02783nas a2200457   4500000000100000008004100001653001600042653003100058653001800089653002200107653002700129653001500156653001400171653001900185653001600204653000900220653001500229653001100244653004200255653002100297653001700318653001100335653003700346653002900383653002500412653001000437653001500447100001800462700001500480700001200495700001400507700002000521700001400541700002400555245007000579856006900649300001000718490000800728520157500736022001402311       2012                            d10aYoung Adult10aSurveys and Questionnaires10aSocial stigma10aSocial Perception10aRejection (Psychology)10aPrevalence10aPrejudice10aonchocerciasis10aMiddle Aged10aMale10aIvermectin10aHumans10aHealth Knowledge, Attitudes, Practice10aHealth Education10aFocus Groups10aFemale10aDemocratic Republic of the Congo10aCommunity health workers10aAntiparasitic Agents10aAdult10aAdolescent1 aTchounkeu YFL1 aOnyeneho N1 aWanji S1 aKabali AT1 aManianga Célé1 aAmazigo U1 aAmuyunzu-Nyamongo M00aChanges in stigma and discrimination of onchocerciasis in Africa.  uhttp://trstmh.oxfordjournals.org/content/106/6/340.full.pdf+html  a340-70 v1063 a<p>Forms of onchocerciasis-related stigmatisation, following over 10 years of implementation of community directed treatment with ivermectin (CDTI), were documented through a survey conducted between September and November 2009 to look at perceived changes in stigma over the past 7-10 years. We documented people's perceptions towards stigma before and after the introduction of CDTI from 1600 structured interviews with households selected from the community treatment registers; in-depth interviews with 57 community leaders, community directed distributors and health personnel; 33 focus group discussions with male and female community members in different age groups (18-24, 25-54 and ≥55 years) and 13 case studies. People with onchocercal skin disease (OSD) with rough skin, swellings and rashes were the most stigmatised. People still fear sexual intimacy with infected persons. In the past, people with OSD were considered unclean and stigmatised because of fear of OSD transmission and embarrassment. People who had lived in the community less than 5 years tended to stigmatise OSD patients more than those people who had lived in the community for longer than 5 years. The youth stigmatised the most. Although stigmatisation persists, avoidance of people with OSD decreased from 32.7% to 4.3%. It is notable that treatment availability has improved relationships between healthy people and those with OSD symptoms in endemic communities and this can be attributed to CDTI. Health education should be emphasised in the communities during distribution.</p>
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