Abstract
SummaryGlobal eradication of the guinea worm (Dracunculus medinensis) is near, although perhaps delayed a little by the discovery of a transmission cycle in dogs. It is therefore an appropriate time to reflect on the severe impact of this infection on the life of the communities where it was endemic prior to the start of the global eradication programme in 1981. From 1971 to 1974, we conducted a series of unpublished studies on guinea worm in a group of villages in Katsina State, northern Nigeria, where the infection was highly endemic. These studies demonstrated the high rate of infection in affected communities, the frequent recurrence of the infection in some subjects and the long‐standing disability that remained in some infected individuals. Immunological studies showed a high level of immediate hypersensitivity to adult worm and larval antigens but a downregulation of Th1‐type T‐cell responses to worm antigens. Freeing communities such as those described in this article from the scourge of guinea worm infection for good will be an important public health triumph.
Highlights
Thanks to the work of The Carter Foundation, WHO, other international organisations and local communities, eradication of the guinea worm Dracunculus medinensis is imminent [1, 2], perhaps delayed a little by the discovery of a transmission cycle in dogs in Chad [3,4,5]
We describe our experience of this infection in northern Nigeria 40 years ago, when it was a truly neglected disease, to emphasise the public health importance of its imminent eradication
In the early 1970s, when the studies described in this article were carried out, guinea worm was almost completely unrecognised as a significant health problem in Nigeria and elsewhere as severely affected subjects were usually too disabled to travel to the nearest clinic and they knew that there was little that conventional medicine could offer them
Summary
Thanks to the work of The Carter Foundation, WHO, other international organisations and local communities, eradication of the guinea worm Dracunculus medinensis is imminent [1, 2], perhaps delayed a little by the discovery of a transmission cycle in dogs in Chad [3,4,5]. The importance of this achievement should not be underestimated for the devastating impact of this infection, when uncontrolled, has frequently been neglected. As the day approaches when the world can celebrate the eradication of this infection, we believe that it is worth recording how guinea worm affected a group of Nigerian villages prior to the initiation of the eradication programme in 1981
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