Mali is hoping to eradicate guinea-worm in the next two years, according to the World Health Organization (WHO).
Picked up in contaminated water, the disease is debilitating enough to prevent those infected from working, going to school or farming. It “causes such excruciating pain that sufferers can be immobilized for months”, says WHO, which classifies it as a neglected tropical disease.
Most cases are in the north: “The persistence of the disease in Mali’s north is due to the nomadic population, lack of clean water in endemic sites, the vastness of the area and residual instability that has strongly thwarted interventions,” Mali’s national health director, Toumani Sidibé, told IRIN.
“This is a disease of extreme poverty,” Ernesto Ruiz-Tiben, technical director of a guinea-worm eradication programme at the US-based Carter Center, told IRIN in September 2009. “It is a disease of forgotten people in forgotten places.”
In 2008 there were 417 reported infections in Mali, 64 percent of which were in the northern region of Kidal. As of January 2010 Mali had 186 reported cases, according to the Health Ministry.
“In 2007, the security situation prevented us from intervening and in 2008 we started interventions despite residual insecurity,” Sidibé told IRIN. Health workers hospitalized 97 percent of guinea-worm patients to limit their exposure to water and distributed water filters.
Periodic fighting among factions of Tuareg nomads and the military have led to dozens of deaths and displacement in Kidal Region, one of the poorest and most arid regions in Mali.
Unlike malaria and other water-borne diseases, guinea worm - also known as dracunculiasis - is incubated in people and not in stagnant water. Because the larvae can burst out of the human body into pools of water where they grow into roundworms, infected people are told not to wade in water to avoid spreading the disease.
There is no known preventative or curative treatment for the disease, which leads to itching, fever, swelling and burning.
In 2009, 85 percent of infected persons nationwide were hospitalized, which minimized the risk of them contaminating water sources, said health director Sidibé. “Health workers are aiming for 100-percent hospitalization in 2010 in order to wipe out any risk of transmission.”
WHO recommends water filters, health education, clean water sources, epidemiological surveillance for early detection and quick medical treatment for guinea-worm infections in epidemic areas, which are most often rural.
Because it is a “parasite of humans”, once eradicated, there is no risk of guinea worms resurfacing in an area cleared of infection, the Carter Center’s Ruiz-Tiben told IRIN.
“Eradication is feasible… If we manage to wipe it out, it will become only the second disease to have been eradicated after smallpox, and the first without drugs or vaccines,” said Ruiz-Tiben.
In 1986 more than three million people in about 20 countries were infected with guinea worm; in 2009, there were about 3,000 cases reported in four African countries, according to WHO.
The Bill & Melinda Gates Foundation pledged US$40 million to the Carter Center and WHO in a 2008 challenge grant to wipe out the disease. WHO estimates it needs an additional $15 million to eradicate it by 2013.
Last December, WHO declared Benin, Cambodia, Guinea, Mauritania, the Marshall Islands, Palau and Uganda clear of guinea worms. A country must have no reported cases for three consecutive years to qualify.
“If everything goes well in the next two years, this disease will be no more than a bad memory [in Mali],” WHO’s representative in Mali, Fatoumata Binta Diallo, told IRIN.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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