Lymphatic filariasis related perceptions and practices on the coast of Ghana: implications for prevention and control

A qualitative study to investigate lymphatic filariasis related perceptions and practices that may be relevant for the design of appropriate health ed ucation and control programmes was conducted in four endemic villages in co astal Ghana. The villagers were aware of the common manifestations of filar iasis, such as adenolymphangitis (ADL), lymphoedema, elephantiasis and hydr ocele, which were specifically described with local terminology. ADL attack s were identified as the most dreaded health problem in the communities, an d elephantiasis and hydrocele also ranked high in importance among reported diseases. Generally the respondents did not accept the mosquito theory of transmission, but they believed in other physical, and in spiritual and her editary causes. Hydrocele was considered to have no link to the other disea se manifestations. The manifestations were most often treated with herbal p reparations which were used orally, smeared on affected parts or given as e nema. In some cases the affected parts were scarified before herbal prepara tions were applied. The manifestations affected the work output of its vict ims and subjected them to hardships such as teasing, unsuitability for marr iage, sexual dysfunction and divorce. Although the etiology was seen as dif ferent, the local perception of the developmental process of elephantiasis closely paralleled that of the biomedical understanding. It is suggested th at this coincidence is used as an entry point for health education, to adva nce a broader biomedical knowledge on etiology, transmission and treatment options, and thereby to ensure co-operation of the target populations in th e control of this complex disease. (C) 1999 Elsevier Science B.V. All right s reserved.