ELIMINATION OF GUINEA WORM DISEASE IN ETHIOPIA; CURRENT STATUS OF THE DISEASE’S, ERADICATION STRATEGIES AND CHALLENGES TO THE END GAME

Authors

  • Habtamu Bedimo Beyene Addis Ababa University, College of Health Sciences
  • Abyot Bekele Woyessa
  • Amanu Shifara
  • Yehenew Asemamaw Ebstie Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • Zelalem Desalegn Woldesenbet Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • Zeyede Kebede Zeleke World Health Organizations (WHO), National Program Country Office, Ethiopia
  • Abate Mulugeta BESHAH World Health Organizations (WHO), National Program Country Office, Ethiopia
  • Kebede Deribe Neglected Tropical Diseases Case Team, Disease Prevention and Control Directorate, Federal Ministry of Health, Ethiopia, Research Training International (RTI), Addis Ababa, Ethiopia Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK
  • Zerihun Tadesse The Carter Center-Ethiopia
  • Tamrat Abebe Zeleke Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • Biruck Kebede Negash Neglected Tropical Diseases Case Team, Disease Prevention and Control Directorate, Federal Ministry of Health, Ethiopia
  • Getaneh Abrha ESTAYEW 2Ethiopian Public Health institute (EPHI)
  • Daddi Jima Ethiopian Public Health institute (EPHI)

Abstract

Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as ‘fiery serpent’ from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods. Given, its feasibility for eradication, the Guinea Worm Eradication Program (GWEP) was launched in 1980 with the aim of eradicating the disease. Since its inception, GWEP has made an extraordinary progress in interrupting transmission. Globally, the number of reported cases reduced from 3.5 million in 20 countries in 1986 to only 22 cases in 2015 from only four countries namely South Sudan, Mali, Chad and Ethiopia. Since Mali has interrupted transmission of GWD in 2016, currently, the disease remains endemic in only three sub-Saharan African countries namely, South Sudan, Chad and Ethiopia. Each endemic country has its own national Guinea Worm Eradication Program. In Ethiopia, the Ethiopian Dracunculiasis Eradication Program (EDEP) which was established in 1993 has made remarkable move towards interruption of disease transmission and now the endgame is fast approaching. The EDEP with support mainly from The Carter Center, WHO, and UNICEF has reduced GWD by more than 99% from 1994 to 2015. In 2015, only 3 indigenous cases in humans and 14 in animals (13 in dogs and 1 in baboon) were reported.  In 2016, 3 human cases, 14 dogs and 2 baboon infections were reported.. Refugee influx from the Republic of South Sudan (RSS), increased animal infections with unknown role in transmission of Dracunculiasis, the presence of hard to reach communities and lack of safe water sources in remote non-village areas remain among important challenges at this final stage of GWD eradication in Ethiopia. This paper reviews progress made towards Guinea Worm Eradication with a focus on the experience of the Ethiopian Dracunculiasis Eradication Program (EDEP), and intervention strategies that need further intensification to realize the endgame. Eradication strategies encompassing community education for behavioral change including raising awareness towards  cash reward for reporting Guniea Worm Disease (GWD) and animal infection, case containment, surveillance systems, provision of safe water supply, and ABATE chemical application are discussed. It also summarizes challenges the end game faces and recommendations to strengthen the eradication effort.

Key words: Guinea Worm Eradication, Endgame, EDEP, Ethiopia

 

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2017-08-04

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