Chad
Brief background
Chad experienced an outbreak of dracunculiasis during 2010, after almost 10 years of reporting 0 cases.
In 2010, a total of 10 indigenous cases were reported from 5 districts in 4 regions.
Measures to control transmission are being implemented by the local health authorities, assisted by WHO and The Carter Center. WHO and United States Centers for Disease Control and Prevention (CDC) have been providing support in investigating the possible causes of this outbreak.
Status: January - September 2011
A total of 8 cases were reported during January-August 2011. Only two out of the eight cases were contained. None of these cases has a history of travel out of Chad.
One indigenous case was detected and contained in the village of Toulomeye-Bardai, Bere district, Tanjile region in February 2011.
Two indigenous cases were detected in Bousso district, Chari Baguirmi region; one of the two cases was detected in village of Wandal in April 2011 and the second case was detected in July 2011 in the village of Mossio/Tchigaga. None of them was contained.
Another case was detected in Mailaou village, Mandalia district Chari-Baguirmi region. This case was not contained and it's said to be imported from Mossio/Tchigaga village, Bousso district of Chari Baguirmi region.
Four additional cases were detected in:
- Bilo, Massenya, Chari Baguirmi, (1 case)
- Goudoum Goudoum, Bousso district, Chari Baguirmi (2 cases)
- Madoubou Akoum, Mandalia, Chari Baguirmi, (1 case)
As of 30 September 2011, there were 50 rumours of dracunculiasis reported. Forty-six out of the fifty rumours were reported and investigated within 24 hours. Eight rumours were confirmed as dracunculiasis cases.
A total of 40 villages are under active surveillance in Chad in 2011.
2010 outbreak
6 cases were confirmed as Dracunculiasis medinensis in laboratory, 5 of them by polymerase chain reaction at the WHO Collaborating Centre for Research, Training & Eradication of Dracunculiasis at the CDC.
A total of 10 cases occurred between April 2010 and October 2010 in 8 villages in 5 districts in 4/22 regions. Villages in which cases were reported are as follow:
- Nanguigoto (2 cases) Moulkou (1 case) and Abba-Limane (1 case) in Guelendeng district in Mayo Kebbi East region;
- Matassi (1 case) in Mandalia district Chari Baguirmi region
- Abourgui (1 case) and Mouray (1 case) in Massenya district in Chari Baguirmi region;
- Kakoua (1 case) in Sarh district in Moyen Chari region; and
- Sila village (2 cases) in Melfi district in Guera region.
None of the above case was contained.
Support has been provided to Chad by WHO and its partners (the Carter Center, the CDC and UNICEF) to investigate and control transmission of the disease.
None of the cases had a history of travel outside Chad during the 10–14 months prior to the worm’s emergence. This suggests that indigenous transmission has been occurring in recent years. None of the 8 villages was known to be endemic. A total of 30 villages, including those with cases in 2010, were put on close, active surveillance following the outbreak.
As there had been no previous report of any case of dracunculiasis after 2000, it is not possible to ascertain:
- whether the current outbreak is the result of continuing undetected low-level indigenous transmission for a decade;
- or, if it originated from an imported case in the recent past that was not detected.
During its last meeting in October 2009, the ICCDE deferred the certification of Chad as free of dracunculiasis following the recommendation of the international certification team.
Chad is presently in the pre-certification stage as it had been reporting zero cases. However, the present outbreak needs to be interrupted by 2012 through effective implementation of containment strategies. If this is not achieved by 2012, endemicity will be considered to have been re-established in Chad.
A reward of CFA (Communauté Financière Africaine) 50 000 (about US$ 100) for information on confirmed indigenous cases and CFA 25 000 (about US$ 50) for information on internationally imported cases is offered.
However , an assessment carried out in 2010 showed that only about 20% of the population was aware of the reward system