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Towards global Guinea worm eradication in 2015: the experience of South Sudan.
[dracunculiasis]
For
centuries
,
the
Guinea
worm
parasite
(
Dracunculus
medinensis
)
has
caused
disabling
misery
,
infecting
people
who
drink
stagnant
water
contaminated
with
the
worm
's
larvae
.
In
2012
,
there
were
542
cases
of
Guinea
worm
reported
globally
,
of
which
521
(
96
.
1
%
)
were
reported
in
South
Sudan
.
Protracted
civil
wars
,
an
inadequate
workforce
,
neglect
of
potable
water
provision
programs
,
suboptimal
Guinea
worm
surveillance
and
case
containment
,
and
fragmented
health
systems
account
for
many
of
the
structural
and
operational
factors
encumbering
South
Sudan
's
Guinea
worm
eradication
efforts
.
This
article
reviews
the
impacts
of
six
established
Guinea
worm
control
strategies
in
South
Sudan
:
(
1
)
surveillance
to
determine
actual
caseload
distribution
and
trends
in
response
to
control
measures
;
(
2
)
educating
community
members
from
whom
worms
are
emerging
to
avoid
immersing
affected
parts
in
sources
of
drinking
water
;
(
3
)
filtering
potentially
contaminated
drinking
water
using
cloth
filters
or
filtered
drinking
straws
;
(
4
)
treating
potentially
contaminated
surface
water
with
the
copepod
larvicide
temephos
(
Abate
)
;
(
5
)
providing
safe
drinking
water
from
boreholes
or
hand
-dug
wells
;
and
(
6
)
containment
of
transmission
through
voluntary
isolation
of
each
patient
to
prevent
contamination
of
drinking
water
sources
,
provision
of
first
aid
,
and
manual
extraction
of
the
worm
.
Surveillance
,
community
education
,
potable
water
provision
,
and
case
containment
remain
weak
facets
of
the
program
.
Abate
pesticide
is
not
a
viable
option
for
Guinea
worm
control
in
South
Sudan
.
In
light
of
current
case
detection
and
containment
trends
,
as
well
as
capacity
building
efforts
for
Guinea
worm
eradication
,
South
Sudan
is
more
likely
to
eradicate
Guinea
worm
by
2020
,
rather
than
by
2015
.
The
author
highlights
areas
in
which
substantial
improvements
are
required
in
South
Sudan
's
Guinea
worm
eradication
program
,
and
suggests
improvement
strategies
.
Diseases
Validation
Diseases presenting
"weak facets of the program"
symptom
dracunculiasis
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