The effect of antibiotic- and hydrocortisone-containing ointments in preventing secondary infections in guinea worm disease

Dracunculiasis (Guinea worm disease) and the eradication initiative

Dracunculiasis, also known as guinea worm disease, is caused by the large female of the nematode Dracunculus medinensis, which emerges painfully and slowly from the skin, usually on the lower limbs. The disease can infect animals, and sustainable animal cycles occur in North America and Central Asia but do not act as reservoirs of human infection. The disease is endemic across the Sahel belt of Africa from Mauritania to Ethiopia, having been eliminated from Asia and some African countries. It has a significant socioeconomic impact because of the temporary disability that it causes. Dracunculiasis is exclusively caught from drinking water, usually from ponds. A campaign to eradicate the disease was launched in the 1980s and has made significant progress. The strategy of the campaign is discussed, including water supply, health education, case management, and vector control. Current issues including the integration of the campaign into primary health care and the mapping of cases by using geographic information systems are also considered. Finally, some lessons for other disease control and eradication programs are outlined.

An introduction to guinea worm on the eve of its departure: dracunculiasis transmission, health effects, ecology and control

A broad ranging discussion of the basic nature of guinea worm disease, fused with personal field observations in Ghana, shows its long-overlooked serious clinical aspects, and the many environmental and social influences that explain its persistence in the face of control efforts. It is a disease of neglect par excellence in remote rural areas. The global eradication campaign (which is not reviewed here) may be expected to come to closure over the next half decade. This account offers an overview, synthesis, and interpretation of a fascinating example in disease ecology at the time of its global vanishing.