Update: Dracunculiasis Eradication -- Ghana and Nigeria, 1991
Ghana and Nigeria, the two countries with the highest number
of known cases of dracunculiasis (i.e., Guinea worm disease) in
1991, recorded substantial declines in the reported incidence of
the parasitic infection caused by Dracunculus medinensis.
Provisional surveillance data from 1991 indicate that the combined
incidence of dracunculiasis declined 32.7% in the two countries
since 1990 and 57.5% since 1989 (Figure 1). This report summarizes
surveillance data for the two countries.
Ghana
Based on monthly reports from trained village-based health
workers in villages where the disease is endemic (1), the incidence
of dracunculiasis in Ghana declined 46.1% from 1990 to 1991. Since
1989, the number of reported cases has decreased 62.8%. In
addition, during 1991 the number of villages with endemic
dracunculiasis declined from 5111 to 3718 -- including 469 newly
detected during the year -- a net reduction of 27.3%. At the end of
1991, more than 81.3% of the known villages with endemic disease
were reporting to national authorities on time (i.e., within 30
days of the end of the reporting month); most of the remaining
villages reported late.
Nigeria
Based on retrospective surveys conducted from July 1990
through June 1991, the incidence of dracunculiasis in Nigeria
declined 28.6%, in comparison with the previous 12-month period.
Since 1989, the number of reported cases has decreased 55.9%. In
addition, the number of villages where the disease was endemic
declined from 5270 in 1990 to 4908 in 1991, a reduction of 6.9%.
States recording the highest individual reduction in cases from
1990 to 1991 included Kwara (54.8%), Ondo (48.1%), and Enugu
(31.9%). Sokoto state, with 50,452 cases in 1991, recorded a
reduction of 9.5% in the number of cases from 1990 through 1991.
Reported by: Ministry of Health, Ghana. Federal Ministry of Health
and Human Svcs, Nigeria. Global 2000, Inc, Carter Center of Emory
Univ, Atlanta. WHO Collaborating Center for Research, Training, and
Eradication of Dracunculiasis. Div of Parasitic Diseases, National
Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: The substantial reduction in incidence of
dracunculiasis in Ghana and Nigeria has been associated with
specific interventions (i.e., health education and social
mobilization, and targeted provision of safe drinking water to
populations at risk) that were implemented during the respective
national dracunculiasis eradication programs (2). The more rapid
reduction in the number of villages in Ghana where the disease was
endemic may reflect in part the smaller population of most villages
in Ghana compared with those in Nigeria. Ghana now has fewer cases
of dracunculiasis than Uganda, which has recorded more than 100,000
cases since initiating its first national search for cases in 1991
(3).
Both Ghana and Nigeria plan to implement more rigorous
monitoring of interventions in 1992 in villages where the disease
is endemic, as well as expanded use of Abate * (temephos) for
control of the intermediate host of the parasite in selected
villages. During the 1991 reporting period, Ghana completed its
transition to monthly surveillance by village-based health workers;
Nigeria will complete its transition during 1992.
References
CDC. Surveillance for dracunculiasis, 1981-1991. MMWR
1992;41(no. SS-1):1-13.
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