Update: Dracunculiasis Eradication -- Ghana and Nigeria, 1994
The plan for the global eradication of dracunculiasis (i.e.,
Guinea worm disease) was developed in October 1980 (1). Since 1987-
1988, Global 2000, Inc., the United Nations Children's Fund
(UNICEF), and the U.S. Agency for International Development have
assisted the Guinea Worm Eradication Programs in Ghana and Nigeria,
countries in west Africa. In 1989, Ghana and Nigeria ranked first
and second in the number of reported cases of dracunculiasis with
179,556 and 640,008 cases, respectively (2). This report summarizes
data for the two countries during 1994 and describes efforts toward
eradication of dracunculiasis.
Ghana
In 1994, Ghana (1991 population: 16 million) reported to the
World Health Organization (WHO) 8432 cases of dracunculiasis in
1347 villages with known endemic disease, representing substantial
declines in the numbers of cases (53%) and villages with known
endemic disease (42%) from 1993. Since initiation of active
surveillance in 1989, the numbers of cases and villages with known
endemic disease have been reduced by 95% Figure_1 and 79%,
respectively.
In 1994, an average of 74% of villages with known endemic
disease submitted surveillance reports on time each month; the rate
of timely reporting increased from 30%-45% during January-March
(when ethnic disturbances occurred in parts of the northern region,
which has high rates of dracunculiasis) to 98% during October-
December. During 1994, the northern region reported 69% of all
cases in the country. Five of the 10 regions reported no indigenous
cases for greater than or equal to 3 consecutive months. Overall,
65% of the reported cases were fully contained (i.e., the case was
detected within 24 hours of worm emergence, the worm extracted
surgically and/or the lesions bandaged, and the affected person
prevented from entering sources of drinking water to prevent
transmission); the percentage of contained cases increased steadily
during the year, from 30% in January to 93% in December.
Nigeria
In 1994, Nigeria (1992 population: 90 million) reported to WHO
35,749 cases of dracunculiasis in 2571 villages with known endemic
disease, representing substantial declines in the numbers of cases
(53%) and villages with known endemic disease (29%) from 1993 (3).
From July 1988 through December 1994, the annual numbers of cases
and villages with known endemic disease declined 95% Figure_2
and
56%, respectively.
In 1994, an average of 75% of villages with known endemic
disease submitted surveillance reports on time. Five of the 30
states and the Federal Capital Territory reported 66% of the total
number of cases; seven states reported no cases. By December 31,
approximately 72% of the remaining villages with known endemic
disease had begun case-containment measures designed to prevent
further transmission.
Reported by: S Bugri, MD, Ghana Guinea Worm Eradication Program,
Ministry of Health, Ghana. AA Adeyemi, MD, Nigeria Guinea Worm
Eradication Program, Federal Ministry of Health and Social Svcs,
Nigeria. Global 2000, Inc, The Carter Center, Atlanta. World Health
Organization Collaborating Center for Research, Training, and
Eradication of Dracunculiasis, Div of Parasitic Diseases, National
Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: This report documents continued progress in Ghana's
and Nigeria's efforts to eradicate dracunculiasis. However, the
civil disturbances in Nigeria and ethnic fighting in Ghana during
1994 may slow this progress. For example, during January 1995 in
Ghana, 1971 cases of dracunculiasis were reported, a 136% increase
over the 834 cases reported in January 1994. However, concerted
efforts to rapidly reinstitute eradication efforts in Ghana as the
ethnic strife subsided resulted in rapid detection and full
containment of 97% of the cases. Improvements in surveillance and
case containment in Ghana and Nigeria indicate that the two
countries may reach the goal of eradicating dracunculiasis by the
end of 1995.
Disclaimer
All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
