Dracunculiasis eradication.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D R Hopkins.
Explore the source record for details and available documents.
The idea of a global campaign to eradicate dracunculiasis was first proposed by the Centers for Disease Control and Prevention in 1980, during the advent of the International Drinking Water Supply and Sanitation Decade (IDWSSD) (1981-1990). In 1981, the Steering Committee of the IDWSSD adopted eradication of dracunculiasis as a subgoal of their efforts to provide safe drinking water to unserved populations. In 1988, African ministers of health voted to eradicate dracunculiasis by the end of 1995, a target date that was endorsed by UNICEF in 1989 and the World Health Assembly in 1991. Although nine of 18 endemic countries, India (1980), Pakistan (1987), Nigeria and Cameroon (1988), Ghana (1989), and Mauritania, Benin, Burkina Faso, and Togo (1990) completed national searches for cases of the disease, only four countries, India (1983), Pakistan (1988), Ghana (1989), and Nigeria (1989), actually started eradication programs during the 1980s. The remaining 14 endemic countries began their eradication programs between 1991 and 1995. At the end of 1996, dracunculiasis had not been entirely eradicated, but its incidence had been reduced by 95%, from an estimated 3.2 million cases in 1986 to 152,805 cases in 1996. Sudan reported a total of 118,578 (78%) of the 152,805 cases of dracunculiasis reported during 1996. Insufficient funding and the civil war in Sudan continue to be the major obstacles to overcome. A primary aim of the eradication program in 1997 is to seek to ensure that all cases of dracunculiasis outside of Sudan are contained. In Sudan the challenge is to pursue all appropriate control measures in all accessible areas as vigorously as possible until political circumstances allow access to all of the remaining affected areas.
In 1986 the World Health Organization targeted dracunculiasis (Guinea-worm disease), which seriously impairs socioeconomic development in 16 African countries, India, Pakistan, and Yemen, to be eradicated globally. The target date for eradication by the end of 1995 was established in 1991. Pakistan eradicated dracunculiasis from the country in October, 1993, after a national campaign which began in 1987 with a nationwide village-by-village search for cases. The infection, which is transmitted by drinking water from ponds containing infected water fleas, was eradicated by using health education, cloth filters, and the cyclopsicide, temephos; and in the later stages, by case containment. Methods pioneered in Pakistan's National Guinea Worm Eradication Program are now being applied in remaining endemic countries.
Substantial progress has been realized in the global campaign to eradicate dracunculiasis by the end of 1995 since a previous review of the subject was published in this journal a year ago. All known endemic countries are now engaged in the eradication effort, and one or more control measures are now in place in 93% of endemic villages. Despite improved surveillance for the disease, the number of reported cases of the disease has been reduced by 41% (to about 221,000), and the number of known endemic villages has been reduced by 28% (to about 16,500) in the past year. Priorities for national eradication programs in 1994 include increasing the use of vector control and intensifying the case containment strategy in endemic villages. It is still possible to achieve the eradication target of December 1995, but greatly intensified efforts this year will be required to do so.
Explore the source record for details and available documents.
Beginning with the International Drinking Water Supply and Sanitation Decade (1981-1990), an increasingly broad coalition of international and bilateral agencies, organizations, private companies, and other institutions have joined forces to eradicate dracunculiasis (Guinea worm disease). From an estimated annual incidence of 10 million persons just before the campaign began, the remaining incidence of cases is now less than two million. More than 23,000 villages are known to be endemic. All 18 countries where the disease is still endemic have completed or begun nationwide searches to identify endemic villages, except Kenya. Dracunculiasis is nearly eradicated in Asia, where Pakistan found only 23 cases in 1992, and India found 1,081 cases. Cameroon and Senegal are close to achieving eradication in Africa, where the two formerly highest endemic countries, Nigeria and Ghana, reduced their combined total of cases from approximately 820,000 in 1989 to less than 240,000 in 1992. Much remains to be done, however, in francophone West Africa and especially in East Africa. The most serious current obstacles to eradicating dracunculiasis by 1995 are the civil war in Sudan, apathy of some national and international health officials, and inadequate funding for the campaign.
Explore the source record for details and available documents.
The transformation of dracunculiasis from an obscure and neglected rural disease to the highly visible target of a national eradication campaign in Nigeria is described in this report. This process progressed through four overlapping stages: documentation of the extent and nature of the disease as a national problem, demonstration in Nigeria that dracunculiasis could be effectively prevented by targeted provision and use of protected rural water supplies, mobilization for community participation in, and political support of, the eradication effort, and implementation of interventions nationwide. The conduct of the first national village-by-village search for cases and documentation of the adverse socioeconomic impact of the disease (e.g., on rice production) in Nigeria were the key elements used to solicit greater attention to the problem and mobilize support for its eradication. The critical role of the mass media in this effort and other benefits of this mobilization strategy are also highlighted.
Explore the source record for details and available documents.
In 1986 the World Health Organization (WHO) designated dracunculiasis (guinea worm disease) as the next disease scheduled to be eradicated (by 1995) after smallpox. Dramatic improvement in national and international surveillance has played a key role in the global eradication campaign, which was initiated at CDC in 1980. About 3 million persons are still affected by the disease annually, with adverse effects on their health as well as on agricultural production and education. Over 100 million persons are at risk of having the disease in more than 20,000 villages in India, Pakistan, and 17 African countries. At least one nationwide, village-by-village search to detect all villages with endemic dracunculiasis and count cases is recommended at the outset of each national campaign, followed by monthly reporting by village-based health workers in the targeted villages during the implementation phase. Rapid dissemination of the results of the surveillance is critical. Intensive case detection and containment--with rewards for reporting of cases--are most appropriate near the end of each campaign. Cameroon, Ghana, India, Nigeria, and Pakistan have pioneered the various surveillance methods for this disease in recent years. Methods for conducting surveillance of dracunculiasis and other important diseases must continue to be developed and improved as countries now believed to be free of dracunculiasis prepare to apply to WHO for certification of elimination of dracunculiasis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In 1991 the Forty-fourth World Health Assembly declared the goal of eradicating dracunculiasis (guinea worm disease) by the end of 1995. This article summarizes the recommended strategies for surveillance and interventions in national dracunculiasis eradication programmes. It is based on personal experience with dracunculiasis programmes in Ghana, Nigeria and Pakistan. Three phases are described: establishment of a national programme office and conduct of a baseline survey; implementation of interventions; and case containment. The relevance of dracunculiasis eradication activities to strengthening of primary health care in the three countries is discussed briefly. Similar strategies would help eradicate this disease in the remaining endemic countries.
Explore the source record for details and available documents.
To determine the effect of low-impact aerobic dance on sedentary elderly women (N = 53), functional fitness was measured by items from the proposed American Alliance of Health, Physical Education, Recreation, and Dance (AAHPERD) fitness test for older adults. After 12-weeks of low-impact aerobic dance, the group improved significantly on all functional fitness components except motor control/coordination, including cardiorespiratory endurance, strength/endurance, body agility, flexibility, body fat, and balance.
Substantial progress has been achieved over the past 3 years by the campaign to eradicate dracunculiasis. The target of eradication by 1995 has been set by the African Regional Office of the World Health Organization and accepted by the United Nations Children's Fund (UNICEF) and the United Nations Development Program. India and Pakistan continue to reduce their cases of the disease dramatically. In Africa, Ghana and Nigeria conducted national village-by-village searches in 1988-1990 and, between them, found greater than 800,000 cases of the disease. Most African countries have now prepared national plans of action, appointed national coordinators, and intend to use UNICEF's assistance to conduct national searches by the end of 1990. An international donors' conference held in 1989 facilitated major new assistance for the initiative by UNICEF, the United Nations Development Program, the United States Agency for International Development, the Japanese International Cooperation Agency, the Peace Corps, the American Cyanamid Company, and DuPont. The World Health Organization held a meeting early in 1990 to draft criteria and recommend the process for certifying achievement of elimination of dracunculiasis in formerly endemic countries. The major remaining obstacles to eradication of dracunculiasis by 1995 are civil wars in northeastern Africa and the apathy of some national and international officials.
Explore the source record for details and available documents.