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Dracunculiasis: 11 confirmed human cases reported from 3 out of 4 remaining endemic countries

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Chad
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WHO
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Chad reports 5 cases while insecurity in South Sudan limits full access to endemic areas

19 August 2016¦ Geneva

The World Health Organization (WHO) has received reports of 5 confirmed human cases of dracunculiasis (guinea-worm disease) from Chad – the highest number reported so far this year by a single country endemic for the disease.

Furthermore, Chad has reported a total of 769 infections in dogs since January 2016. This sizeable increase from the 419 cases reported for the corresponding period in 2015 is largely attributed to increased surveillance and the introduction since early 2015 of a cash reward of about US$ 20 for reporting infections in dogs.

“The Programme is investigating the dynamics of transmission in dogs” said Dr Dieudonné Sankara, Team Leader of WHO’s Dracunculiasis Eradication unit.“While waiting for conclusive results, temephos is being regularly used to kill copepods in ponds and other water bodies to minimize risks of transmission. The Programme has also initiated research to determine the behaviour of dogs by tracking their movements through GPS and by analysing aquatic animals to verify if they are a source of infection or whether transmission is attributable to drinking unsafe water, or both.”

Besides increased surveillance, other measures in Chad include community sensitization and awareness creation, which include promoting the tethering of dogs to prevent contamination of water bodies.

Insecurity: South Sudan

In South Sudan, a country already affected by mass population displacement and civil unrest, 4 human cases have been reported from Udici Payam Jur River County in Western Bahr el Ghazal State (3 cases) and Tonj East County in Warrap State (1 case).

Despite safety concerns, the South Sudan Guinea-Worm Eradication Programme (SSGWEP) is working hard to maintain surveillance in almost all endemic villages and ensure containment measures (including application of temephos, distribution of filter mesh, promoting health education and increasing awareness about the cash reward). As a result, Kapoeta East County in Eastern Equatoria State, the most affected county in previous years, has reported zero cases to date in 2016.

“We laud the bravery of the SSGWEP in carrying out surveillance and other field activities” said Dr Sankara._ “We hope the current unrest and fighting will end in order to improve the remarkable gains and momentum achieved over the past few years.”_

The recent escalation of conflict in South Sudan has forced many people to flee, including the evacuation of health workers. Many displaced people do not have access to adequate shelter while the ongoing rainy season is increasing the risk of water-borne diseases and of dracunculiasis transmission in endemic areas. With more than 1.6 million people displaced internally, and the decreasing availability of health workers and aid workers, work on the ground is becoming ever more challenging. Despite this situation, the SSGWP investigated 3568 rumours of dracunculiasis cases from January to May 2016.

Ethiopia: low-level transmission

In Ethiopia, low-level transmission has continued in the Gambella Region where 2 human cases have been reported so far this year. Infection has also been confirmed in 3 dogs and 1 baboon.

The Ethiopian Dracunculiasis Eradication Programme (EDEP) has recently reorganized its activities in the Gambella and Southern Nations Nationalities and Peoples Region (SNNPR). The national coordination team comprises several staff and operates out of a new office with a fulltime hotline operator to respond to rumours from different parts of the country. Any person reporting a confirmed human case is entitled to a cash reward of US$100 equivalent. The EDEP has investigated 1263 rumours in the past 7 months.

Mali reports zero cases

Mali, the fourth country where the disease remains endemic, has reported zero human cases since January 2016.

However, 3 infected dogs were reported in the Fangasso area of Segou Region. From January to July 2016 around 135 rumours in humans were reported and investigated.

1 Larvicide that kills water fleas carrying dracunculiasis larvae.