmanifestations jeopardise these aspirations.The skin manifestations in onchocerciasisare characterised by severe dermatitis and itching,the thickening and atrophy of skin and pigmentaryaberrations. Obikeze (1992) reported that thesepigmentary aberration (onchodermatitis) has verygrave social, economic and psychologicalimplications for victims of onchocerciasis. Youngwomen and men with the disease arediscriminated against, humiliated by peers,avoided by friends and stigmatized by society.Married women with onchodermatitis lose theaffection of their husbands while marriage chancesof infected persons are adversely affected, if nottotally ruined. Psychologically, onchodermatitisengenders withdrawal behaviour, isolationism andsocietal maladjustment on the part of the affectedindividual.Ovuga et al. (1995) investigated someaspects of social anthropological implications ofonchocercal skin disease in Nebbi district inUganda. Results indicated that onchocerciasis wasconsidered to be mysterious disease, especially thedermal manifestations of lizard and leopard skin.The disease was often mistaken for measles andleprosy and as such affected individuals sufferedfrom discriminatory practices applied on sufferersof measles and leprosy. The belief systems of thecommunity were said to be responsible for thediscriminatory practices of the people againstthose affected by onchocercal skin diseases.Persons who had these skin conditions rankedseparation from spouses as the most painfulaspect of the stigma.Lymphatic Filariasis: Lymphatic filariasis iscaused by the filarial nematode Wuchereriabancrofti and transmitted by the bites of Culexmosquito species. Although the disease caused bythis parasite is rarely fatal, the morbidity due tothe disease is high due to lymphoedema andhydrocoele which are results of impairment inlymphatic drainage. The socio-economicimplications of this disease include social isolationor stigma in reaction to the enlarged limbs orhydrocoel (WHO 1998).It is estimated that 40 million peoplesuffer from the chronic, disfiguring manifestationsof this disease, including 27 million men withtesticular hydrocoele, lymph scrotum orelephantiasis of the scrotum (Dreyer et al. 1997).An estimated 13 million people, the majority ofwhich are women have filarial-associatedlymphoedema or elephantiasis of the leg, arm orbreast (WHO 1998). Although lymphatic filariasis isranked as the second leading known cause ofdisability worldwide (WHO 1998) little attentionhas been paid to the important but hidden