What It Means to Be Guinea Worm Free: An Insider's Account from Ghana's Northern Region.

Adam Weiss ,Franklin Aseidu-Bekoe,David Agyemang,Donald R Hopkins,Torben Vestergaard Frandsen ,Ernesto Ruiz‐Tiben

doi:10.4269/ajtmh.17-0558

Abstract

.Despite several periods of stagnating guinea worm disease (GWD) incidence in Ghana during its national eradication campaign in the 1990s and early 2000s, the last reported case of GWD was in May 2010. In July 2011, Ghana celebrated the interruption of guinea worm (GW) transmission. Although it has been established that GWD causes disability, pain, and socioeconomic hardship, there is a dearth of population-based evidence collected in post-GW–endemic countries to document the value attributed to GWD eradication by residents in formerly endemic communities. Given Ghana’s recent history of GWD and a concentrated burden of the disease in its Northern Region, a pattern which remained true through to the final stage of the eradication campaign, seven villages in the Northern Region were targeted for a retrospective, cross-sectional study to detail the perceptions, attitudes, and beliefs about the impact of eradication of GWD in northern Ghana. The study revealed that respondents from the sampled communities felt GW eradication improved their socioeconomic conditions, as the impact of infection prohibited the pursuit of individual and social advancement. The value residents placed on the absence of GWD highlights both the impact infection had on the pursuit of social and economic advancement and the newfound ability to be disease-free and productive. Of the 143 respondents, 133 had GWD in the past and were incapacitated for an average of 6 weeks annually per GW infection, with each infected person affected nearly four times in his or her lifetime.

Highlights

Dracunculus medinensis, commonly referred to as guinea worm (GW), is a nematode parasite that typically affects only human beings.[1,2] known as the fiery serpent because of the generalized burning sensation one feels when the worm is about to emerge, GW is referenced in the bible and has been recovered from mummies in Ancient Egypt nearly 3,000 years old.[1]
It has been established that guinea worm disease (GWD) causes disability, pain, and socioeconomic hardship, there is a dearth of population-based evidence collected in post-GW–endemic countries to document the value attributed to GWD eradication by residents in formerly endemic communities
Interruption of GWD transmission nationwide in Ghana satisfies the definition of a public health success, this study provides an account of how the eradication of GWD was perceived in northern Ghana

Summary

Introduction

Dracunculus medinensis, commonly referred to as guinea worm (GW), is a nematode parasite that typically affects only human beings.[1,2] known as the fiery serpent because of the generalized burning sensation one feels when the worm is about to emerge, GW is referenced in the bible and has been recovered from mummies in Ancient Egypt nearly 3,000 years old.[1]. In 1986, former U.S President Jimmy Carter agreed to become the lead advocate for eradication of GWD and for the Carter Center to provide technical and financial assistance to countries with endemic GWD, including Ghana. The region experienced repeated internal conflicts throughout the mid-1990s, including the highly referenced “Guinea Fowl War,” which led to an exodus of health workers, including U.S Peace Corps volunteers, and a reduction in the provision of health services, including interventions to eradicate GWD.[8,9] These challenges, together with a long dry season (November–April), difficulties in extracting safe drinking water from underground sources, and the creation of large impoundments to provide water for farmers and their livestock and for humans, provided suitable conditions for the transmission of GW.[10]

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Results

Conclusion