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Epidemiologic Notes and Reports Regional Workshop on Dracunculiasis in Africa

The First Regional Workshop on Dracunculiasis (guinea-worm disease) in Africa was convened at the Palais des Congres in Niamey, Niger, from July 1-3, 1986. Over 50 participants attended, including representatives of 14 of the 19 African countries affected (Benin, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Ethiopia, Guinea, Mali, Niger, Nigeria, Senegal, Sudan, Togo, and Uganda). The objectives of the workshop were to assist the affected member states in:

! reviewing the progress made to date in establishing a

reasonable baseline for the necessary surveillance; ! clarifying the extent of the disease and its adverse

socioeconomic impact; ! reviewing the various intervention measures and strategies

available for guinea-worm control and their relative cost-effectiveness; and ! identifying areas in which specific research is required. Significant new surveillance information was presented at the workshop. With the exception of Cote d'Ivoire, all the data on nationally reported incidence in Africa are based on passive surveillance. The following eight countries in the African Region reported surveillance information covering 1985: Burkina Faso, Cameroon, Cote d'Ivoire, Ethiopia, Mali, Mauritania, Togo, and Uganda. Although this represents an improvement over recent years, several countries are still not providing official reports.

Numerous qualitative, anecdotal examples of the negative socioeconomic effects of dracunculiasis were cited during the meeting. These included temporary disability lasting for months or even up to a year in some victims; permanent disability (unusual although not rare); sterility; frequent absenteeism from school; and substantial agricultural losses.

The disease is sporadically distributed over a wide band north of the equator from Mauritania to Ethiopia. Over 100 million people are now estimated to be at risk of contracting dracunculiasis in Africa alone, if one considers as being at risk any person living in a rural district or subprefecture where at least one case of the disease occurs.

Although dracunculiasis is officially reportable in at least eight of the countries affected (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Ethiopia, Ghana, Togo, and Uganda), it is still vastly under-reported even in those countries. Adapted from WHO Weekly Epidemiological Record 1986;61:321-4.

Editorial Note

Editorial Note: At the time of this conference, eight of the 19 affected African countries (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Niger, Nigeria, Togo, and Uganda) had dracunculiasis programs underway or planned. This meeting took place 6 weeks after the 39th World Health Assembly adopted a resolution calling for elimination of dracunculiasis. A second African regional meeting on this subject is to be held in Accra, Ghana, in 1988.

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