Background: Onchocerciasis a disease of poverty continues to place huge health, economic and social burden on communities at risk. Understanding critical factors that impact on access to treatment, acceptance and overall control measures are pivotal to the march towards its elimination. Objective: To assess Onchocerciasis perception and treatment experiences in a rural community in Cross River State, Nigeria. Methodology: A cross-sectional descriptive study using mixed method was undertaken. Data were collected using pretested questionnaire and in-depth interview guide. Quantitative data were Ejemot-Nwadiaro et al.; AJMAH, 16(2): 1-14, 2019; Article no.AJMAH.50720 2 analysed using SPSS while the in-depth interviews were audio taped, transcribed verbatim and thematic analysis done. Findings were presented in frequencies, charts, percentages, tables and quotes. Tests of significance were determined using Chi-square ( 2 ) at significance level of 5%. Results: Ignorance, myths and negative perception about the cause of Onchocerciasisas pervade in 64 (31.2%) of the respondents that did not know that the bite of infected Blackfly is the cause. Some attributed the disease to curse from the gods (45.3%) and witchcraft (23.4%). This poor knowledge is associated with lower highest attained level of education (p =0.01). Non-availability of drugs (23.9%) and lack of knowledge on where to access ivermectin (9.8%) were the major challenges to ivermectin uptake. Inequity in treatment access was identified from the thematic analysis. Conclusion: Poor knowledge of the cause of the disease, non-availability of ivermectin and misconceptions about cause of onchocerciasis had negative influence on health-seeking behaviors, discriminatory practices and treatment coverage. By integrating contextual knowledge awareness creation about Onchocerciasis into the design of control strategies will facilitate the vantage march towards achieving elimination target. Original Research Article
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