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Dracunculiasis Dracunculiasis, also called Guinea-worm disease, is a parasitic infection by the Guinea worm, ''Dracunculus medinensis''. A person becomes infected by drinking water containing water fleas infected with guinea worm larvae. The worms penetrate t ...
, or Guinea worm disease, is an infection by the
Guinea worm ''Dracunculus medinensis'', or Guinea worm, is a nematode that causes dracunculiasis, also known as guinea worm disease. The disease is caused by the female which, at up to in length, is among the longest nematodes infecting humans. In contr ...
. In 1986, there were an estimated 3.5 million cases of Guinea worm in 20 endemic nations in Asia and Africa. Ghana alone reported 180,000 cases in 1989. The number of cases has since been reduced by more than 99.999% to 22 in 2015 in the five remaining endemic nations of Africa:
South Sudan South Sudan (; din, Paguot Thudän), officially the Republic of South Sudan ( din, Paankɔc Cuëny Thudän), is a landlocked country in East Africa. It is bordered by Ethiopia, Sudan, Central African Republic, Democratic Republic of th ...
,
Chad Chad (; ar, تشاد , ; french: Tchad, ), officially the Republic of Chad, '; ) is a landlocked country at the crossroads of North and Central Africa. It is bordered by Libya to the north, Sudan to the east, the Central African Republic ...
,
Mali Mali (; ), officially the Republic of Mali,, , ff, 𞤈𞤫𞤲𞥆𞤣𞤢𞥄𞤲𞤣𞤭 𞤃𞤢𞥄𞤤𞤭, Renndaandi Maali, italics=no, ar, جمهورية مالي, Jumhūriyyāt Mālī is a landlocked country in West Africa. Ma ...
,
Ethiopia Ethiopia, , om, Itiyoophiyaa, so, Itoobiya, ti, ኢትዮጵያ, Ítiyop'iya, aa, Itiyoppiya officially the Federal Democratic Republic of Ethiopia, is a landlocked country in the Horn of Africa. It shares borders with Eritrea to the ...
, and
Angola , national_anthem = "Angola Avante"() , image_map = , map_caption = , capital = Luanda , religion = , religion_year = 2020 , religion_ref = , coordinat ...
. The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
(WHO) is the international body that certifies whether a disease has been eliminated from a country or eradicated from the world. The
Carter Center The Carter Center is a nongovernmental, not-for-profit organization founded in 1982 by former U.S. President Jimmy Carter. He and his wife Rosalynn Carter partnered with Emory University just after his defeat in the 1980 United States presid ...
, a nongovernmental, not-for-profit organization founded by former U.S. President
Jimmy Carter James Earl Carter Jr. (born October 1, 1924) is an American politician who served as the 39th president of the United States from 1977 to 1981. A member of the Democratic Party (United States), Democratic Party, he previously served as th ...
, also reports the status of the Guinea worm eradication program by country. As of 2019, the WHO goal for eradication in humans and animals is 2030 (previously targets have been set at 1991, 2009, 2015, and 2020).


Eradication program

Since humans are the principal host for Guinea worm, and there is no evidence that ''Dracunculus medinensis'' has ever been reintroduced to humans in any formerly endemic country as the result of non-human infections, the disease can be controlled by identifying all cases and modifying human behavior to prevent it from recurring. Once all human cases are eliminated, the disease cycle will be broken, resulting in its eradication. The eradication of Guinea worm disease has faced several challenges: * Inadequate security in some endemic countries * Lack of political will from the leaders of some of the countries in which the disease is endemic * The need for change in behavior in the absence of a magic bullet treatment like a vaccine or medication * Inadequate funding at certain times In January 2012 the WHO meeting at the
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
in London launched the most ambitious and largest coalition health project ever, known as ''
London Declaration on Neglected Tropical Diseases The London Declaration on Neglected Tropical Diseases was a collaborative disease eradication programme launched on 30 January 2012 in London. It was inspired by the World Health Organization roadmap to eradicate or prevent transmission for negl ...
'' which aims to end/control dracunculiasis by 2020, among other
neglected tropical disease Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bac ...
. This project is supported by all major pharmaceutical companies, the
Bill & Melinda Gates Foundation The Bill & Melinda Gates Foundation (BMGF), a merging of the William H. Gates Foundation and the Gates Learning Foundation, is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was ...
, the governments of the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
, United Kingdom DFID and United Arab Emirates and the
World Bank The World Bank is an international financial institution that provides loans and grants to the governments of low- and middle-income countries for the purpose of pursuing capital projects. The World Bank is the collective name for the Inte ...
. In August 2015, when discussing his diagnosis of melanoma metastasized to his brain, Jimmy Carter stated that he hopes the last Guinea worm dies before he does.


Countries certified free

Endemic countries must report to the International Commission for the Certification of Dracunculiasis Eradication and document the absence of
indigenous Indigenous may refer to: *Indigenous peoples *Indigenous (ecology), presence in a region as the result of only natural processes, with no human intervention *Indigenous (band), an American blues-rock band *Indigenous (horse), a Hong Kong racehorse ...
cases of Guinea worm disease for at least three consecutive years to be certified as Guinea worm-free by the World Health Organization. The results of this certification scheme been able to certify, by 2007,
Benin Benin ( , ; french: Bénin , ff, Benen), officially the Republic of Benin (french: République du Bénin), and formerly Dahomey, is a country in West Africa. It is bordered by Togo to the west, Nigeria to the east, Burkina Faso to the nort ...
,
Burkina Faso Burkina Faso (, ; , ff, 𞤄𞤵𞤪𞤳𞤭𞤲𞤢 𞤊𞤢𞤧𞤮, italic=no) is a landlocked country in West Africa with an area of , bordered by Mali to the northwest, Niger to the northeast, Benin to the southeast, Togo and Ghana t ...
, Chad,
Ivory Coast Ivory Coast, also known as Côte d'Ivoire, officially the Republic of Côte d'Ivoire, is a country on the southern coast of West Africa. Its capital is Yamoussoukro, in the centre of the country, while its largest city and economic centre i ...
,
Kenya ) , national_anthem = " Ee Mungu Nguvu Yetu"() , image_map = , map_caption = , image_map2 = , capital = Nairobi , coordinates = , largest_city = Nairobi , ...
,
Mauritania Mauritania (; ar, موريتانيا, ', french: Mauritanie; Berber: ''Agawej'' or ''Cengit''; Pulaar: ''Moritani''; Wolof: ''Gànnaar''; Soninke:), officially the Islamic Republic of Mauritania ( ar, الجمهورية الإسلامية ...
,
Togo Togo (), officially the Togolese Republic (french: République togolaise), is a country in West Africa. It is bordered by Ghana to the west, Benin to the east and Burkina Faso to the north. It extends south to the Gulf of Guinea, where its c ...
, and
Uganda }), is a landlocked country in East Africa. The country is bordered to the east by Kenya, to the north by South Sudan, to the west by the Democratic Republic of the Congo, to the south-west by Rwanda, and to the south by Tanzania. The ...
had stopped transmission, and
Cameroon Cameroon (; french: Cameroun, ff, Kamerun), officially the Republic of Cameroon (french: République du Cameroun, links=no), is a country in west-central Africa. It is bordered by Nigeria to the west and north; Chad to the northeast; the ...
,
Central African Republic The Central African Republic (CAR; ; , RCA; , or , ) is a landlocked country in Central Africa. It is bordered by Chad to the north, Sudan to the northeast, South Sudan to the southeast, the DR Congo to the south, the Republic of th ...
,
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area, the List of countries and dependencies by population, second-most populous ...
,
Pakistan Pakistan ( ur, ), officially the Islamic Republic of Pakistan ( ur, , label=none), is a country in South Asia. It is the world's List of countries and dependencies by population, fifth-most populous country, with a population of almost 24 ...
,
Senegal Senegal,; Wolof: ''Senegaal''; Pulaar: 𞤅𞤫𞤲𞤫𞤺𞤢𞥄𞤤𞤭 (Senegaali); Arabic: السنغال ''As-Sinighal'') officially the Republic of Senegal,; Wolof: ''Réewum Senegaal''; Pulaar : 𞤈𞤫𞤲𞤣𞤢𞥄𞤲𞤣𞤭 ...
,
Yemen Yemen (; ar, ٱلْيَمَن, al-Yaman), officially the Republic of Yemen,, ) is a country in Western Asia. It is situated on the southern end of the Arabian Peninsula, and borders Saudi Arabia to the north and Oman to the northeast and ...
were WHO certified.
Nigeria Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
was certified as having ended transmission in 2013, followed by Ghana in 2015.


Endemic countries

With the current eradication campaign the areas that dracunculiasis are found in are shrinking. In the early 1980s, the disease was endemic in Pakistan, Yemen and 17 countries in Africa with a total of 3.5 million cases per year. In 1985, 3.5 million cases were still reported annually, but by 2008, the number had dropped to 5,000. This number further dropped to 1,058 in 2011. At the end of 2015, South Sudan, Mali, Ethiopia and Chad still had endemic transmissions. However, endemic transmission was discovered in Angola and Cameroon in 2018 and 2019 respectively. For many years the major focus was South Sudan (independent after 2011, formerly the southern region of
Sudan Sudan ( or ; ar, السودان, as-Sūdān, officially the Republic of the Sudan ( ar, جمهورية السودان, link=no, Jumhūriyyat as-Sūdān), is a country in Northeast Africa. It shares borders with the Central African Republic t ...
), which reported 76% of all cases in 2013, but today the last few cases are spread over several African countries.


Timeline of events


1980s

In 1984, the WHO asked the United States
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georg ...
(CDC) to spearhead the effort to eradicate dracunculiasis, an effort that was further supported by the
Carter Center The Carter Center is a nongovernmental, not-for-profit organization founded in 1982 by former U.S. President Jimmy Carter. He and his wife Rosalynn Carter partnered with Emory University just after his defeat in the 1980 United States presid ...
, former U.S. President Jimmy Carter's not-for-profit organization. In 1986, Carter and the Carter Center began leading the global campaign, in conjunction with CDC,
UNICEF UNICEF (), originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing humanitarian and developmental aid to c ...
, and
WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...
. At that time the disease was endemic in Pakistan, Yemen and 17 countries in Africa, which reported a total of 3.5 million cases per year. Carter made a personal visit to a Guinea-worm endemic village in 1988. He said, "Encountering those victims first-hand, particularly the teenagers and small children, propelled me and Rosalynn is wifeto step up the Carter Center's efforts to eradicate Guinea worm disease."


1990s

In 1991, the World Health Assembly agreed that Guinea worm disease should be eradicated. At this time there were 400,000 cases reported each year. The Carter Center has continued to lead the eradication efforts, primarily through its Guinea Worm Eradication Program. In the 1980s, Carter persuaded President
Zia-ul-Haq General Muhammad Zia-ul-Haq HI, GCSJ, ร.ม.ภ, ( Urdu: ; 12 August 1924 – 17 August 1988) was a Pakistani four-star general and politician who became the sixth President of Pakistan following a coup and declaration of martial ...
of Pakistan to accept the proposal of the eradication program, and by 1993, Pakistan was free of the disease. Key to the effort was, according to Carter, the work of "village volunteers" who educated people about the need to filter drinking water.


2000s

Other countries followed the example of Pakistan, and by 2004, Guinea worm was eradicated in Asia. In December 2008, The Carter Center announced new financial support totaling $55 million from the
Bill & Melinda Gates Foundation The Bill & Melinda Gates Foundation (BMGF), a merging of the William H. Gates Foundation and the Gates Learning Foundation, is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was ...
and the United Kingdom
Department for International Development , type = Department , logo = DfID.svg , logo_width = 180px , logo_caption = , picture = File:Admiralty Screen (411824276).jpg , picture_width = 180px , picture_caption = Department for International Development (London office) (far right ...
. The funds will help address the higher cost of identifying and reporting the last cases of Guinea worm disease. Since the worm has a one-year incubation period, there is a very high cost of maintaining a broad and sensitive monitoring system and providing a rapid response when necessary. One of the most significant challenges facing Guinea worm eradication has been the civil war in Southern Sudan, which was largely inaccessible to health workers due to violence. To address some of the humanitarian needs in Southern Sudan, in 1995, the longest
ceasefire A ceasefire (also known as a truce or armistice), also spelled cease fire (the antonym of 'open fire'), is a temporary stoppage of a war in which each side agrees with the other to suspend aggressive actions. Ceasefires may be between state ac ...
in the history of the war, and the longest humanitarian cease-fire in history, was achieved through negotiations by Jimmy Carter. Commonly called the "Guinea worm cease-fire", both warring parties agreed to halt hostilities for nearly six months to allow public health officials to begin Guinea worm eradication programming, among other interventions. Public health officials cite the formal end of the war in 2005 as a turning point in Guinea worm eradication because it has allowed health care workers greater access to Southern Sudan's endemic areas. In 2006, there was an increase from 5,569 cases in 2005 to 15,539 cases, as a result of better reporting from areas that were no longer war-torn. The Southern Sudan Guinea Worm Eradication Program has deployed over 28,000 village volunteers, supervisors and other health staff to work on the program full-time. The program was able to slash the number of cases reported in 2006 by 63% to 5,815 cases in 2007. Since 2011, at the time that
South Sudan South Sudan (; din, Paguot Thudän), officially the Republic of South Sudan ( din, Paankɔc Cuëny Thudän), is a landlocked country in East Africa. It is bordered by Ethiopia, Sudan, Central African Republic, Democratic Republic of th ...
became an independent nation-state, its northern neighbour Sudan had reported no endemic cases of dracunculiasis . Sporadic insecurity or widespread civil conflict could at any time ignite, thwarting eradication efforts. The remaining endemic communities in South Sudan are remote, poor and devoid of infrastructure, presenting significant hurdles for effective delivery of interventions against disease. Moreover, residents in these communities are nomadic, moving seasonally with cattle in pursuit of water and pasture, making it very difficult to know where and when transmission occurred. The peak transmission season coincides with the rainy season, hampering travel by public health workers. Another remaining area in Africa remained challenging to ending Guinea worm: northern Mali, where
Tuareg The Tuareg people (; also spelled Twareg or Touareg; endonym: ''Imuhaɣ/Imušaɣ/Imašeɣăn/Imajeɣăn'') are a large Berber ethnic group that principally inhabit the Sahara in a vast area stretching from far southwestern Libya to southern Al ...
rebels made some affected areas unsafe for health workers. Four of Mali's regions (
Kayes Kayes ( Bambara: ߞߊߦߌ tr. ''Kayi'', Soninké: ''Xaayi'') is a city in western Mali on the Sénégal River with a population of 127,368 at the 2009 census. Kayes is the capital of the administrative region of the same name. The name "Kayes ...
,
Koulikoro Koulikoro (Bambara language, Bambara: ߞߎߟߌߞߏߙߏ tr. Kulikoro) is a town and Communes of mali, urban commune in Mali. The capital of the Koulikoro Region, Koulikoro is located on banks of the Niger River, downstream from Mali's capital Bam ...
,
Ségou Ségou (; bm, ߛߋߓߎ, italic=no, ) is a town and an urban commune in south-central Mali that lies northeast of Bamako on the right bank of the River Niger. The town is the capital of the Ségou Cercle and the Ségou Region. With 130,690 ...
, and
Sikasso Sikasso ( Bambara: ߛߌߞߊߛߏ tr. Sikaso) is a city in the south of Mali and the capital of the Sikasso Cercle and the Sikasso Region. It is Mali's second largest city with 225,753 residents in the 2009 census. History Sikasso was founded ...
) have eliminated dracunculiasis, while the disease is still endemic in the country's other four regions ( Gao,
Kidal Kidal ( Tuareg Berber: ⴾⴸⵍ, KDL, Kidal) is a town and commune in the desert region of northern Mali. The town lies northeast of Gao and is the capital of the Kidal Cercle and the Kidal Region. The commune has an area of about and incl ...
,
Mopti Mopti ( Bambara: ߡߏߕߌ tr. Moti) is a town and an urban commune in the Inner Niger Delta region of Mali. The town is the capital of the Mopti Cercle and the Mopti Region. Situated 630 km northeast of Bamako, the town lies at the confl ...
, and
Timbuktu Timbuktu ( ; french: Tombouctou; Koyra Chiini: ); tmh, label=Tuareg, script=Tfng, ⵜⵏⴱⴾⵜ, Tin Buqt a city in Mali, situated north of the Niger River. The town is the capital of the Tombouctou Region, one of the eight administrativ ...
). Late detection of two outbreaks, due to inadequate surveillance resulted in a meager 36% containment rate in Mali in 2007. The years 2008 and 2009 were more successful, however, with containment rates of 85% and 73% respectively. The civil war prevented accurate information from being gathered in northern Mali in 2012. In Ghana, after a decade of frustration and stagnation, in 2006 a decisive turnaround was achieved. Multiple changes can be attributed to the improved containment and lower incidence of dracunculiasis: better supervision and accountability, active oversight of infected people daily by paid staff, and an intensified public awareness campaign. After Jimmy Carter's visit to Ghana in August 2006, the government of Ghana declared Guinea worm disease to be a public health emergency. The overall rate of contained cases has increased in Ghana from 60% in 2005, to 75% in 2006, 84% in 2007, 85% in 2008, 93% in 2009, and 100% in 2010. From June 2006 to March 2008, there were no cases reported in Ethiopia. No indigenous cases were reported in Chad in the 2000s; however, the country was known to have poor surveillance.


2010s


2011

In 2011, 1,060 human cases were reported—1,030 in South Sudan, 12 in Mali, 10 in Chad, and 8 in Ethiopia. The majority of cases in South Sudan were in Kapoeta East County, and Kapoeta North County. These adjacent counties are in the state of
Eastern Equatoria Eastern Equatoria is a state in South Sudan. It has an area of 73,472 km². The capital is Torit. On October 1, 1972, the state was divided into Imatong and Namorunyang states and was re-established by a peace agreement signed on 22 Febr ...
. Of the 70 counties in South Sudan, 56 (80%) are considered free of dracunculiasis. The cases reported in Chad were part of an outbreak that was originally identified in 2010 as part of a pre-certification process. Chad had not reported any cases between 2001 and 2009. Two of the cases in Ethiopia were imported from South Sudan. Ghana appears to have eradicated guinea worm. In August 2011, their public health officials reported that Ghana was free of reported cases for over 14 months. While promising, given the incubation period, it will be some time before the WHO certifies Ghana as free of this disease. After South Sudan separated from
Northern Sudan Sudan ( or ; ar, السودان, as-Sūdān, officially the Republic of the Sudan ( ar, جمهورية السودان, link=no, Jumhūriyyat as-Sūdān), is a country in Northeast Africa. It shares borders with the Central African Republic t ...
, Northern Sudan has been free of guinea worm disease since 2002 and it has been certified free of this disease by the WHO.
Burkina Faso Burkina Faso (, ; , ff, 𞤄𞤵𞤪𞤳𞤭𞤲𞤢 𞤊𞤢𞤧𞤮, italic=no) is a landlocked country in West Africa with an area of , bordered by Mali to the northwest, Niger to the northeast, Benin to the southeast, Togo and Ghana t ...
and
Togo Togo (), officially the Togolese Republic (french: République togolaise), is a country in West Africa. It is bordered by Ghana to the west, Benin to the east and Burkina Faso to the north. It extends south to the Gulf of Guinea, where its c ...
were both certified free of dracunculiasis in 2011, as the last endemic cases were in November 2006 and December 2006, respectively.


2012

In 2012, 542 human cases were reported—521 in South Sudan, 10 in Chad, 7 in Mali, and 4 in Ethiopia. This represents a 49% reduction compared to 2011. The containment rate was 64%. However, since March 2012, Mali's Guinea Worm Eradication Program workers have had limited access to northern Mali due to the
Tuareg rebellion (2012) The Tuareg Rebellion of 2012 was an early stage of the Mali War; from January to April 2012, a war was waged against the Malian government by rebels with the goal of attaining independence for the northern region of Mali, known as Azawad. It w ...
, and were not able to investigate cases there.
Médecins du Monde ''Médecins du monde'' (MdM; ), or Doctors of the World, is an international humanitarian organization which provides emergency and long-term medical care to the world's most vulnerable people. It also advocates to end health inequities. It was f ...
reported rumours of a further 5 unconfirmed cases in northern Mali since March.


2013

In 2013, 148 human cases were reported—113 in South Sudan, 14 in Chad, 11 in Mali and 7 in Ethiopia, and 3 in Sudan (imported from South Sudan). This represents a 73% reduction over 2012. Due to civil insecurity in South Sudan, monitoring was suspended in parts of the country in December. Containment was 66%. After a decade without any reported cases, it is clear that dracunculiasis has since reestablished itself in Chad. There were concerns that surveillance vigilance has decreased, and renewed efforts were made to increase monitoring. This includes coordinating monitoring with its neighbours Nigeria and
Cameroon Cameroon (; french: Cameroun, ff, Kamerun), officially the Republic of Cameroon (french: République du Cameroun, links=no), is a country in west-central Africa. It is bordered by Nigeria to the west and north; Chad to the northeast; the ...
.
Ivory Coast Ivory Coast, also known as Côte d'Ivoire, officially the Republic of Côte d'Ivoire, is a country on the southern coast of West Africa. Its capital is Yamoussoukro, in the centre of the country, while its largest city and economic centre i ...
,
Niger ) , official_languages = , languages_type = National languagesNigeria Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
were all certified free of dracunculiasis in 2013, as the last endemic cases were in November 2006, October 2008, and November 2008, respectively.


2014

In 2014, 126 human cases were reported—70 in South Sudan, 40 in Mali, 13 in Chad, and 3 in Ethiopia. 13% fewer Guinea worms emerged from humans in 2014 compared to 2013 (172 vs. 197), and 57% fewer villages had indigenous cases (30 vs. 69). The figure for total worms emerging is larger than new cases because a person may be infected by more than 1 worm, and it may emerge many months later than when the case is first reported. The big drop in cases was again in South Sudan. Containment increased from 66% to 73%, mainly due to Mali's 24% improvement to 88%. The increase of the reward for reporting cases of the disease in South Sudan, Ethiopia and Mali from the equivalent of about US$50 to about US$100 has improved reporting, as did the campaign to advertise this reward in Mali. In Mali, part of the increase has been caused by improved security allowing more of the country to be monitored. While parts of the country were still not monitored, all known endemic areas were covered. Advertising the increased reward for reporting cases may have allowed cases to be found earlier, and so contained before the victims become a risk of spreading the parasite. A report from the WHO Collaborating Center for Research, Training and Eradication of Dracunculiasis, CDC noted two specific problems encountered while eliminating the last few cases in Chad—some dogs seemed to be infected with the parasite, and the large number, size and heavy vegetation of lagoons used by fishermen reducing the effectiveness of the Abate larvicide. It is likely that the disease is being caused by eating undercooked fish from these sources. The Carter Center reported the general consensus that in Chad the disease has found an alternate host in dogs, and will have to be eradicated from both humans and dogs.


2015

In 2015, 22 human cases were reported—9 in Chad, 3 in Ethiopia, 5 in Mali, and 5 in South Sudan. The proportion of people contained was 36%, compared to 73% in 2014. That means 14 cases were not contained in 2015, compared to 34 cases in 2014. Nine of these 14 cases not contained were in Chad. Ghana was certified free of dracunculiasis in 2015, as the last endemic case was in May 2010. A significant change from 2014 was the increased effort being used to identify and treat infected dogs—mainly in Chad where the vast majority of cases of dogs hosting the worm were found, but also significantly in Ethiopia. In 2015, 483 infected dogs were identified and treated in Chad—more than 20 times the number reported in humans worldwide. This was more than four times larger than the number treated in 2014 (114 dogs). A major factor in this increase was probably the financial reward started in January for reporting an infected dog. 68% of dogs treated were also contained, compared to 40% in 2014. Dogs are now believed to be the major source of the parasite infecting humans in Chad, a country in which no indigenous cases of guinea worm were reported in the decade leading up to 2010. Fifteen dogs outside Chad were also been identified and treated, as well five cats and one baboon. The August Carter Center report predicts that Chad may be the last country that eliminates dracunculiasis, and reports on further ongoing research into the relationship between the parasite and dogs there, and some different treatments for dogs.


2016

In 2016, 25 human cases were reported—16 in Chad, 6 in South Sudan, and 3 in Ethiopia. No cases were reported in Mali. This was the first increase in yearly case count. The 2016 Juba clashes in South Sudan led to the evacuation of all expatriate staff from the Southern Sudan Guinea Worm Eradication Program. Members of the local staff were given the option of continuing to work if possible. It is unclear what impact the evacuation had. The efforts against infected dogs continue to increase in Chad, with 498 dogs being identified and treated up to 31 May, compared to 196 cases in the same period the previous year. The level of containment of infected dogs before they become a risk of spreading the parasite has improved to 81% compared to 67% last year. By the end of 2016, Chad reported provisional totals of 1,011 infected domestic dogs (66% contained), 11 infected domestic cats (55% contained), and one infected wild frog. Mali reported 11 infected dogs (8/11 contained) in 2016, and Ethiopia reported 14 infected dogs (71% contained), and two infected baboons.


2017

In 2017, 30 human cases were reported—15 in Chad, and 15 in Ethiopia; 13 of which were fully contained. For the first time ever, South Sudan reported no human infections for a whole calendar year: the last reported case was on 20 November 2016. No human cases were reported in Mali for the second year in a row. In addition to their human cases, Chad reported 817 infected dogs and 13 infected domestic cats, and Ethiopia reported 11 infected dogs and 4 infected baboons. Despite no human infections, Mali reported 9 infected dogs and 1 infected cat.


2018

In 2018, 28 human cases were reported worldwide: 17 in Chad, 10 in South Sudan and one in Angola. In terms of animal cases Chad has so far reported 832 infections in dogs and 17 infections in domestic cats, Mali reported six infected dogs and two infected domestic cats, and Ethiopia reported eight infected dogs and three infected domestic cats. On June 29, a case was reported in
Angola , national_anthem = "Angola Avante"() , image_map = , map_caption = , capital = Luanda , religion = , religion_year = 2020 , religion_ref = , coordinat ...
, a country not known to have had any cases in the past. At the end of 2018, 28 human cases and 1,102 animal cases were reported. Of the animal cases 1,069 were in dogs, 32 in cats and one in a baboon.


2019

By the end of 2019, 54 human cases had been reported: one case each in Angola and Cameroon, four cases in South Sudan and 48 cases in Chad. In addition to this: * Angola reported a single animal case; * Mali reported nine animal cases; * Chad reported 1,899 animal cases, the vast majority in dogs (but a few also in cats); * Ethiopia reported eight animal cases, including a case in a baboon. A trial of
flubendazole Flubendazole is an anthelmintic. Its brand name is Flutelmium which is a paste manufactured by Janssen Pharmaceutica N.V. used by veterinarians for protection against internal parasites and worms in dogs and cats. Other brand names are Flubenol, ...
to treat dogs has been started. The World Health Organization revised its target date for eradication from 2020 to 2030, citing civil conflicts and new information about transmission between humans and dogs. The new goal includes eradication in both humans and animals.


2020s


2020

At the end of 2020, 27 total cases had been reported: one case each in Angola, Cameroon, Mali, and South Sudan, eleven cases in Ethiopia, and twelve cases in Chad. In addition, there were: * 8 animal cases reported in Mali; * 15 animal cases reported in Ethiopia; * 1,570 animal cases reported in Chad.


2021

In 2021, 15 cases were reported, of which eight cases were in Chad, four cases in South Sudan, two in Mali, and one in Ethiopia. The single Ethiopian case was a family member of a previously infected individual and the case was contained. 863 animal cases were reported almost entirely in cats and dogs.


2022

12 human cases and at least 490 animal cases have been reported.


Notes and references


Notes


References


External links

*
Nicholas D. Kristof from the New York Times follows a young Sudanese boy with a Guinea Worm parasite infection who is quarantined for treatment as part of the Carter program


* ttps://www.who.int/health-topics/dracunculiasis World Health Organization on Dracunculiasis {{Portal bar, Medicine
Dracunculiasis Dracunculiasis, also called Guinea-worm disease, is a parasitic infection by the Guinea worm, ''Dracunculus medinensis''. A person becomes infected by drinking water containing water fleas infected with guinea worm larvae. The worms penetrate t ...
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