The end of the Guinea worm disease appears imminent, with just 25 cases reported in 2016 and the number of affected countries dropping from four to three, according to the Carter Center. Mali reported no cases last year, leaving Chad, Ethiopia and South Sudan as the last places in the world where the disease exists.
“The progress we have seen in restricting Guinea worm disease to these few cases in only three countries is a testament to the dedication of people in endemic areas to caring for their health and that of their communities,” Carter Center Vice President of Health Programs Dean Sienko said in a statement. “It’s a privilege to partner with them as we tackle this challenge together.”
The achievement in Mali is dampened by the fact that the total number of cases increased from 22 in 2015 to 25 in 2016. But the Carter Center, an international organization founded by former U.S. President Jimmy Carter, is optimistic. It said that the ability to track and contain cases before they could spread improved significantly. That may lead to fewer cases in 2017.
The 25 cases in 2015 occurred in 19 isolated villages across the three countries. By tracking cases, health officials are able to target programs that promote filtering drinking water and prevent infected people from going into local water sources. That could reduce cases in 2017 and lead to eradication.
“These last few cases of Guinea worm disease remain because they are the most difficult to reach, often appearing in conflict areas or among remote, disenfranchised populations,” Carter said in a statement. “The Carter Center is bringing to bear all of our experience and every resource available to track down, isolate and treat these last remaining cases. Every case and every person counts when eradication is the goal.”
A woman in Nigeria endures the painful extraction of Guinea worm.
The Guinea worm larvae reside in stagnant water and infect people who drink the water. The larvae grows into a worm as long as three feet, which emerges through a blister on or around the feet. It is extremely painful to remove. More larvae is released into the water when the blisters come in contact with water. More than 3.5 million people in 21 countries were infected with the water-borne disease in 1986.
With no vaccine, eradicating Guinea worm requires public health education programs. Stopping its spread requires access to clean drinking water and teaching people how it is spread. Community health workers and local leaders are a crucial part of the effort by going to some of the hardest-to-reach parts of affected countries.
The Carter Center works with governments, the U.N. and the U.S. Centers for Disease Control and Prevention to interrupt transmission of the disease. It is confident in the ability of Ethiopia and South Sudan to eliminate Guinea worm soon. South Sudan’s civil war is an additional challenge, but fighting has not prevented elimination in the past.
Chad is the bigger challenge. Cases increased from nine in 2015 to 16 in 2016. Last year’s cases were spread across 12 different villages and 11 different ethnic groups. The sporadic nature of the cases means that 1,497 villages are under active surveillance in Chad, as of October. Complicating things further, more than 1,000 dogs were reportedly infected by the disease last year.
“We’ve navigated plenty of challenges – including wars – over the 30 years we’ve been working to eradicate Guinea worm,” Donald Hopkins, Carter Center special adviser for Guinea worm eradication, said in a statement. “Sporadic infections in animals constitute another puzzle to be solved, and we are working with a host of partners to confirm the best interventions to prevent this.”
