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Onchocerciasis or river blindness, a major cause of irreversible blindness among adults, has been the focus of international disease control efforts for over 20 years in West Africa. This paper employs the international classification of impairment, disability and handicap (ICIDH) to interpret results from a field study to assess the socioeconomic consequences of onchocerciasis in Guinea in 1987. In a sample of 136 blind, 94 visually impaired and 89 well-sighted persons, decreasing visual acuity is strongly associated with mobility, occupational and marital handicaps. Individual, household and disease correlates were explored. The implications of these findings for the ICIDH concept of handicap are discussed with particular emphasis on the need to extend analysis beyond the individual when assessing the socioeconomic consequences of disabling disease.The author assesses the impact of decreased visual acuity, including irreversible blindness, on 319 individuals in northeast Guinea, an area in which onchocerciasis (river blindness) is highly endemic. 136 of the individuals in the 1987 study were blind, 94 visually impaired, and 89 well-sighted. Subjects' visual statuses were classified based upon the international classification of impairment, disability, and handicap (ICIDH). Analysis found individuals' decreasing visual acuity to be strongly associated with mobility, occupational, and marital handicaps. Individual, household, and disease correlates were explored. The implications of these findings for the ICIDH concept of handicap are discussed with particular emphasis upon the need to extend analysis beyond the individual when assessing the socioeconomic consequences of disabling disease. |
