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Dracunculiasis Eradication
“Hopefully Guinea worm
will be the first parasitic disease ever
eradicated. If and when that happens, we
will have done it without a drug and without
a vaccine to treat or prevent the disease.
If we can do that, it will be one of the
greatest achievements in public health.”
~Dr. Ernesto Ruiz-Tiben,
technical director of the Guinea Worm
Eradication Program
Why is eradication
possible?
--Diagnosis is
unambiguous because of the emerging worm
--Transmission vector
is not mobile
--Interventions, like
cloth filters, are effective, low cost, and
simple to use
--Limited geographical
distribution
--Political commitment
from governments
Who is involved?
Logo:
Carter Center
Source
 --The
Carter Center of Emory University
*President Jimmy Carter
--Carter Center’s
Guinea Worm Eradication Program
--UNICEF
--Centers for Disease
Control and Prevention
Logo:
CDC
Source
--World Health
Organization
*Interesting
fact: Dracunculiasis has been around for
a long time (found in the remains of
Egyptian mummies). But in just 20 years, through the
collaboration of these organizations, it is
likely to be eradicated.
Logo:
WHO
Source
WHO Strategy - 1997
--Implement containment
measures in all endemic villages
--Establish
community-based surveillance systems
--Target implementation
of specific interventions
--Map all endemic
villages and maintain dracunculiasis
databases
--Manage certification
process
Containment Measures
--Cases identified
prior to emergence or at least within 24
hours after
--Containment measures
initiated immediately
Then…clean wound
--Bandage for 2-3 weeks
--Avoid contact with
water
2004 – only 34% endemic
cases were contained
Surveillance 
Table:
Example
showing recorded surveillance data
Source
Specific
Interventions
--Provide safe
water
--Health education
--Community
mobilization
--Filter distribution
--Treatment of infected
water sources
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Mapping and Databases
1993 – WHO/UNICEF created
HealthMap
--Created to service the
mapping/monitoring needs of the Dracunculiasis
Eradication Program
--Assists national eradication
programs in the successful use of GIS
--Maps produced allow for easy
visualization of problem (magnitude and location)
--Use of system requires no
special training or software
HealthMap
Picture:
Sample screens from
HealthMap
Source
The maps include information on
the following:
--Number of cases
--Distribution of safe water
supply
--Historical maps show trends
--New software in 1997
--Monthly data input and
results are automatically available for viewing
--Facilitates certification
process
Certification --
International Commission for the Certification of
Dracunculiasis Eradication (ICCDE) was established
in May 1995
--Verify and confirm
information from countries claiming absence of
indigenous dracunculiasis
--So far, 168 countries have
received certification. This includes ALL of Asia.
Picture:
Family seeking information
on dracunculiasis
Source
Carter Center Involvement
1986 – provided technical and
financial assistance to eradication programs
--Unique in its ability to
provide and mobilize the necessary components of a
successful eradication campaign
--Also, they have the political
will, financial support, technical expertise, and
strong partnerships necessary to perpetuate the
campaign.
99.5% Reduction in
the Past Twenty Years!!
1986 = 3.5 million cases
worldwide
2005 = 10,000 reported cases
worldwide
Currently, dracunculiasis is present in 12
countries in sub-Saharan Africa -- not all of
those are considered endemic…Sudan is a main concern
due to its ongoing civil war (7275 cases in 2004).
The civil war has taken a toll on, among other
things, dracunculiasis eradication efforts. All other countries, however,
are attempting to eradicate dracunculiasis as soon
as possible!
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