Neglected tropical diseases

Eradicating dracunculiasis: WHO certifies Kenya as South Sudan and Mali continue to report zero human cases

2 March 2018 | Geneva -- The World Health Organization (WHO) has certified Kenya free of dracunculiasis transmission following the recommendation of the International Commission for the Certification of Dracunculiasis Eradication (ICCDE).

During its 12th meeting held at WHO headquarters in Geneva, Switzerland the ICCDE reviewed the report of an International Certification Team that visited Kenya in October 2017 to assess the country’s claim of having eliminated the disease.

WHO/L. Cipriani

We congratulate Kenya and salute the work of the thousands of health workers and volunteers who braved difficult conditions for decades to achieve this milestone,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
This triumph should inspire us all to overcome diseases of poverty and improve the lives of vulnerable people while leaving no one behind.

In his first face to face meeting with ICCDE members since he took office as Director-General of WHO in May 2017, Dr Tedros expressed his appreciation for the Commission’s work over the years and reiterated WHO’s unparalleled commitment to eradicating dracunculiasis.

He added that with the help of partners such as The Carter Center, UNICEF and CDC, WHO will redouble its efforts in providing optimal support to Chad, Ethiopia, Mali and South Sudan, the four countries that remain endemic for the disease. Dr Tedros also announced that he will personally follow up with leaders of those countries where transmission is still occurring and organize high-level visits to further motivate them to reach the finish line.

Kenya now becomes the 187th WHO Member State to be certified dracunculiasis-free, a major achievement for Kenya as it strengthens its commitment to advancing its agenda for universal health coverage.

©MoH Kenya/ Members of International Certification Team interviewing villager to validate Kenya's claim of having interrupted dracunculiasis transmission - October 2017

Only seven countries remain to be certified.1 WHO is the only organization mandated to certify countries as free of transmission following the recommendation of the ICCDE.

Zero cases: positive trend

In another important move, WHO has congratulated South Sudan for reporting zero human cases of the disease during the whole of 2017. This unprecedented achievement is the consequence of a sustained eradication campaign led by the South Sudan Guinea Worm Eradication Programme and the country’s Ministry of Health and partners.

This is the result of good leadership as well as concerted efforts by all partners to get to where we are. Given the difficulties we experienced, we would not have done it by ourselves and we want to thank our partners – WHO, UNICEF and The Carter Center and many others – who stood with us,” said Dr Riak Gai Kok, Minister of Health of South Sudan. “I also want to pay tribute to the country's leadership for staying focused to tackle the magnitude of this problem. Even during the war, we made sure that work continued in areas that were beyond control lines and that the people continued to get the care they needed.

In 2006, South Sudan reported more than 20 000 human cases. This decreased to six cases in 2016; the last human case was reported in November of that year.

South Sudan has progressively introduced a national reward scheme for voluntarily reporting of dracunculiasis cases, raised awareness levels and maintained its readiness for case containment. Over the past year and faced with insecurity, the South Sudan Guinea Worm Eradication Programme has managed to implement robust surveillance despite the evacuation of almost its entire expatriate staff for over a year.

Mali, another country which has reported zero human cases since November 2015, is also implementing surveillance and maintains a cash reward scheme. A dynamic response team has investigated all reported rumours within 24 hours throughout 2017.

Transmission of the parasite in humans and animals

Dracunculiasis (guinea-worm disease) in humans was reported in two countries (Chad and Ethiopia), each with 15 cases in 2017. This brings the cumulative total in 2017 to 30 human cases – 5 cases more than the 2016 total.

An outbreak of dracunculiasis occurred in Ethiopia among migrant labourers in Oromia Region during the period September–December 2017. Case containment and surveillance are continuing. Moreover, 15 infected animals (11 dogs and 4 baboons) were also reported.

In Chad, 15 human cases and 830 animal infections (817 dogs and 13 cats) have been reported. Chad is implementing active surveillance and case containment measures as well as treatment of all surface water with the cyclopicide temephos in order to kill water fleas (cyclops) that carry the infective guinea-worm larvae.

Chad is also intensifying communication and awareness activities in areas where infections are common, with the support of The Carter Center, WHO’s main partner. The Carter Center has been at the forefront of dracunculiasis eradication activities since 1986, along with WHO, the United Nations Children’s Fund and the WHO Collaborating Centre at the United States Centers for Disease Control and Prevention.

1Chad, Ethiopia and Mali are still endemic for the disease. South Sudan and Sudan are in the pre-certification stage. Angola and the Democratic Republic of the Congo, which have had no history of the disease since the 1980s, also need to be certified.

Ashok Moloo
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