{
  "abstract": "Background\n\nOnchocerciasis (river blindness) persists in Bo District, Sierra Leone, despite decades of ivermectin-based mass drug administration (MDA). Programmatic efforts have prioritized parasitological and ocular outcomes, so the socio-economic and psychological burden of the disease within affected communities remains poorly quantified. We aimed to determine the magnitude, structure and distribution of this non-clinical burden.Methods\n\nWe used an explanatory sequential mixed-methods design (QUAN → qual). In the quantitative phase, 1,500 adults across five endemic chiefdoms of Bo District (Bagbwe, Baoma, Gbo, Selenga, Tikonko) were surveyed using multistage cluster sampling. Socio-economic impact (range 0-2) and psychological impact (range 0-3) were each measured with a formative composite index summing binary items on economic hardship, education/employment obstacles, emotional well-being, social stigma, and self-esteem. Instruments were forward- and back-translated into Mende, pilot-tested (Cronbach's α = 0.76-0.81), and administered on Android tablets using ODK Collect. We used chi-square tests, one-way ANOVA, independent-samples t-tests and Spearman correlation in JASP (v0.18). Eleven key informant interviews and eight focus group discussions (five participants each, n = 40) were analysed thematically to explain the quantitative findings. Ethical approval was granted by the Njala University Institutional Review Board (NUIRB) on 14 April 2024.Results\n\nThe burden was extensive: 71.7% (95% CI 69.4-74.0) of respondents reported economic hardship and 95.8% (95% CI 94.7-96.7) scored at least one psychological impact. The socio-economic and psychological indices were statistically independent (ρ = .026, p = .311) and did not differ significantly across chiefdoms (F(4,1495) = 1.91, p = .106), sexes (t(1498) = 0.26, p = .796), or age groups (F(2,1497) = 0.80, p = .451). Qualitative themes described a productivity-poverty cycle, stigma experienced as \"social death,\" and an unrecognized gendered caregiving load.Conclusions\n\nOnchocerciasis imposes a pervasive, uniformly distributed dual burden in Bo District that is invisible to parasitological surveillance. Morbidity-management, stigma-reduction and psychosocial support should be delivered population-wide and integrated into primary healthcare and MDA delivery rather than targeted narrowly at demographic risk groups.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Public Health, School of Medical Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone. augustineb.moseray@njala.edu.sl.",
    "Department of Public Health, School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone. augustineb.moseray@njala.edu.sl.",
    "Ernest Bai Koroma University of Science and Technology, Port Loko Campus, Port Loko, Sierra Leone.",
    "School of Medical Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Augustine Bob Moseray",
      "orcid": "0009-0000-2145-1327"
    },
    {
      "affs": [
        2
      ],
      "name": "Alhaji Brima Gogra"
    },
    {
      "affs": [
        3
      ],
      "name": "Rashid Ansumana"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a1jg4wf7ms4g8.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-28720-3",
  "fulltext_url": "https://europepmc.org/articles/PMC13685242",
  "id": "a1jg4wf7ms4g8",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://europepmc.org/article/MED/42907833",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RA1-1270"
    ],
    [
      "openalex",
      "2725|Parasitic Diseases Research and Treatment"
    ]
  ],
  "openalex": "W7171283099",
  "pdf_url": "https://europepmc.org/articles/PMC13685242?pdf=render",
  "pmcid": "PMC13685242",
  "pmid": "42907833",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/a1jg4wf7ms4g8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42907833",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42907833"
    },
    {
      "first_seen": "2026-10-30T13:46:30Z",
      "native_id": "23584b757ddc4c5291087b4d03adc57d",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12889-026-28720-3"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Parasitic Diseases Research and Treatment",
      "subfield": "infectious-disease"
    }
  ],
  "title": "The pervasive socio-economic and psychological burden of onchocerciasis in endemic communities of Bo District, Sierra Leone: an explanatory sequential mixed-methods study.",
  "title_text": "The pervasive socio-economic and psychological burden of onchocerciasis in endemic communities of Bo District, Sierra Leone: an explanatory sequential mixed-methods study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:30Z",
  "url": "https://research.draconitic.com/paper/a1jg4wf7ms4g8",
  "venue": "BMC public health",
  "versions": []
}