Investigation of an onchocerciasis educational intervention for improving knowledge, attitude, and prevention practices among endemic communities in Ghana

Jamila Taffe¹Ekbal Djibril¹Sandra Abankwa Kwarteng²Patrick Obuam²Ernest Ampon²Sarah Franklin¹Eric Laarison Bawah²Pauline E Jolly^1*

• ¹University of Alabama at Birmingham, Birmingham, United States
• ²Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Background: Despite substantial efforts to eliminate onchocerciasis, the disease remains a significant public health problem in endemic communities in Ghana. We investigated the suitability of an educational intervention as an effective tool to strengthen onchocerciasis knowledge, attitudes, and prevention (KAP) among residents in endemic communities in southern Ghana. Methods: The intervention consisting of a pre-test, a PowerPoint presentation covering the agent, vector, symptoms, groups at risk, treatment, prevention practices, and misconceptions of onchocerciasis, and a post-test was conducted in nine communities of three districts from June to August 2024. Results: Four hundred and eighty residents participated in the study. Comparison of pre-test with post-test scores showed significant improvement in KAP for 17 of the 21questions. Scores related to the organism and vector for onchocerciasis increased from 11.0% and 35.2%, respectively, on the pre-test to over 95.0% for both on the post-test. Regarding symptoms, while 69.4% reported itching of the skin, only 6.3% knew that eye disease and blindness was a major symptom; these responses increased to 97.0% and 86.6%, respectively, on the post-test. No respondent knew the correct breeding places of blackflies on the pre-test compared to 92.0% on the post-test. Participants' scores also improved significantly regarding attitude and prevention questions, such as whether they would try to prevent onchocerciasis, methods to prevent blackfly bites, and willingness to participate in the next mass drug administration (MDA) of ivermectin. On the post-test, the majority of participants felt they were better prepared in preventing onchocerciasis (99.1%), and in educating others (98.5%). Conclusion: This educational intervention improved the KAP of residents and seems to be an effective tool for strengthening onchocerciasis literacy and prevention practices in vulnerable communities. Follow-up of the intervention along with timely MDA of ivermectin should lead to decrease in onchocerciasis transmission and eventual elimination of the disease.