Guinea worm being eradicated worldwide – Carter Centre

Former U.S. President Jimmy Carter tries to comfort 6-year-old Ruhama Issah at Savelugu Hospital as a Carter Center technical assistant dresses Issah's extremely painful Guinea worm wound.

In 2013, there were only 148 cases of guinea worm recorded globally.

The Carter Centre, an international guinea worm eradication campaign, has disclosed that there were only 148 recorded cases of guinea worm in the world in 2013.

The disclosure was made to PREMIUM TIMES on Thursday by the Carter Centre in Atlanta, United State of America.

The Carter Centre leads the international Guinea worm eradication campaign and works in close partnership with national programs, the World Health Organization, WHO; U.S. Centre for Disease Control and Prevention, CDC; and UNICEF. However, WHO is the only organization that can officially certify the eradication of a disease.

The WHO has certified Nigeria a guinea worm free country with the certificate presented to President Goodluck Jonathan on Wednesday.

Studies by the Carter Centre show that South Sudan, Chad, Mali, and Ethiopia are the nations still affected by guinea worm.

The centre said it obtained figures of cases of guinea worm from the ministries of health of affected countries. The total figure from all four countries indicates a 73 per cent reduction when compared with 2012 which had about 542.

The Centre said that when it began leading the first international campaign to eradicate a parasitic disease, there were about 3.5 million guinea worm cases occurring annually in Africa and Asia with 650,000 emerging from Nigeria.

In 1991, when the number of endemic villages reached its peak, there were 23,735 villages in 21 countries in Africa and Asia where guinea worm still existed. In 2013, there were only 63 endemic villages in four countries – all in Africa.

South Sudan, the world’s youngest nation, reported 113 cases or 76 per cent of the worldwide case total in 2013. Most of those cases were in the Eastern Equatorial state. The remaining indigenous cases in 2013 were reported in isolated areas of Chad (14), Mali (11), and Ethiopia (7).

Under investigation are three cases reported in Sudan along the South Sudan-Sudan border.

The head of the Carter Centre, Jimmy Carter, said “as we near the finish line in this eradication campaign, the Carter Centre and its partners remain committed to ending the devastating suffering caused by guinea worm disease, recognizing that the final cases of any eradication campaign are the most challenging and most expensive to eliminate”.

Guinea worm is a neglected tropical disease that is contracted when people consume water contaminated with Guinea worm larvae. Medical studies indicate after a year, a meter-long worm slowly emerges from the body through a painful blister in the skin.

In the absence of a vaccine or medical treatment, community-based interventions are being used to eradicate the disease. This is done in the form of educating people to change their water habits such as filtering all drinking water and preventing contamination by keeping anyone with the disease from entering water sources.

The Carter Centre, alongside its partners, ministries of health, and local communities, has reduced cases by more than 99.9 percent since 1986. The Centre estimates that the eradication campaign has averted

more than 80 million cases among the world’s poorest and most neglected people. Guinea worm disease is positioned to be the second human disease, after smallpox, to be eradicated.

Remaining guinea worm countries

Carter Centre’s vice president for health programs and head of the International Task Force for Disease Eradication, Donald Hopkins, said that the remaining endemic areas are not random.

“These last countries continue to have Guinea worm cases because of geographic remoteness, insecurity, or inadequate political will”, he explained.

Records show that the South Sudan Guinea Worm Eradication Program reported 113 cases in January-November 2013 compared to 520 cases for the same period in 2012, a reduction of 78 percent. Until political and ethnic hostilities broke out on December 15, 2013, the program had reported zero cases for that month.

The current insecurity does not affect the country’s most endemic area and coincides with the lowest transmission season for the disease there.

“South Sudan’s Guinea Worm Eradication Program has overcome exceptional challenges while reducing cases by 99 per cent since 2006. The program operated at its highest level in 2013, and we expect the team’s hard work to bear fruit this year.

“Immediate and sustained peace is critical to restore the program’s momentum and resume full operational surveillance and supervision to prevent any transmission in 2014,” Mr. Hopkins further explained.

In Ethiopia, the federal ministry, including the Minister of Health, redoubled its efforts to stop transmission by the end of 2014 in the only remaining Guinea worm-endemic area, the Gambella region.

In Chad, the program continues to investigate the unusual epidemiology of its Guinea worm cases in 2013, and the government is preparing additional control measures to address remaining transmission.

In Mali, the security crisis that began in April 2012 has delayed Guinea worm disease intervention because the national program has not been able to operate fully and consistently in all of its Guinea worm-endemic regions. In 2013, the program was partially operational in three regions and absent in one region due to insecurity.

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