Eradicating Dracunculiasis – Where are we? September 16, 2013 by Dr Abdu Adamu, Dracunculiasis otherwise called Guinea Worm was once a significant public health problem with over 3.5 million cases endemic in 20 countries as at 1986. However, extensive and systematic interventions over time have steadily resulted in a gradual drop in number of reported case. According to WHO, 1058 cases were reported in 2011, and 542 cases were reported in 2012 and between 1st January 2013 and 28th February 2013, only 1 case was reported as against 6 in the same period in 2012. The interventions were remarkably effective, in fact, the disease has since being targeted for global eradication and if successful it would become the first parasitic infection to be eradicated and even more interesting is that it does not have any medicine or vaccine. The disease is caused by a nematode called Dracunculus medinensis and humans primarily become infected when they ingest water contaminated with the copepods that host the Dracunculus larva. History shows that this disease dates back to the 2nd century as descriptions of it were documented by Greek chroniclers and with information about it being mentioned in the Ebers Papyrus. Dracunculiasis is derived from Latin meaning “affliction with little dragons” and the name Guinea Worm emerged in the 17th Century when Europeans saw the disease on the Guinea Coast of West Africa. It is found in some of the poorest place in the world especially in areas with water shortage as such preventive efforts were tailored in that direction. As a disease which is only transmitted by drinking contaminated water, preventive measures taken were basically to ensure people don’t drinking contaminated water and also to prevent people with emerging disease from entering any water source used for drinking. The CDC, UNICEF, WHO, Carter Center and other agencies came together to fight this disease through the Guinea Worm Eradication Program after the mandate of the World Health Assembly (WHA) in 1986 to eradicate Guinea Worm. These agencies collaborated with the government of countries where the disease was endemic and they instituted interventions like ensuring adequate and clean water supply, use of larvicide, boiling drinking water, water filtration among others in an effort to ensure that individuals don’t ingest contaminated water. Disease surveillance was embarked on through village search for case and prompt measures to ensure that an individual with an emerging disease don’t go near sources of drinking water. Also, infected people place their legs in buckets of water as the parasite release a lot of its larva in that process making it less infective. The progress of these interventions was quite significant and in 1991 the WHA set a goal to eradicate the disease by 1994. This was not achieved due to lack of adequate funds even though considerable progress was made. In 2004, the WHA set a new goal to eradicate the disease in 2009 but this was also not achieved, however eradication efforts continued. As of today, this disease is only endemic in 4 countries; Chad, Ethiopia, South Sudan and Mali. The WHO’S International Commission for the Certification of Dracunculiasis Eradication as of 1st January 2012 certified 192 countries and territories as free of Dracunculiasis transmission. nigeriandoctor.wordpress/2013/09/16/eradicating-dracunculiasis-where-are-we/ Interesting to note, is that as of 1988, Nigeria had the highest number of people infected with Guinea Worm, with more than 650, 000 cases reported in all its states; however because of the efforts of international organizations like The Carter Center and a willing Ministry of Health poised to fight the disease, rapid decline was immediately recorded, and the success of Nigeria’s program motivated several other African countries. As of November 2008 transmission was said to have stopped in Nigeria. The complete eradication of Dracunculiasis globally would be one of the key achievements of mankind and would serve as an important evidence of the benefits of global health. Authored by Dr Abdu Abdullahi Adamu (MBBS) Federal Medical Center, Azare Email: audu86@yahoo Phone: 08065459980
Posted on: Mon, 16 Sep 2013 23:54:00 +0000
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