Dracunculiasis is considered a highly eradicable parasitic infection. Transmission can be avoided by the use of cloth filters and sanitation education that warns infected patients to avoid contaminating water sources. Dracunculiasis occurs in a limited geographic area and mainly during particular seasons of the year, therefore allowing campaigns to concentrate their efforts. However, the success of eradication campaigns has largely depended on a cultural acceptance of intervention and a willingness to sustain water purification measures. This, along with generous funding and international support, has led to a very successful eradication effort.
Dracunculiasis carries huge economic costs becaue of the debilitating morbitity effects of infection. Once a female worm has begun to emerge from a lesion, it can take months to remove the worm completely. Frequently, the area may become severely infected, causing disability (locked joints), permenant handicap or even death. Children may miss months of school, adults cannot work or complete their family care-taking tasks. Two longitudinal studies in Nigeria found that 58-76% of patients cannot leave their beds for a month while the worm emerges (1). Particularly, Dracunculiasis tends to reappear seasonally and usually during harvesting months. It takes many farmers out of work, usually simultaneously, and decreases overall productivity. Children, under the age of 6, with more than one adult family member infected with Dracunculiasis, are three times more likely to be malnourished (2). The World Bank has estimated that the rate of return on investment in the eradication of Dracunculiasis would be 29% per year (3).
Children back in school with the help of the Carter Foundation's eradication efforts (4)
The global Dracunculiasis eradication campaigns have been supported by many foundations, including The Center for Disease Control and Prevention, the World Health Organization, the Carter Foundation, UNICEF, and most recently, the Bill and Melinda Gates Foundations. The 1980's were deemed the "United Nations International Drinking Water Supply and Sanitation Decade" and Dracunculiasis was targeted as an important, eradicable, water-borne disease. (5) The Center for Disease Control and Prevention (CDC) began a campaign in the 1980s to bring many organizations together to fight Dracunculiasis. Varied donation sources, regional cooperation and sustainable community-oriented programs have been largely successful and have helped to decrease the prevalence of Dracunculiasis by 98%. The main interventions used were: sanitary water supply, water filtration, vector control (killing/removing Cyclops), and the prevention of infected patient contact with drinking water sources. (6)
Jimmy Carter supporting Dracunculiasis patients in Africa (7)
An example of the extreme efforts that have been put into Dracunculiasis eradication is the work done by the Carter Center in the Sudan. Guinea worm has been particularly difficult to eradicate in the area because of political instabilities, and the 20-year-long civil war has made public health intervention nearly impossible. In 1995, former president Jimmy Carter arranged a 4-month cease-fire in the Sudan in order to help eradicate Guinea worm(8). The cease-fire was successful, and health workers attempted to educate and distribute cloth filters throughout Sudan. Though ultimately their attempts were not completely successful, the Carter Center continues their commitment to eradication in the area.
One man helps to guard a water source from Dracunculus medinensis contamination (9)
The support of community leaders and disemmination of education has helped the eradication campaign's success. In 2001, less than 65,000 cases remained in 13 Africa countries, and Asia has been free of the disease. There had been a 98% reduction of cases since the beginning of the campaign. With further long-term funding, education and commitment, Dracunculiasis experts predict that eradication may be feasible in the next few decades. (10)