Dracunculiasis

Epidemiology

Burden in figures

The global eradication campaign has made steady progress. Both the number of cases and endemic villages has fallen significantly since the launch of the eradication efforts in the 1980s when 20 countries were endemic for the disease.

In 1986, an estimate of 3.5 million new cases occurred. In 1989, based on active village-based searches, 892 055 cases were reported to have occurred in 15 out of the 20 endemic countries (not included are data from Chad, Central African Republic, Senegal and Sudan).

In 2012, the disease was confined to 4 countries: Chad, Ethiopia, Mali and South Sudan. By the end of 2012, a total of 542 cases were reported. A reduction of 49% as compared to the 1058 cases reported in 2011, and more than 99% reduction from the cases reported in 1989.

In 2012, South Sudan reported 521 cases, which represented 96% of the global total cases. The rest of the 2012 cases were reported in Chad 10 cases, Ethiopia 4 cases, Mali 4 cases, and Niger 3 cases all imported from Tanzikratène locality in Ansongo district in Mali.

The number of villages which reported cases reduced from 483 in 2011 to 272 in 2012; a 44% reduction. The number of endemic villages declined from 142 in 2011 to 101 in 2012, a 29% reduction.

Of these 542 cases reported in 2012, 273 cases were women and 201 cases were children under 15 years old. Together women and children under 15 years old represented more than 87% of all dracunculiasis cases reported in 2012; women and children under 15 years old represented about 72% of all cases in 2011.

Ghana, with the second highest number of dracunculiasis cases ever reported annually in the world (>179 000 cases reported in 1989) the first being Nigeria (>653 000 cases in 1988), reported its last indigenous case in May 2010 in Diare village in the Savelugu–Nanton district. Since then, no cases were reported in Ghana; the country is now in the pre-certification phase.

In Chad: the outbreak that was first detected in 2010 continued into its third year in 2012; 10 new indigenous cases were reported from 9 villages of 7 districts in 4/24 regions. As a result, Chad was reclassified as a country endemic for the disease. Only 2 of the villages (Mossio-Massa and Akoum- Mabaye) that notified a case in 2012 had also reported a case in 2011; this is similar to the situation in 2011 when only 1 case in 1 locality (Camp-Sara) in 2011 was possibly linked with a case reported in Matassi village in 2010.

None of the 30 cases reported in 2010, 2011 and 2012 had a history of travel out of Chad.

Of the 30 cases reported in 2010, 2011 and 2012 specimens from 6 cases, 10 cases and 4 cases respectively were confirmed positive for Dracunculus medinensis by the WHO Collaborating Centre for Research, Training and Eradication of Dracunculiasis at the US Centers for Disease Control and Prevention (CDC) by parasitological examination and/or molecular testing.

As of the end of 2012, 192 countries, territories and areas have been certified free of dracunculiasis transmission. Fourteen countries remain to be certified, of which 4 countries (Angola, Democratic Republic of the Congo, Somalia and South Africa) have no recent history of dracunculiasis. The 10 other countries are either endemic-Chad, Ethiopia, Mali, and South Sudan or in pre certification phase -Côte d’Ivoire, Ghana, Kenya, Nigeria, Niger, and Sudan.


The last stage of the programme is the most difficult; it requires more concentrated and focused efforts on surveillance, not only in endemic areas but also in areas free of transmission but at risk of importation from endemic areas.

GW in the news!

©Sankara D. WHO/NTD<br />Treating patient with emerging worm in Ethiopia

23 May 2013 | Geneva
A bilingual informative brochure which provides a snapshot of progress being made in eradicating dracunculiasis
Winding up the Worm