Abstract
Few human infectious diseases have been driven as close to eradication as dracunculiasis, caused by the Guinea worm parasite (Dracunculus medinensis). The number of human cases of Guinea worm decreased from an estimated 3.5 million in 1986 to mere hundreds by the 2010s. In Chad, domestic dogs were diagnosed with Guinea worm for the first time in 2012, and the numbers of infected dogs have increased annually. The presence of the parasite in a non-human host now challenges efforts to eradicate D. medinensis, making it critical to understand the factors that correlate with infection in dogs. In this study, we evaluated anthropogenic and environmental factors most predictive of detection of D. medinensis infection in domestic dog populations in Chad. Using boosted regression tree models to identify covariates of importance for predicting D. medinensis infection at the village and spatial hotspot levels, while controlling for surveillance intensity, we found that the presence of infection in a village was predicted by a combination of demographic (e.g. fishing village identity, dog population size), geographic (e.g. local variation in elevation), and climatic (e.g. precipitation and temperature) factors, which differed between northern and southern villages. In contrast, the presence of a village in a spatial infection hotspot, was primarily predicted by geography and climate. Our findings suggest that factors intrinsic to individual villages are highly predictive of the detection of Guinea worm parasite presence, whereas village membership in a spatial infection hotspot is largely determined by location and climate. This study provides new insight into the landscape-scale epidemiology of a debilitating parasite and can be used to more effectively target ongoing research and possibly eradication and control efforts.
Highlights
Few human parasites and pathogens have been driven as near to the brink of eradication as the Guinea worm (Dracunculus medinensis)
Guinea worm infections have been diagnosed in domestic dogs, in the Republic of Chad, and numbers of infections have continued to increase
Some of our findings, including the importance of fishing villages and the difference in correlates between northern and southern villages can be used by researchers to guide additional data collection and by public health workers to better target eradication efforts
Summary
Few human parasites and pathogens have been driven as near to the brink of eradication as the Guinea worm (Dracunculus medinensis). The number of Guinea worm disease cases per year decreased from 3.5 million to hundreds between the mid-1980s and the early2010s [3]. This consistent downward trajectory slowed in a handful of endemic countries by the late 2000s. Disease cases have persisted and all available evidence links the persistence of human cases to the emergence of Guinea worm in domestic dogs (Canis lupus familiaris) [2,3,5,6]
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