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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

  1. CDC. Surveillance for dracunculiasis, 1981-1991. MMWR 1992;41(no. SS-1):1-13.

  2. CDC. Update: dracunculiasis eradication -- Ghana and Nigeria, 1990. MMWR 1991;40:245-7.

  3. WHO. Dracunculiasis -- global surveillance summary, 1991. Wkly Epidemiol Rec 1992;67: 121-7.

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