Public Health Service
Centers for Disease Control
and Prevention (CDC)
Memorandum
DEPARTMENT OF HEALTH & HUMAN SERVICES
Date: July 16, 2007
From: WHO Collaborating Center for
Research, Training and Eradication of Dracunculiasis
Subject: GUINEA WORM WRAP-UP #174
To: Addressees
Countdown to Glory
Consecutive months with zero indigenous cases: Ethiopia 12 Cote d’ Ivoire 9 Burkina Faso 7 Togo 6 Nigeria 3 Niger 1 SUDAN VS GHANA: WHO WILL REACH ZERO CASES FIRST?
Figure 1
Cumulative Number of Cases of Dracunculiasis Reported During 2006 and 2007*
25
25
South Sudan
Ghana
2007*
19,760
20
18,508
16,367
15
2006
20,368 20,582
Number of cases reported (Thousands)
Number of cases reported (Thousands)
2006
14,153
10,804
10
7,070
5
2007*
20
15
10
5
2,703
1,761
1,611
0
402
13
551
90
889
203
1
Jan
Feb
Feb
Mar
Apr
0
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
1,009
621
1,227
Jan
Feb
2,237
1,660
Mar
2,534
2,805
2,693
2,932
2,971
3,115
2,400
2,855
2,063
Apr
May
Jun
Jul
Aug
Sept
Oct
3,527
Nov
4,136
Dec
*provisional
As of the mid point of calendar year 2007, Ghana has reported substantially more cases (2,805
cases through May) of Dracunculiasis than Sudan (1,611 cases through May) so far this year
(Figure 1, Table 1). Although most of Sudan’s peak transmission months (April-October) still
lie ahead, only the second half (October-December) of Ghana’s peak 2007 season is still to
come. Another important difference between the two programs in 2007, however, is in their
reductions in cases compared to the same period of 2006: -77% In Sudan so far this year vs.
+17% in Ghana. If these disparate trends were to hold for the remainder of the year, Sudan will
report approximately 100 fewer cases than Ghana for calendar year 2007 (4,733 cases vs. 4,834).
Table 1
Number of Cases Contained and Number Reported by Month during 2007*
(Countries arranged in descending order of cases in 2006)
COUNTRIES
REPORTING
CASES
NUMBER OF CASES CONTAINED / NUMBER OF CASES REPORTED
%
JANUARY
33
SUDAN
897
GHANA
0
MALI
3
NIGER
0
TOGO
7
NIGERIA
2
BURKINA FASO
0
COTE D'IVOIRE
0
ETHIOPIA
0
UGANDA
942
TOTAL*
/
/
/
/
/
/
/
/
/
/
/
FEBRUARY
43
203
692
1009
0
0
0
3
0
0
9
32
0
2
0
0
0
0
0
0
744
1249
/
/
/
/
/
/
/
/
/
/
/
MARCH
49
199
455
752
1
0
0
0
0
1
1
9
0
0
0
0
0
0
1
0
507
961
/
/
/
/
149
255
476
0
1
0
0
0
/
/
/
/
/
/
/
APRIL
121
0
0
1
0
0
0
0
0
0
0
1
376
628
/
/
/
/
338
239
297
0
0
1
0
0
/
1
0
/
/
/
/
0
0
0
0
0
0
0
1
/
/
MAY
459
0
700
636
/
/
/
/
271
1
0
0
1
0
0
0
/
/
0
0
0
0
0
1
/
0
/
/
2
AUGUST
/
SEPTEMBER
/
OCTOBER
/
NOVEMBER
/
DECEMBER
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
1
0
0
0
0
0
1
/
0
2
/
0
0
/
0
0
/
0
0
/
0
0
/
0
0
/
TOTAL*
705
/
/
/
1
995
JULY
/
722
/
/
JUNE
2538
2
4
0
17
2
0
1
2
3271
0
/
/
/
/
/
/
/
/
/
/
/
1611
44
2805
90
2
100
4
100
2
0
42
40
2
100
0
0
1
0
2
100
4471
73
% CONTAINED
75
77
81
59
70
100
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
73
% CONT.
OUTSIDE SUDAN
87
92
96
86
88
100
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
90
* provisional
Shaded cells denote months when zero indigenous cases were reported. Numbers indicate how many imported cases were reported and contained that month. CONT.
#DIV/0!
#DIV/0!
Figure 2
Number of Indigenous Cases Reported During the Specified Period in 2006 and 2007*, and Percent
Change in Cases Reported
Country
Indigenous Cases
Reported
2006
% CHANGE 2006 - 2007
2007 -100%
Togo (6)
8
0
-100%
Cote d'Ivoire (6)
2
0
-100%
Ethiopia (6)
1
0
-100%
20
2
7070
1609
16
4
0
0
Ghana (5)
2400
2804
Nigeria (6)
15
42
9532
4461
62
48
Mali (6)
Sudan (5)
Niger (6)
Burkina Faso (6)
-50%
0%
50%
100%
-90%
-77%
-75%
0%
17%
180%
Total
All countries, excluding
Sudan and Ghana
Overall % change outside of Sudan = 17%
(6) Indicates months for which reports were received, i.e., Jan. -June
* Provisional
-53%
-23%
129
IN BRIEF:
Ethiopia has now reported 12 consecutive months with zero known indigenous cases of
Dracunculiasis! CONGRATULATIONS, Ethiopia! This good news is slightly qualified by the
4 cases allegedly exported into southern Sudan in December 2006 and January 2007 by persons
residing in Gambella Region of Ethiopia, where program access has been limited because of
sporadic insecurity over the past few years. The Government of Ethiopia plans to conduct a
thorough search of this area over the next few months.
Nigeria. The numbers of consecutive months with zero indigenous cases in each of the Nigerian
Guinea Worm Eradication Program’s five operational zones is shown in Figure 3.
Sudan. Dr. Joshua Ologe of the Nigerian Guinea Worm Eradication Program has arrived in
southern Sudan to begin assisting that program as a technical advisor.
Figure 3
Zones of Nigeria’s GWEP and Number of Months Elapsed
Since the Last Reported Indigenous Case
Sokoto
NORTH WEST 34 months
Katsina
Yobe
Jigawa
Zamfara
Borno
Kano
Kebbi
NORTH CENTRAL
18 months
Bauchi
Kaduna
Gombe
Niger
Adamawa
Plateau
FCT
Kwara
Nasarawa
Taraba
Oyo
SOUTH WEST
16 months
Kogi
Ekiti
Osun
Ogun
Benue
Ondo
elsa
Bay
Imo
Ak
w
Rivers
r
ss
Ri
ve
Cr
o
Delta
Ebonyi
Ab
ia
Edo
Anambra
Enugu
Lagos
a
Ib
om
SOUTH EAST
3 months
NORTH EAST
34 months
MEETINGS
Ghana GWEP National Program Review, July 25-27, Tamale, Northern Region.
South Sudan GWEP Coordination Meeting, July 31 – August 1, 2007, Juba South Sudan. Meeting for pre-certification countries (Benin, Chad, Mauritania), September 4-5, 2007, Abidjan, Cote d’Ivoire. Program Review for endemic francophone countries, September 6-7, 2007, Abidjan, Cote d’Ivoire. Program Review for Nigerian GWEP, week of October 22-26,. 2007, Abuja Nigeria. Meeting for pre-certification areas (Ethiopia, Kenya, N. Sudan, Uganda), October 16-17, 2007, Addis Ababa. RECENT PUBLICATIONS
WHO, 2007. Dracunculiasis eradication ministerial meeting, Geneva 16 May 2007. Wkly Epidemiol Rec
82: 236 - 237.
Inclusion of information in the Guinea Worm Wrap-Up does not constitute “publication” of that information. In memory of BOB KAISER For information about the GW Wrap-Up, contact the WHO Collaborating Center for Research, Training, and Eradication of
Dracunculiasis, NCZVED, Centers for Disease Control and Prevention, F-22, 4770 Buford Highway, NE, Atlanta, GA 30341-3724,
U.S.A. FAX: 770-488-7761. The GW Wrap-Up web location is http://www.cdc.gov/ncidod/dpd/parasites/guineaworm/default.htm.
CDC is the WHO Collaborating Center for Research, Training, and Eradication of Dracunculiasis.