Nigeria’s Success Story in Guinea Worm Eradication

A woman undergoing Guinea Worm treatment
A woman undergoing Guinea Worm treatment
Steve Dada writes that Nigeria has achieved a feat in eradicating guinea worm through a concerted effort in the face of difficult challenges

Guinea worm is one of the diseases the World Health Organisation (WHO) is striving hard to eradicate from the face of the earth, but unlike in other cases, Nigeria remains one of the countries that would make the objective of eradication unachievable. WHO had set 2005 as the target year for eradicating the poverty-related disease from the surface of the earth.

Most countries had succeeded in meeting the desire to put the burden of guinea worm behind them, but certainly not Nigeria. It is cheering news however, that a few years after the WHO target year, the country been has able to join the league of nations that have eradicated the disease.

Otherwise known as Dracunculiasis, (guinea worm) a crippling parasitic disease caused by Dracunculus medinensis, a long thread-like worm. The disease is transmitted exclusively by drinking contaminated water.

Entering the body through contaminated water sources, the parasite migrates through the victim’s body causing severe pain around joint areas; it eventually emerges (from the feet in 90 per cent of the cases) as a fully developed worm, causing an intensely painful wound accompanied by fever, nausea and vomiting.

Although rarely fatal, dracunculiasis continues to be a major public health problem causing dreadful suffering and disability among many rural communities in Africa dependent upon unprotected water sources for drinking and farming. It was until recently, ranked among the most neglected diseases of mankind.

No drugs are currently available to prevent or heal this parasitic disease. However, it is easy to combat and should no longer be prevalent, because of the easy and unambiguous diagnosis, and immobile transmission agent. Dracunculiasis is the first parasitic disease in history set for eradication through behavioural change, without the use of vaccines or a cure.

At least if Nigeria is still battling with disease like polio, while most countries have succeeded in eradicating the disease, Nigeria can boast of eradicating guinea worm and since 2008, there had not been any tangible case of guinea worm attack in any part of the country, so declared by the members of the National Steering Committee on Certification.

For the country to achieve its current feat of eradicating guinea worm in 2008, the federal government had set up the Nigeria Guinea worm Eradication Programme (NIGEP) in 1988 with a mandate to ensure that Guinea Worm Disease (GWD) transmission in Nigeria is interrupted and Nigeria certified GWD free by the WHO.

At a recent round table meeting with media for advocacy support for GWD pre-certification activities, the Assistant National Coordinator, NIGEP and a member of the steering committee, Mr. Babatunde Tokoya explained that with concerted effort in the implementation of GWD eradication strategies, the disease transmission had been interrupted in Nigeria and GWD eliminated.

According to Tokoya, a total of 653, 620 GWD cases were identified at the inception of NIGEP in 1998 in 5, 879 villages throughout Nigeria, noting that the last case of GWD was reported in the country on November 11, 2008. He added that, in 2008, a total of 38 guinea worm disease cases were reported in Nigeria.

“From December 2008 till date, Nigeria has maintained a zero guinea worm disease case status for 52 consecutive months. Nigeria marks the 2013 National GWD eradication and incidentally the last one before the imminent visit of the international certification team to the country,” he noted.

Any country that succeeds in eradicating guinea worm must receive the WHO certification, making it authentic that such country has truly eradicated the disease. Since 2008, when the last case of the disease was recorded, Nigeria has not received the certification, which implies that the country’s claim to have eradicated guinea worm does not have the WHO backing.

A team to certify Nigeria guinea worm free will be visiting the country very soon. By the visit the country has ample opportunity to present evidence to the visiting team and thereby be certified a guinea worm free country.

How will Nigeria convince the team that there had been no cases of guinea worm attack since 2008. GIGEP has encouraged Nigerians to report any suspected case of GWD to the nearest health facility or health worker or call the NIGEP toll-free number immediately and if such case is confirmed, the person would be given a cash price of N25, 000 reward.

GIGEP has instituted surveillance and publicity to ensure that at least 85 per cent timely reporting from all health facilities (public and private, primary, secondary and tertiary health institutions in all 774 LGAs in the states, noting that, from 2009 till date the GIGEP has received 545 rumour cases of GWD out of which 21 was recorded from January to March 2013.

The body assured that, at least, 80 per cent monthly reporting from all 774 LGAs has been maintained, giving a breakdown of the completeness reporting from January to December, 2012 as 83 per cent and timeliness, 51 per cent, while completeness for January to February, 2013 is 81 per cent and 81 per cent also for timeliness. The body claims that at least 80 per cent of general public in rural and urban areas know about the reward for reporting GWD.

GIGEP has made a follow up phone calls to all the state commissioners of health in the country to solicit their support in convincing the health workers in their states to improve the level of health facility reporting to a minimum of 85 per cent and also increase the timeliness and completeness of their reports.

GWD publicity activities for case detection and reporting have been maintained and intensified. Nationwide surveillance is conducted through routine disease surveillance, National Immunisation Days Campaigns and other community-based disease control programmes.

In his speech, a member of the National Steering Committee on Certification, Mr. Buki Ponle noted that total eradication of guinea worm disease on the surface of the earth would be historic and a success story to be associated with, as it will be the second disease to be eradicated after small pox.

According to him WHO has confirmed that guinea worm disease which has plagued people for thousands of years, is on the verge of eradication, stressing that the United Nations (UN) agency added that the disease will be declared eradicated only after its transmission in the affected countries has been interrupted for a minimum period of three years and good enough, Nigeria is already at this stage.

WHO officials say finding and containing the last remaining cases of the disease is the most difficult stage of the eradication process, because cases usually occur in remote, hard-to-reach areas. However, ensuring wide access to safe drinking water and promoting health education and behaviour change, is the best way to prevent infection or a recurrence.

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