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.
After reporting zero cases to WHO for more than 10 consecutive years, Chad, a country in the precertification phase, reported an outbreak in 2010 when10 cases were reported in 8 villages from 5 districts in 4 regions. In 2011, 10 additional cases were reported from 9 villages in 3 districts of 2 regions.
Investigations conducted in Chad did not reveal a definitive link between cases reported in 2010 and 2011; except the locality of Camp-Sara (1 case in 2011) which is a section of Matassi village (1 case in 2010), none of the remaining 8 localities that reported cases in 2011 had reported a case in 2010. None of the 20 cases reported in 2010 and 2011 had a history of travel out of Chad.
Of the 20 cases reported in 2010 and 2011, specimens from 6 cases and 10 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.
By the end of 2011, a total of 192 countries and territories representing 180 WHO Member States were certified free of dracunculiasis. 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-Ethiopia, Mali, and South Sudan or in pre certification phase -Chad, Côte d’Ivoire, Ghana, Kenya, Nigeria, Niger, and Sudan
This atlas shows the certification status of dracunculiasis eradication and the epidemiological status of the 20 countries considered endemic during the 1980s.
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.