East Africa on course to eradicating worm

Tuesday July 3 2018

Guinea worm, south sudan

A volunteer health worker (left) removes a guinea worm from the leg of a patient in the village of Yari in Central Equatoria state on February 2, 2010. South Sudan is drawing inspiration from its neighbour Kenya, which was last moth declared free of guinea worm. AFP PHOTO | LOUISE GUBB 

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East African countries are on course to winning the war against the guinea worm disease (GWD), thanks to intensified efforts their governments in partnership with the World Health Organization (WHO).

South Sudan, one of the seven African countries which are yet to be declared free of the infection, is now inching closer to getting the crucial certification even as it celebrates 17 months without any guinea worm case reported.

According to the Health Ministry, South Sudan is already engaging the relevant multilateral partners to fast-track the process of being certified guinea worm free, about 12 years since the South Sudan Guinea Worm Elimination Programme (SSGWEP) was established in 2006.

“Having known the suffering it inflicted, one is very happy today,” Health Minister Dr Riek Gai Kok, said at the Carter Center, in March.

“Future generations will just read of Guinea worm in the books as history.”

South Sudan is drawing inspiration from its neighbour Kenya, which was last moth declared free of guinea worm by the WHO, becoming the 41st country in the WHO African Region to be certified free of GWD.

The certification followed the recommendation of the International Commission for the Certification of the Dracunculiasis Eradication (ICCDE) in February.

The commission made the recommendation after reviewing a report by experts who found no evidence of transmission of the disease in the country over the past three years.
“The certification of the second disease to be successfully eliminated in Kenya, after small pox, validates our efforts,” Health Cabinet Secretary Sicily Kariuki said after receiving the certificate last month.

Endemic countries

Meanwhile, Ethiopia — one of the four guinea worm endemic countries besides Chad, Ethiopia, Mali, and South Sudan — is determined to get rid of the infection in the next two years even as it battles the resurgence witnessed in 2017.

According the WHO, Ethiopia reported 15 human cases of GWD in 2017, a significant rise from the three cases reported over 2016.

Zero human cases and animal cases had been reported as at February but 144 villages are under active surveillance.

Guinea-worm disease is caused by the parasitic worm Dracunculus medinensis which is contracted through drinking of contaminated water that hosts the worm’s larvae, which then grows inside the body of the victim.

After about 100 days, the adult female guinea worm erupts through the victim's skin, causing painful blisters that look like hot water burn wounds mostly on the legs, which later burst creating a wound that reveals a whitish worm.

Treatment of the wound involves pulling out the worm, in a painful process that can take days.

Only the WHO — based on ICCDE’s recommendations — has the mandate to certify countries free of the worm whose global eradication campaign began in 1986, towards the current target date to extinguish guinea worm by 2020.

In the WHO Africa region, Ethiopia and Chad are the only remaining countries reporting ongoing cases of the disease, with a total of 30 cases reported over 2017.

With Kenya’s certification last month, only six countries in the region —Angola, the Democratic Republic of Congo, Mali, South Sudan, Chad and Ethiopia — are yet to be declared Guinea-worm-free.