The demographic and human effects of onchocerciasis in villages examined in Ghana

'-i ; t g0 WoRLD HEALIH oRGAi{IZAIIoN Onchoceroj.asis Control Prograrnne jn the Yolta Rlver Baslr EpJ.d.eilio1ogical Eva-luation Urrit Ilorlci:cg Paper O1P/EPI4 6.;,J2 R. C. SAflADoGO ['iIE DflVIOGNAPHIC AI{D HUMAN EFFECTS OF ONCHO(ERCIASIS I}I VILIAGfiS ETAMINED III GHAN/L Paper presented at the Meeting of the Natior:a-l 0nohooeroiasj.s Oomittee jrl Bolgatarga Julyl 76 t THE DIITOGru'fiIIC .AND IIUXU.}I EFFECTS OE OIICHOC,EN,CIASIS U{ VIIId,GES HT..U/IU[ED III GIIAI..IA.o flrls prorisional and oonoise text (1) is to assess the relation between the ttenogmphio faotsz popula'Uion movements and thsir probable ir:flexion by Onchocerclasis. It shows, i:: a sl:orb way, the provisj-onal restrlts on the foJ-lo- wi4g : T age structr.ue of the population in vjJ-lages exa:n:ined: ags - distrC-bution by age group and age pyralrid.. - outlines of present migrating population: volune, a8e groups concezned and natrt destinatlons. - natur^al population movement. - ohange of dwe].Iing places and the abandorurent of v:Lllageso 1, Aqe .stnrctrue of the population jn villaEeis, e;<a.nl+El 1.I S-qFs d,enoqraphio i.trdereqs a) {verase vjJJaEe population In 4.o rri.Llages (or soction of viJ.tages) I the EPI teain reoorded L7.7N personsrwhioh moans that on average, the rrLllage poprrlation nr.urbered. 745. Frm these figures it is proper to rnake trryo obserrrations: - In marly cases the task cf the sociologist was to define rrthe vi.Llagerr or the cluster to be enam:Lned. The borders of the dvre].lings are not always well tieli- rnlted and. houses jl a village are often scattered and blend irithout perceptible ,/caseli-ults j.nto the nerb vallage.. Such is therlof Gengenlrper [iJ.:[, Daruguz Sekotil eto.' Pure\y sociological criteria (adrninistratlve set-trp of tire rrjJ-Iages; cluleftaincyjurisd.icti.on, the kingsidp systems, etc) si:or.rld be the on\r rneans used by the obse:rrer. DuxiJr€ the short ti.ne the team spent in the villagesl 1t was diflfioult to define suoh a criteria preciseJ-y. - On the other h.md., it was often necessaqf to r:elect a secti.on of the viJ-lage for the exanination. It has been decirled., fron epldeiclologiaa-I point of view,thatr a cluster should. have the size of about J00 persons. Tlhen the popula- tion of a vILLage e:coeeds thls figure very much, the sociologlst seleots a section vrh:loh ls to be c:caruiaed. [he choiee is made in relation to the locati-on of farus and fields i-,'ith regard. to $g3!!rgg breeding sites. u) se+ rptio Out of L5,,6L5 persons irl 58 vi-Llages or parbs of rrillages (e) , 54 are mon and 4fl" lyom.err Ind.ividtra-l rates vary in considerable prcportion, roostly in: - Yapa'r a (l:Zz ana Vil (Narrunba) - M% rerr; 55/o women ; Sabarl (f:S) (paeonua) = 5$o meln; 44" wcrrrar.- Oe the contra.rXr, Datoko (fzS) (r.ra+'r"a) shornrs a perfoct balanoe: ,€/o men; 5€o womenr. o) ottrer Lnd.sles A percent d.istribution of age groups for eaoh vi'llage visited is presented in table Io Here a-lso, one can see that iJr some cases, rer,rarkable varlations e:dst. (r) (z) A more detajLerl. report on the work doire in Ghana is ln p:repamtion. I substraoted Taruila (fr+) frora the previousJ;y 6iven tota1. furtlrerznoret 2 sociologically honogeneous vi]i€tges (tez ann L27) irave been grouped together. 2/ . . ,... 1.2 Age wt=udds lhe map presents aJ-I.age pyra.nlds of villages erern:ined, with the exceptlon of farri.:ra. A fUl-I reporb (:rl preparation) v.ri-11 anatyse and compare them with regional pyra.mid.s from the Ghana lltlas. 1.5 Aee structrrre end Qechocerciasis The a.ge pJrraJLtd uap is si-gnificant for age structr-rre of the populations vislter]. tr'rom a demographic point of view, Danugu lOSe) and Secharmsi (fof) gresent a no:ma-l g.ener"a-I pyraruld. On the other hand, the poprrlations of Asebuga(095) , Saboro (roo) r Sugu (foZ) and Kullwl (rrf) are not no::ual-ly rl.istrtbuted:in some casos the lovrer age grouirs are curtaj-Lecl (Sailor.o) , in others it is the age groups of over l0 years: these are sla11 and even non.exlsti.i:g as far as lYof,Ien are ooncetned. Al-though it is necessary to tone rtown the interpretations(3), Onchoce:rciasls maor irave 8, bearing on these observations and cause increaeed nortality in persons aged. more tlran !0 years and a general weaisress resrlting i-u, lovr feound.lty, rvl:-lch fjralljf distorts the age distributions. It is perhaps sigdflca.nt the"t the most serious cases (Vlia:r:aUa1 Apodabogor Sugrtr l(rr1fun) comespond to viJ-Iages j.:: a kqpe:r-endernic situation of Onchoceroiasiso 2, ChamotgBistj.cs of r:re_sent rIi.E+ra.tinq popuLatloJns 2.L Volune qgd. vil-Iase.s. concerned Yfith regard. to our census population figures (4) 1 the proportlon of the enigrated. peo;rIe during our visit renained 1ow: 7.L% in arithneti-o itr€E:rr The per.centage extend.s from 4.1% (SaUari) to L},.flo (r,ayonr-Vfi:rtr). Ii:e 8 viJ-Iages presented in table 2 are classj-fied as such: - 4 :n lrypor-endemio sitr:ation of Orohocer.ciasis: Keyoro-t/r.rrtr (IrZ,t{)Itssa (].:o.f/), Nakong-saboro and. seicott (5,4)-. - 4 in a Ir-igh moso-endenr:ic slttration of Orrchooe:rciasis: Darnrgu (A4r4/" of Onohocerclaii-s prevalence; 9.5% of eulgra'bion), Kparefa (AT.fl" otpi'e'ralence; 5.1" pf er,rlg:eation), Kayoro-ila-fiu (Oa.Jfi of prevalence;4.rt of enlgratton) and Saba:rt '(Ao,'l% of prevalonce and. a.il, ot emig::ation). If the vol:ne of nig:ratj-on remains relative\y Iov in relation to the popu- lations ooncertred.l it is str"ange to see that tirls eulgration, wherever it has been obse:rred. in a noticeable vr4yl affects viltages jl a l1yper-endemic situationr 2.2 Other fe-atrlnes o_f rd"eratjxE poanrlatio_rrs - AEe groups affected are mostly those of 2O-fj years v,rith a predo- nLiJutnce of 20-29 [€&rsr - Main d.estiriations are the regi-onaI centros: fanal e but parbicr.rlar\yI(unasi; Accra comes to the tLrird. positlon. 7, I{atr.Ea-1_popr:lation novengnts Herel the question is to loeow whether, vrith regard to previous Ghalta popu-lation census the resurl-ts of vririoh are recorded jn the Consus Book, there have been an j.:rcrease or decrease of the popirlations uncler the probabLe effect of Onchocerciasis, [IhILe it is not possible to present the situation for all the vi]lages exa.ni.:red.1 the case of Sekoti, one of the most affectecl by Onchocerpiasis is here-u:der given. 3) Several factors cotrJ.cl be taken into accor:nt: epj-clenios, gene::a.l Iteal-th and econoro.ic conclitj-ons, general fecund.ity condltj,onsl. cha::acte- ristj-cs of an ethn-io grcup or region (chron:ic diseases: ym) , etc.(+) On Tab1e 2 (see am.ex) r onJ.y one of the eigtrt v11Iages where a noticeable eutg::ation has been lrartially recorded. 'Ihe seven others were whol\r d.oneo 5/ """ -7 - On page s 172 and 177 of the 1970 ion Census of Ghana ecial F,eport arga. identified. The comparison betvreen the figures d.ifferent d.ates gives us t}'r.e results in the following table : rrDrr, one w'111 see 15 localities s have taken 4 which have been well ,wE of Sections Po ticn pulation an 1960 L97o l-975 948-60 1960-70 t97o-75 1948-70 rsemble ekoti ym, Agt^0 4 569l4F€. 285 56t 22t5 798 318 t75 1S6 1B09 276 101 58 l-57 187B 616 28 4O 77 l_l-02 i -5t5 tt- '-4rO -5 14 ., -tr7 - 0r1 -11r 4 -ao r5 - lt9 + Or4 +17 14 -2216 -7t2 -1219 -lo 12 -7 t6 -7 rO -3rB -0, B t948-7' ]-960-75x -114 -15 ?rx - 7rL - 516 - 216 Benzure IIyoga Dasanga Kparabook The and, ]-.5.3% dacrease in population of the rrillage is patent : 2e6/, for the whole village for l,Iyoga section. Several reasons cor-r-l-d be calted for such a decreass. The fact is thatr the nost affected. section is tj:e one mostly exposed from onchocerciasis point of viewi 4. Change of dwel-l-ine_plAc!_s and abandonmBnt of rriEages -There is no cloubt tltat/is primarily responsible in some specific cases, S!' charrge of dwel-ling places end, consequently, the abandonment of lrilIages. Ir Selirti peopLe eom:ing from the ilangod.i area said they left their original sltes because of Onchocereiasis and water shortager-.eld destructlon. of crops by elophants, but ln Sheshie (vitfage eituated' E&een Danugu and ttre Morago river) it is significant that some resettlements have taken plaee in tI:e same viLlage, further from the river. Here are some detal].s : -, Sheshig lUr/totaf of 29 families wirichQnstitute presently the village2 15 have left their ffrst site, thou3ht to be too near the rlver giving rise to rrscra.tching disease and to prog:resslve but certaln blind.ness'r (tnu lriftagers). Ort of the 15 : - 4 have resettled in the same village but galning !00 to 800 metres more away from the rlver, - 61eft to se-btle in Danugu, village 1,5 Im alYay. 3 2 left for lTalerlgu. - 4left to settle in ltrasu.rri, ItrarlJrabo, Congo and Bavrlo. respeetively. U) Setoti The Tapene sectlon whicl: was rlear the river has today conplety disappeared. the same applies to Ktangpa vrhere the rlins can still be seen. Each of these sections was inhabited by rrore than 5C farn:ilies, 4/ s I-+- In Kparabooll and Nyoga scctions, thc compor,rnds r,vhi-ch v/crc nearcr to thc rivcr have disqppca:rcd or movcd. Eyo lvitncsscs cf thcefa.cts are still livingin Selcoti, retreatcd. from thc ricinity of thc rj-vcr: morc than l7 fnmiflss whlchleft Toficne, morc than 20 others fron i(parabook, only onc surriyal from the o1d Ktangpa. 5. Conatrgsion Notvrtthstanding further analysi-s, brinuing out thc conplex influcnce of the varlous factors, we can right now assess the {mpact of Onchoccrciasis on the demographic structure and sevcral population movements in llypen-endemi c areaso NGHA}I 6IRACgg1511fi,ES DEHOGfu1PHI€UES DE tI. POPI,L,..TION DEs I,IIIJTGES EVALiJES ET ONciiOcERcosE DETIOGRAPHTC FEATI'RES OF TIIE POPUL]TTION IN IILLAGES EXAMI}IED ,lND ONCHOCERCLISIS Code 090 091 092 093 094 095 096 097 098 099 r.l0 102 103 104 105 106 10'l 108 '109 110 111 112 '113 114 '115 116 , 117 r1 18 a- 1g ) 121 .1 221 1231 124 1% 18 127 1n 1n 1. isterlska (.) d€aote vlllages partly talcen ln EPI census and evaluation. 2. a) VUl3Aes underllned vith a contlnued 11ne(-) are ln hlryer-endenlc sltuation of Onchocerclasls. b) Those underllned rlth I broken the (- - -) ,"" ln a neso-endenlc eltuatton (q0y'" fo 69fifi1. c) Those not underllned are 1n h;po-'endemlc situatloa (1Ofi to 39rgfi). 3. Tanlna has been dlscarded because of lnolgniflcant censug data. Populatlonllon du vlllage Nane of vlIIage Total M ib F ft Qrelques tranches dttge (ans) Sone age g"oups (rn years) 0-4 i ethalc Ethnie donlnante Doainatlng goup gEgcsNpE ?IIIJT SKOTI WIDINABA iPgDAqgcg AEBgCA DANUGU K,\t!RO-WURU KAloRo;Bg[u_ }I]U(ONG.ATTNTA NII(O}IG.SABORO BECILII'NST WIASI ErruBIsI [.t!EU^- lrlga_ J.ryOA S,[IGU tISA -$!1N- XPirl{t'A Eg@u NIATRI DW 14Ury _ XPASENI.(PE YACIlBA s EpE{,rgA_ -$rs-48r_ suogA- SANDUA g@p. s+F_ Eq4U9- 4K4IE4ERqM_ l{uRucu $NI'I,I DAN'KI' YI\P/J/\ 373 343 1102 n0 69 168 s71 428 *1 134 210 331 365 329 357 174 475 213 769 z71 444 zl5 456 195 ( 1oT) 376 322 340 333 370 334 443 T6 z6t %1 188 346 *z *6 49 16 47 t2 51 ,1 57 ro 49 ro 56 15 5o'2 53,7 51ro 52,2 48r6 49 r8 51 r2 45 r0 5'l '851r7 5116 51,3 52t7 5a 12 55t4 49,5 48r7 50r 8 44 '7 47 19 49 14 53r7 54r3 50 14 50 r0 4819 50,0 49,7 58ro 49,2 51 t5 47,6 50t4 52rB 4819 43tQ 51r0 4315 49 tB 46r3 49,0 47 rB 51 t4 50 t2 48r B 55ro 48.2 48r3 48,4 43t2 43t3 48, B 44 16 50 t5 51'3 58t2 51 ,1 50,0 50 13 42rO 5or8 49 15 5214 5513 52r1 50 16 4613 45 r7 49 t6 50r0 14r2 11r1 1 tr0 131 0 13t1 8rg 16,6 1o r3 1212 9r7 Brl 11 r8 11 o1 1a.o 14 ro 14.4 13rg 19 ,2 9rB ur'l 14 r4 14 19 1? t3 15 o9 15 t2 15,2 18 15 14,'l 13r0 19 19 18, 1 18 19 15t2 14 12 15t4 17 19 16.8 17,3 43t7 4216 41 13 4119 3316 37,5 5a14 1614 4 2rtr 4815 32r9 40 14 42.2 51t'l 45r7 49 14 50 t3 46r5 40 r2 50 t6 43r7 43'3 49,8 49 r7 53,8 43rB 46rB 4819 41 ,6 5214 49 to 4814 51 13 41ro 4814 46 ro 41 16 44,O 52rB 50 14 5015 4811 4o 15 4213 58r0 44 r6 49 19 54r5 39,5 50 t5 49 t9 56., 51 ,3 5816 56t2 54 r0 52r1 59 t4 46 19 53,8 55,7 52r3 63r2 5a r7 55,9 53r2 52,2 57 tB 58"/ 52rB 61 r2 51 t0 5816 55 r2 49 '654'1 Dfi 31 t5 D13 %rg 20ro 3415 34tB %r2 3o'2 31 t3 %r8 8r7 30 t'l 37,1 31 ,7 35 11 3614 45r1 3or2 32ta D13 Br4 32,3 33,8 38'6 %r6 28r2 34 rB 2ar6 33,5 pt9 35rB 36 11 %18 31 t9 %ro 24 rB %r7 l:,r 110,8 I g,t l6,l | ',, I a,e I 7,6 110,5 I t,s I ,,0I e,l I n,,| 7,1 4rg 516 9t2 519 715 12ro 8rg 8r7 10 15 5rg 2r6 9'3 10 19 8rg 4t2 1or 5 514 9 r'l oo/r/ loro 1or 1 9r2 8r0 10 12 414 13'1 11 t4 17 '11819 18r 5 1or 7 16 13 18r'l 14,4 13r4 14 rB 17 tB 17 15 1119 41 ,7 10 '315 16 1g,7 15 15 15 15 b19 10,2 14 19 14 14 lorB 15 r5 15 19 1? ,1 15 r7 't5.o 14 r'l 18r 9 1o r3 17 16 19 r7 14 t'l 2',1r8 12rB 614 6r'l 21 14 1813 21,6 2I ,4 13'5 19 ,2 1 3r0 22r4 23r'7 17 tB 16 r4 17 o3 14,8 11 ,5 15 t6 18, B 1215 11 ,4 19 ,2 15r6 14 15 17 19 15r7 15 12 15 16 15,6 13rB 15r6 1115 11 ,3 13t3 14 19 10, 1 1 1ro 1314 13t5 10,2 7t3 6r7 613 13t5 15r6 7t3 14r2 loro 14r2 16,1 11 ,1 12r1 916 14 11 12ro B16 413 14 r7 l oro 716 11 ,9 13 11 10 14 8rB lorg 815 lorB 14,g 7rB lor l 1o 13 76,.8 loro 13r6 11 ,9 11ro 11r1 Dagarl Kusase Nabdaa Kusase ^* ha-Fa tr!a-ha Blnoba KaseEa KaseDA Kasena KaseDa Bulsa Bulsa BuIsa Nanlcaoa NcDkana Manpursl Er6 & llaopursi Dagarl Dagart Lobt Slsala Ma,npursl I,lanpursl I,la'lB Maupursl Ma,npurst Chunburu Dagonba Konlconba Konkonba Chekoel Birlfor SafaJabe $rd & Dagarl Nanunba Taopulna f,ra-trla Itreilrnba NOTES: A n-D 3044 +500-1 4 5-190-19 5-14 fl c0 co\o A -l r{ r{ r{ crr \o |r\ c! + lf\c0 oLn r{ tc\ \o or c\l v)I{ o) Po I a q) r{ cd c{l9{ Sl .r{ OO .r{g{J .rl c)lr c.rOr tt .rl urd oc 'r{ .r{ .PCS 8Ett .rl A o .rJ +,d c aP{doOA .r.| .P b0g5 +€ 'r{ dat{ h0O .r{ r{f, Eo-PEHoolr{8HodHbD .r{da .Hd ,A 0)Frd(dd a (l) rq I olrl ,old\*/ +) ou2 .flH r{P Hgoo8&t{d .oo) O{ .( PlPd .r{ F.P odg o)do .rl .d r{F{ .qoo .c, .r{d.c5B QU) ool$ q0ddAr{flf, .a rq a Ho .rl {J $P ,A a o .H 0)dg o) I F{ c) P{ .h .r{ E o fl ,d o g Eoo dtf B 'd0) .5 r{t{ o rJg (n c)qc fil r-{ -{ .d a a oI{ d. .r{ql Ho .r{ Pd F{t P{ o Pr c. {J oP 0) .qP oP( o 'rlPd r{ ot{ .5 4c q) Pd B o -l C) a .A co .r{ + NHb! 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H F{ l(\ F{ tf\ r{ \O }r\ C\J.+tr\+r{rl\OC{r{ or{d r{OO .r{ ,P+:doFtd h.0 .r'lgg o .rl P H8I{rat$ o) .r{ F{Ea{ d +, oH EG C\l Ln G b- C\, 6 C! lf\GiCNGhO-6tr\olr{.+Lnr{t(\+\/ \J v v v v v L-tc\NF-r{r{}n\otf|COtr\r{r{CONrl b, Er Elql4iql Hi$l$islgrHiHi oqo cd r{ r{ E td E{ o a HHo Mf.la qr o 0) Ha I t a u t- I