Neglected tropical diseases

Eradicating dracunculiasis: Chad intensifies national campaign as ninth human case is confirmed

6 September 2017 | Geneva -- The Ministry of Public Health of Chad has launched a national “Heroes of Guinea-worm campaign” to accelerate the prompt detection and containment of all human cases and animals infected with Dracunculiasis medinensis (the Guinea worm).

The campaign focuses on creating awareness about the disease and sensitizing people living in districts and regions about ways to prevent the infection,” said Dr Tchindebet Ouakou, national coordinator of the Guinea Worm Eradication Programme in Chad. “Anyone who provides information about a confirmed case is awarded US$ 45.00 (CFA 25 000); the infected person also receives US$ 45.00 (CFA 25 000). The patient receives a total of US$ 90.00 (CFA 50 000) if he or she is also the informant.”

A reward is also in place for voluntarily reporting and tethering an infected dog.1 The national programme’s enhanced communication campaign, launched on 22 July 2017 as a joint effort of the Ministry of Public Health and the Ministry of Information, is supported by The Carter Center.

From 1 January to 31 July 2017, the World Health Organization (WHO) has received reports of nine human cases of dracunculiasis, all of them in Chad.

The recent move by Chad to accelerate case detection and containment of transmission is an excellent initiative,” said Dr Dieudonné Sankara, who heads the WHO dracunculiasis eradication unit. “We need to interrupt transmission decisively through systematic and sustained use of vector control interventions.”

Infection in animals

Besides human cases, Chad has also reported infections in dogs and cats. Two countries – Ethiopia and Mali have not reported human cases but have registered D. medinensis infections in animals. South Sudan is the only country that has not reported any human or animal cases since September 2015.

  • Chad
    • 639 infected dogs
    • 7 infected cats
  • Ethiopia
    • 9 infected dogs
    • 4 infected baboons
  • Mali
    • 3 infected dogs

The unusual epidemiology of D. medinensis infection in animals (mainly dogs) was detected in Chad in 2012. Along with other measures to prevent infections in dogs and people as well as contamination of water bodies, vector control remains a vital element in interrupting transmission of D. medinensis, particularly in Chad, Ethiopia and Mali. National programmes, with support from The Carter Center, are responding by treating water bodies and ponds with temephos.

Surveillance and rumours

As of the end of July 2017, Chad’s Guinea-Worm Eradication Programme has received 1528 rumoured cases of dracunculiasis, of which 1468 (95%) were investigated within 24 hours.

Mali has responded to 186 rumours as of the end of June 2017, all of which were investigated within 24 hours.

Ethiopia has reported 7730 rumours as of the end of July 2017, of which 95% were investigated within 24 hours.

South Sudan has reported no human and animal cases and will implement an accelerated communications campaign in October 2017.

Dracunculiasis is a crippling parasitic disease caused by infection with D. medinensis, a long thread-like worm. The infection is transmitted when people drink water contaminated with parasite-infected water fleas.

When the eradication campaign began in 1986, there were an estimated 3.5 million cases of dracunculiasis.

1Types of rewards in Chad:
• Information on an infected dog before emergence of worm
­If the owner of an infected dog keeps the animal tethered until the worm is removed and the wound is completely healed, the owner is awarded CFA 10 000 [US$ 18.00], including three bars of soap. The informant is also rewarded with three bars of soap.
• Information on an infected dog with worm already emerging
­If the owner of an infected dog keeps the animal tethered until the worm is removed and the wound is completely healed, the owner is awarded CFA 2000 [US$ 3.50]. The informant is not rewarded.
• Anyone who provides information about an animal infected with D. medinensis with no worm emergence – and provided the animal stays tethered until its symptoms disappear –leads to the owner and the informant each being awarded with three bars of soap.