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Surveillance for dracunculiasis, 1981-1991.
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1992
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Parasitic DiseaseWorld Health OrganizationMalariaDiagnosisPathologyEradication Of DiseaseDisease OutbreakPublic HealthParasitologyHistopathologyDisease SurveillanceInternational SurveillanceEpidemiologyVaccinationGlobal HealthZoonotic DiseaseInternational HealthSoil-transmitted HelminthiasisMedicineGlobal Eradication CampaignDisease Monitoring
Dracunculiasis, affecting about 3 million people yearly and threatening over 100 million in more than 20 000 villages across India, Pakistan, and 17 African countries, was slated for eradication by 1995, with surveillance improvements playing a pivotal role in the global campaign. The study aims to develop and refine surveillance methods for dracunculiasis as countries prepare to seek WHO certification of elimination. Surveillance involves an initial nationwide village‑by‑village search to identify endemic villages, followed by monthly reporting by village health workers, rapid result dissemination, and intensified case detection and containment—often incentivized—toward the campaign’s end.
In 1986 the World Health Organization (WHO) designated dracunculiasis (guinea worm disease) as the next disease scheduled to be eradicated (by 1995) after smallpox. Dramatic improvement in national and international surveillance has played a key role in the global eradication campaign, which was initiated at CDC in 1980. About 3 million persons are still affected by the disease annually, with adverse effects on their health as well as on agricultural production and education. Over 100 million persons are at risk of having the disease in more than 20,000 villages in India, Pakistan, and 17 African countries. At least one nationwide, village-by-village search to detect all villages with endemic dracunculiasis and count cases is recommended at the outset of each national campaign, followed by monthly reporting by village-based health workers in the targeted villages during the implementation phase. Rapid dissemination of the results of the surveillance is critical. Intensive case detection and containment--with rewards for reporting of cases--are most appropriate near the end of each campaign. Cameroon, Ghana, India, Nigeria, and Pakistan have pioneered the various surveillance methods for this disease in recent years. Methods for conducting surveillance of dracunculiasis and other important diseases must continue to be developed and improved as countries now believed to be free of dracunculiasis prepare to apply to WHO for certification of elimination of dracunculiasis.