Update: Dracunculiasis Eradication -- Ghana, 1992

The reported incidence of dracunculiasis (i.e., Guinea worm disease) in Ghana declined substantially during 1992 -- the third consecutive year in which reports of known cases declined. This report summarizes 1992 surveillance data for Ghana that are being used to monitor progress toward eradication of this disease (1).

During 1992, 33,464 cases of dracunculiasis were reported in 3185 villages, compared with 66,697 in 3718 villages in 1991 (a decline of 49.6%) and 179,556 in 6873 villages (a decline of 81.4%) in 1989 (1). In addition, when compared with 1991, the percentage reduction in cases reported by month increased from 20.1% in January to 34% in March, 59.9% in June, 81% in September, and 55.6% in December (Figure 1).

During 1992, at least 84% of the known affected villages reported surveillance findings to national authorities on time each month (i.e., within 20-30 days after the end of the reporting month), compared with 61% during 1991. In seven of 12 months during 1992, more than 90% of the villages reported on time. Data from villages reporting late are included in the subsequent month's report.

Data for 1991 and 1992 were based on monthly reports from trained village-based health workers in villages where the disease is endemic. These workers used visual aids (e.g., flip charts and posters) to provide health education in all villages where the disease is endemic. School teachers in areas where the disease is endemic were provided 10,000 teacher's manuals; in addition, they were provided one million pamphlets about prevention of dracunculiasis for distribution to schoolchildren beginning in December 1992.

By October 31, 1992, approximately 456,720 (66%) of the 692,000 households in villages where the disease is endemic had received cloth filters, and villagers had been instructed on use of these for filtering unsafe drinking water. A collaborative effort has been initiated to provide rehabilitated sources of safe water in 2024 villages where dracunculiasis is endemic. Unsafe water sources in 266 of the villages were being treated with temephos (Abate(Registered) *).

Reported by: Ministry of Health, Ghana. Global 2000, Inc, The Carter Center, 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: Because of the rapid reduction in endemicity of dracunculiasis, Ghana has declined from the second to the third most highly endemic country for this problem. The number of prevalent cases is less than in Nigeria and Uganda (2).

During 1992, more than 33,000 cases of dracunculiasis were prevented as a result of control interventions in 1991. As part of the goal to interrupt transmission of dracunculiasis completely by the end of 1993, Ghana has begun implementing intensive case-containment measures in all remaining areas with endemic disease.

References

1. CDC. Update: dracunculiasis eradication -- Ghana and Nigeria, 1991. MMWR 1992;41:397-9.

2. World Health Organization. Dracunculiasis -- global surveillance summary, 1991. Wkly Epidemiol Rec 1992;67:121-7.

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