Surveillance of Human Guinea Worm in Chad, 2010–2018

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  • 1 Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • 2 Guinea Worm Eradication Program, The Carter Center, Atlanta, Georgia;
  • 3 Guinea Worm Eradication Program, Ministry of Public Health, N’Djamena, Chad

The total number of Guinea worm cases has been reduced by 99.9% since the mid-1980s when the eradication campaign began. Today, the greatest number of cases is reported from Chad. In this report, we use surveillance data collected by the Chad Guinea Worm Eradication Program to describe trends in human epidemiology. In total, 114 human cases were reported during the years 2010–2018, with highest rates of containment (i.e., water contamination prevented) in the years 2013, 2014, 2016, and 2017 (P < 0.0001). Approximately half of case-patients were female, and 65.8% of case-patients were aged 30 years or younger (mean: 26.4 years). About 34.2% of case-patients were farmers. Cases were distributed across many ethnicities, with a plurality of individuals being of the Sara Kaba ethnicity (21.3%). Most cases occurred between the end of June and the end of August and were clustered in the Chari Baguirmi (35.9%) and Moyen Chari regions (30.1%). Cases in the northern Chari River area peaked in April and in August, with no clear pattern in the southern Chari River area. History of travel within Chad was reported in 7.0% of cases, and male subjects (12.5%) were more likely than female subjects (1.7%) to have reported a history of travel (P = 0.03). Our findings confirm that human Guinea worm is geographically disperse and rare. Although the proportion of case-patients with travel history is relatively small, this finding highlights an additional challenge of surveillance in mobile populations in the final stages of the global eradication campaign.

Author Notes

Address correspondence to Sarah Anne J. Guagliardo, Centers for Diseases Control and Prevention, Atlanta, GA. E-mail: sguagliardo@cdc.gov

Financial support: This work was supported by The Carter Center, whose work to eradicate Guinea worm disease has been made possible by financial and in-kind contributions from many donors. A full listing of supporters can be found at The Carter Center website: http://www.cartercenter.org/donate/corporate-government-foundation-partners/index.html.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Authors’ addresses: Sarah Anne J. Guagliardo, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mail: sguagliardo@cdc.gov. Ernesto Ruiz-Tiben, Donald R. Hopkins, Adam J. Weiss, and Karmen Unterwegner, Guinea Worm Eradication Program, The Carter Center, Atlanta, GA, E-mails: eruizti@emory.edu, shandal.sullivan@cartercenter.org, adam.weiss@cartercenter.org, and karmen.unterwegner@cartercenter.org. Philippe Tchindebet Ouakou, Guinea Worm Eradication Program, Ministry of Public Health, N’Djamena, Chad, E-mail: tchindebetouakou14@gmail.com. Hubert Zirimwabagabo and Dillon Tindall, Guinea Worm Eradication Program, The Carter Center Chad Office, N’Djamena, Chad, E-mails: hubert.zirimwabagabo@cartercenter.org and dillon.tindal@cartercenter.org. Vitaliano A. Cama, Henry Bishop, Sarah G. H. Sapp, and Sharon L. Roy, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mails: vec5@cdc.gov, hsb2@cdc.gov, xyz6@cdc.gov, and str2@cdc.gov.

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