Sudan: Final push to eradicate Guinea worm

Guinea worm, the agonizing water-borne parasite, could be eradicated within “two to three years” from Southern Sudan, health officials say.

Guinea worm, also known as dracunculus medinensis, is a crippling parasitic disease transmitted by larvae in contaminated drinking water. After mating inside the body and growing up to 1m in length, the female worms begin to burrow out after a year, launching thousands of larvae from the blisters formed on the skin.

Once common across Africa and Asia, with some 3.9 million cases in 1986, according to the World Health Organization (WHO), the thread-like worm is now limited to pockets of Mali, Ghana, Ethiopia and Southern Sudan.

“Guinea worm is one of the priority areas in Southern Sudan that the Ministry of Health is focusing on,” said Olivia Lomora from the Health Ministry.

Some 80 percent of cases worldwide are in Southern Sudan, a region left in ruins by a 22-year long civil war, which ended in the 2005 Comprehensive Peace Agreement (CPA) between north and south.

“In 2006, following the Comprehensive Peace Agreement, more than 20,000 cases of Guinea worm were reported in Southern Sudan, in eight of the 10 states,” Lomora added.

“Today we are happy to say that we have about 2,753 cases… it is our hope that we will be able to eradicate guinea worm in Southern Sudan.”

Thousands of health workers have helped slash infection rates worldwide by 99 percent, with some 3,500 cases in 2009, according to the US-based Carter Center, which is spearheading efforts to stamp out the worm.

In Sudan overall, the incidence of Guinea worm has been reduced from 118,578 cases in 1996 to a provisional total of 2,753 cases reported in 2009 - a 98 percent decrease, according to the Carter Center.

Since 2003, there have been no indigenous cases of Guinea worm disease in northern Sudan.

Last year, the previously worm-endemic nations of Nigeria and Niger achieved 12 months without new infections, according to the WHO.

Former US president Jimmy Carter, who founded the Carter Center, believes such successes can be rolled out to the remaining affected areas. “We believe that in the next two to three years we will have zero cases of Guinea worm in the Sudan,” said Carter, after meeting worm-infected patients in Southern Sudan.

If successfully destroyed, it would become the first disease after smallpox to be eradicated - and the first to be wiped out without a vaccine or medicine.

“We hope to come back soon to celebrate the death of the last Guinea worm on the face of the Earth,” he added.

“In many former endemic areas the children no longer know what Guinea worm disease is,” said Clement Wani Konga, the governor of Central Equatoria state.

“We believe that much can be achieved despite the post-war challenges in Southern Sudan. Due to a lack of access to safe water, compounded by a lack of awareness and inadequate funding…Guinea worm pains prevent people from working or [going to] school.”

Breaking the cycle

Victims are often incapacitated for days or even weeks when the worms emerge, causing fever, nausea and weakness.
 
The worms leave the body at a crucial period for farming, so the disease can have a severe impact on agricultural productivity and raise the risk of malnutrition among children in households whose adult members are affected.

While there is no direct treatment, the worm’s breeding cycle can be broken by ensuring people do not wash in sources of drinking water while the worm is emerging from the skin.

In addition, thousands of volunteer health workers have been trained to ensure people use a simple water filter.
 
Extracting the worms requires winding them around a small stick, a process that can take days, to ensure no part of the worm is left inside the human body.

pm/mw

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