Detrimental effects of onchocerciasis on marriage age and breast-feeding.

This paper examines the extent to which onchocercal skin lesions affect the age at marriage and the duration of lactation among infected women in forest areas of Nigeria. In a retrospective study, 145 multiparous women were asked about their breast-feeding behaviour. Ninety-seven per cent routinely breast-fed after delivery, although the duration of lactation for 75 infected and 70 non-infected women was different. Of the 75 women with Onchocerca volvulus infection, 73% experienced itching during breast-feeding; 26% breast-fed for not more than 3 months compared to 2.1% of non-infected women who breast-fed for the same period (p < 0.005). A multiple regression model showed severity of onchocercal lesions as an independent predictor of shorter duration of lactation for women with O. volvulus infection. Duration of breast-feeding was reduced by more than 9 months for 6 (25%) out of 24 infected women who breast-fed infants before and after the onset of itching from lesions. Also, while the minimum age at marriage was 9 years for non-infected women, it was 17 years for women whose lesions appeared before marriage. This preliminary study suggest that incessant itching and severe onchocerciasis lesions may be important predictors of failure of women to breast-feed for longer periods in rain-forest areas of Nigeria.