Onchocerciasis and non-communicable diseases in the Bafut Health District, Cameroon: Knowledge, attitudes, and practices towards community-directed treatment with ivermectin.

BACKGROUND: Onchocerciasis remains a public health problem in Cameroon despite years of community-directed treatment with ivermectin (CDTI). Its persistence increasingly overlaps with the rising burden of non-communicable diseases (NCDs). Community knowledge, attitudes, and practices (KAP) toward onchocerciasis and CDTI, as well as the coexistence of chronic NCDs, may influence the success of elimination programs. METHODOLOGY: A community-based cross-sectional study was conducted between April and June 2022 in Bafut Health District, Northwest Cameroon. Using a structured, interviewer-administered questionnaire, information was collected on sociodemographic characteristics, knowledge, attitudes, and practices related to onchocerciasis and CDTI, as well as symptoms and comorbidities associated with NCDs. Descriptive statistics were used to summarize responses, while the association between quantitative variables was determined using the Chi-square test and logistic regression analysis. Statistical significance was set at p < 0.05. RESULTS: Of the 250 respondents (mean age 40.9 ± 13.6 years), 96.8% had heard of onchocerciasis, though only 46.0% correctly identified the filarial worm as the cause. Good knowledge, a positive attitude, and good practices regarding onchocerciasis and CDTI were observed in 78.0%, 61.3%, and 90.4% of the respondents, respectively. Symptoms of onchocerciasis were reported by 188 participants (75.2%), with itching being the most common (50.4%). Of these, 46 (24.5%) also reported a diagnosis of NCD, while 84 (44.7%) reported a family history of NCDs. Arthritis (32.4%) was the most common self-reported NCD, and hypertension (14.0%) was the most frequent family history. CONCLUSIONS: This study revealed high levels of knowledge and good practices regarding onchocerciasis and CDTI; however, knowledge gaps and concerns about side effects continue to hinder the uptake of ivermectin. The coexistence of onchocerciasis with chronic NCDs highlights the need for integrated disease management and reinforced health education to support elimination goals.