The end is in sight for the global campaign to eradicate dracunculiasis (guinea-worm disease), but daunting challenges still remain in endemic areas of Mali and Sudan, according to the World Health Organization.
During 2007, the campaign was successful in reducing the number of overall cases by 62 percent—from 25,217 in 2006 to 9,585 in 2007. Transmission of the disease was halted in four of the nine countries where it remains endemic (Burkina Faso, Cote d’Ivoire, Ethiopia, and Togo), with all four countries reporting 0 indigenous cases throughout 2007.
The 2007 figures represent a 99 percent reduction in cases since 1989, when 892,055 cases were reported. That was the year that most endemic countries began to report monthly from village-based surveillance systems. The number of villages reporting endemic transmission dropped from a peak of 23,735 in 1991 to 2,016 in 2007—a 92 percent reduction.
Insecurity in Mali and Sudan poses a challenge to eradication. In addition, both countries are remote, poor, and devoid of infrastructure. Residents are nomadic, moving seasonally with their cattle in pursuit of water and pasture, making it difficult to determine where and when transmission is occurring. The peak transmission season coincides with the rainy season, which impedes travel by health workers.
An analysis of the epidemiological situation is featured in WHO’s Weekly Epidemiological Record, No. 18, 2 May 2008.
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