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78% of all guinea worm cases occurring in SudanConflict in southern Sudan has cast a shadow over remarkable global progress towards the World Summit for Children goal of elimination of guinea worm disease (dracunculiasis) by the year 2000. In 1996, Sudan accounted for 78% of all guinea worm cases worldwide, up from 32% just two years before. This reflects both a decline in incidence in other countries and better reporting of cases in Sudan.Guinea worm disease is caused by drinking water contaminated with a
parasite that grows 20 to 30 inches in a patient’s body, bringing debilitating
pain, ulcers, fever and joint deformities. Only 10 years ago, it afflicted
millions of people in Africa and Asia. But today, only 10 countries report
more than 1,000 guinea worm cases, and all except Sudan have shown a decline
in cases in the past three years, nearly conquering the ‘fiery serpent’,
as the parasite is known. Pakistan, which has had no reported cases since
1994, was certified in January as having eliminated the disease, and Kenya
had no reported cases in 1996. India reported nine cases but verified that
the spread of the disease was contained, thereby increasing the possibility
of achieving elimination in 1997.
In Sudan, armed conflict continues to hamper prevention efforts, although there is now greater access for health workers and equipment to southern Sudan where most guinea worm cases occur. Population up-heaval because of the civil war could retard much of the progress in eradication. Unlike immunization, which can be accomplished during a few ‘days of tranquillity’ agreed to by forces in conflict, eliminating guinea worm disease takes continuous work for a year or more. Community water supplies must be improved, cloth water strainers distributed to families, and health education and surveillance programmes set up. |
