Perspectives from the dracunculiasis eradication programme. (1/61)

After a slow beginning in association with the International Drinking Water Supply and Sanitation Decade (1981-1990), the global Dracunculiasis Eradication Programme has reduced the incidence of dracunculiasis by nearly 97%, from an estimated 3.2 million cases in 1986 to less than 100,000 cases in 1997. Over half of the remaining cases are in Sudan. In addition, the programme has already produced many indirect benefits such as improved agricultural production and school attendance, extensive provision of clean drinking-water, mobilization of endemic communities, and improved care of infants. Most workers in the campaign have other responsibilities in their communities or ministries of health besides dracunculiasis eradication.  (+info)

Candidate parasitic diseases. (2/61)

This paper discusses five parasitic diseases: American trypanosomiasis (Chagas disease), dracunculiasis, lymphatic filariasis, onchocerciasis and schistosomiasis. The available technology and health infrastructures in developing countries permit the eradication of dracunculiasis and the elimination of lymphatic filariasis due to Wuchereria bancrofti. Blindness due to onchocerciasis and transmission of this disease will be prevented in eleven West African countries; transmission of Chagas disease will be interrupted. A well-coordinated international effort is required to ensure that scarce resources are not wasted, efforts are not duplicated, and planned national programmes are well supported.  (+info)

Eradicating guinea worm without wells: unrealized hopes of the Water Decade. (3/61)

At the start of the United Nations International Drinking Water Supply and Sanitation Decade in the 1980s, guinea worm disease was targeted as the major indicator of the success of the Decade's efforts to promote safe water. By the late 1980s, most of the guinea worm endemic countries in Africa and South Asia had established guinea worm eradication programmes that included water supply as one of their main technical strategies. By surveying the water supply situation in Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, in June 1996, as a case study, it was possible to determine the role that water supply has played in the eradication effort. Although two major agencies, the former Directorate for Food, Roads and Rural Infrastructure and UNICEF, provided hand dug and bore-hole wells respectively in many parts of the LGA, coverage of the smaller farm hamlets has been minor compared to efforts in the larger towns. This is ironic because the farm hamlets served as a reservoir for the disease in the 1980s, such that when the piped water system in the towns broke down, guinea worm was easily reintroduced into the towns. The survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of the people still drink only pond water. Another 11.3% have wells that have become dysfunctional. Only 14.4% of this rural population has access' to functioning wells. Guinea worm was eliminated from 107 of the hamlets mainly by the use of cloth filters and chemical treatment of ponds. While this proves that it is possible to eradicate guinea worm, it fails to leave behind the legacy of reliable, safe water supplies that was the hope of the Water Decade.  (+info)

The progress of the Polio Eradication Initiative: what prospects for eradicating measles? (4/61)

Although various attempts have been made to eradicate infectious diseases, only smallpox has been eradicated to date. Polio is targeted for eradication in 2000 and already planning has begun for the eradication of measles. However, before we commit to a measles eradication effort, we must examine the lessons to be learned from polio eradication. Of particular importance is the debate over whether resources should be invested in 'horizontal' or 'vertical' programmes. The outcome of these debates will have a very deep and lasting impact on global health development in years to come. Collaboration between targeted programmes and the primary health care sector through polio and measles eradication efforts will help bring about the necessary balance between goal-oriented programmes, which are subject to quality control and can be evaluated by measurable outcomes, and broader efforts to build up sustainable health infrastructure.  (+info)

Dracunculiasis in Cameroon at the threshold of elimination. (5/61)

BACKGROUND: Dracunculiasis is endemic in Mayo Sava Division in the Far North Province of Cameroon. Transmission occurs during the rainy season with a peak in the months of July and August. METHODS: A combination of interventions consisting of active surveillance, social mobilization, health education, distribution of filters, construction of new water sources, chemical treatment of unsafe water sources with temephos, and case containment were applied in Mayo Sava in 1990-1995 by the national Guinea Worm Elimination Programme (GWEP). Dracunculiasis cases were detected by village health workers, confirmed by health outreach teams and reported weekly to the GWEP. RESULTS: A decline in the incidence of dracunculiasis by 98.1% from 778 cases in 1990 to 15 in 1995, and in the number of endemic villages by 92.7% from 82 in 1990 to 6 in 1995 was achieved. The proportion of cases identified < or =24 hours of worm emergence increased from 19% in 1991 to 73.6% in 1993. Over 1500 nylon monofilament filters were distributed yearly to endemic villages lacking safe drinking water sources, while 81 new water sources were constructed (boreholes, wells and dikes), 55% in 1992-1993. The success of GWEP is attributed mainly to: intensive and simultaneous implementation of interventions in highly endemic villages in the first 3 years of the programme, case containment, and cash reward. CONCLUSIONS: Cameroon is on the threshold of eliminating dracunculiasis from Mayo Sava but the major remaining obstacle is the ever increasing threat of re-infestation from neighbouring countries.  (+info)

Acceptance and use of communal filtration units in guinea worm eradication. (6/61)

The use of cloth to filter drinking water for guinea worm prevention is a long-standing control strategy and part of a mixed approach that includes the provision of wells, chemical treatment of ponds and protection of water supplies. As the goal of eradication nears, filters are a useful component of the quick response needed to implement case containment at village level. Various designs of filters have been used. Individual hand-sewn filters (HSFs) using monofilament nylon cloth have played a central role in village-based control to date. Problems such as the need to continually reinforce correct habitual filtering behaviour have led to the design and testing of communal filtration units (CFUs) made from metal oil drums with filter cloth inserted in the top and spigots at the bottom. Approximately one year after the introduction of CFUs in the South-western Zone of Nigeria, village surveys were conducted to determine opinions about the two types of filters and reported use. Percentage use was calculated by dividing the number of times water was filtered in the week preceding the survey by the number of times water was collected in that week. Those respondents with access to CFUs filtered an average of 91.9% of the time compared to 75.7% of those with HSFs. Using the village as level of analysis since it was the main level of intervention, the average percent of times villagers in CFU villages filtered was 91.1% compared to 77.8% in HSF villages. Although CFUs were more expensive in the short run, their greater acceptance by villagers is a factor to recommend their wider implementation to speed up elimination of guinea worm from Nigeria.  (+info)

India eradicates guinea worm disease.(7/61)

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Dracunculiasis eradication: delayed, not denied. (8/61)

By the end of 1998, Asia was free of dracunculiasis (Guinea worm disease), with Pakistan, India, and Yemen having interrupted transmission in 1993, 1996, and 1997, respectively. Transmission of the disease was also interrupted in Cameroon and Senegal during 1997. Chad reported only 3 cases during 1998. Dracunculiasis is now confined to only 13 countries in Africa. The overall number of cases has been reduced by more than 97% from the 3.2 million cases estimated to have occurred in 1986 to 78,557 cases reported in 1998. Because the civil war in Sudan remains the major impediment to eradication of dracunculiasis, the interim goal is to stop all transmission outside that country by the end of 2000. The most important operational need now is for national programs to improve the frequency and quality of supervision of village-based health workers in order to enhance the sensitivity of surveillance and effectiveness of case containment.  (+info)