Eradication of dracunculiasis: current situation

Overview

Of the countries still endemic for dracunculiasis at the start of the eradication campaign, India had the largest number of people exposed to the disease. Thanks to a successful national guinea-worm eradication programme, the country has reported zero cases since August 1996. In February 2000, the International Commission for the Certification of Dracunculiasis Eradication recommended that India be certified free of dracunculiasis transmission. Pakistan (the other country of the region where the disease had recently been endemic) was certified free of transmission in 1997. These 2 countries are among the first to interrupt transmission of the parasite since the international health community declared its commitment to eradicate the disease.

Efforts undertaken by all partners to eradicate dracunculiasis are now being rewarded: not only the number of cases worldwide has decreased by 98% in the past 10 years, but an increasing number of countries which have interrupted transmission are currently in the precertification period of 3 years: Yemen reported its last case in 1997, Senegal in 1998, Chad in 1999. Cameroon and Kenya have had no indigenous cases in 1999. If these countries continue to report monthly the absence of cases, they will be visited by an international certification team whose report will be reviewed by the International Commission for he Certification of Dracunculiasis Eradication.

Transmission of dracunculiasis is now confined to 13 countries in Africa (Map 1). The campaign must be intensified in countries still endemic and a high level of vigilance must be maintained in the countries which have been reed of the disease but not yet certified.