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Date: February 25, 2008 Public Health Service Centers for Disease Control DEPARTMENT OF HEALTH & HUMAN SERVICES and Prevention (CDC) Memorandum Date: February 25, 2008 From: WHO Collaborating Center for Research, Training and Eradication of Dracunculiasis Subject: GUINEA WORM WRAP-UP #179 To: Addressees Number of uncontained cases of dracunculiasis outside of Southern Sudan so far in 2008: 12 (Ghana) SOUTHERN SUDAN & GHANA ROLLING BACK THE WORM The Southern Sudan Guinea Worm Eradication Program (SSGWEP), which in 2007 reported 62% of all remaining cases of Guinea worm disease in the world, held its annual in-country Program Review at the Beijing Hotel in Juba on January 30-31. The Southern Sudan Minister of Health Dr. Joseph Manytuil and the Minister of Cooperative Rural Development Prof. Phillip Yona, both participated in the Opening Ceremony of the Review, as did WHO Country Representative Dr. Mohamed Abdur Rab, UNICEF Director of Operations Southern Sudan Mr. Peter Crowley, and Dr. Ernesto Ruiz-Tiben of The Carter Center. In January-November 2007, Southern Sudan reported 6,068 cases, which is a reduction of -60% from the 15,054 cases estimated to have occurred during the same period of 2006 (adjusted for over-reporting in 2006) (Figure 1). The cases in 2007 were reported from 2,114 villages, including 1,881 villages with indigenous cases. During the same period, Southern Sudan exported 2 cases to the northern states of Sudan, 3 cases to Ethiopia, and 4 cases to Uganda. 74% (4675) of cases in 2007 were in persons 15 years of age and older, while 52% (3279) of cases were in males. Forty-nine percent of cases were reportedly contained in 2006 and again in 2007, while the rate of reporting from endemic villages improved from 63% in 2006 to 75% in 2007. (Tables 1and 2.) Figure 1 GHANA GUINEA WORM ERADICATION PROGRAM SUDAN GUINEA WORM ERADICATION PROGRAM NUMBER OF CASES OF DRACUNCULIASIS REPORTED DURING EPIDEMOLOGIC NUMBER OF REPORTED CASES OF DRACUNCULIASIS: 2006 - 2007* YEAR JULY 2006 - JUNE 2007, AND JULY 2007* - JANUARY 2008* 2006 = 20,582 cases 2007* = 6,068 cases 5,000 1,200 2006 - 2007 2007 - 2008 4,367 1,005 1,000 4,000 3,734 3,349 800 732 3,000 cases es 2,613 as 609 er of 600 b 2,214 m 2,141 Nu 478 2,000 412 Number of c 400 1,392 1,252 293 1,126 272 1,019 241 1,000 200 162 624 608 144 527 492 77 243 241 110 181 152 214 39 77 68 70 73 1 12 63 8 41 19 29 0 0 Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun *P i i l *provisional More than half of the cases in 2007 (53%) were reported from Eastern Equatoria State, which achieved a 94% reporting rate and 55% case containment, and where three counties (East, North and South Kapoeta) alone reported 3,115 (53%) cases. Jonglei State reported 1,025 (17%) cases, Warrap State 929 (15%) cases, and Lakes State 414 (7%) cases. Program indicators for interventions in 2006 and 2007 are shown in Table 1. A total of 503,941 cloth filters and 1,123,832 pipe filters were distributed in 2007. 33% of endemic villages have established geographic coordinates. The SSGWEP Task Force, which was established in 2006, met quarterly throughout 2007. Bishop Emeritus Paride Taban was designated as Eminent Person for the SSGWEP. He will emphasize advocacy for the program, beginning in three Kapoeta Counties. Magwe County, which borders Uganda and had been inaccessible to the program because of insecurity, is now accessible. In 2008, the program aims to contain at least 80% of cases and achieve 100% reporting rate. “You get what you supervise.” (Steven Becknell) Table 1 SOUTHERN SUDAN GUINEA WORM ERADICATION PROGRAM Parameters 2006 2007 Program indicators 2006* 2007 Endemic Villages 3137 1881 Reporting Rate 63% 75% Villages Under Survellance 19152 15190 Containment Rate 49% 49% Cases of Guinea Worm Disease 20582 6060 Trained Village Vollunteer 82% 93% Volunteer Village Workers 10745 18169 1+ Health Education Session 71% 92% Volunter Area Supervisors 896 2152 Full H/H cloth Filter Coverage 47% 72% Field Officers 87 136 Full Pipe Filter Coverage 22% 41% State Guinea Worm Coordinators 6 6 Abate 6% 15% Technical Advisors** 16 26 1+ Safe Water 16% 17% * 3,137 Endemic Villages ** Includes Sudanese and expatriate Technical Advisors Figure 2 Southern Sudan Guinea Worm Eradication Program Seventeen Endemic Payams Reporting 3,663 (60%) of 6,068 Cases of Dracunculiasis in 2007* Number of Cases 0 100 200 300 400 500 600 Jie, Kapoeta E 568 Kauto, Kapoeta E 548 Karukomuge, Kapoeta N 336 Mogos, Kapoeta E 326 Narus, Kapoeta E 281 Machi II, Kapoeta S 216 Paringa, Kapoeta N 197 Riwoto Abuyong, Awerial 136 Paweng, Tonj E 133 Abuyong, Awerial 130 Lomeyen, Kapoeta N 124 Najie, Kapoeta N 124 Mogok, Ayod 120 Tali, Terekeka 114 Alabek, Tonj N 113 Ananatak, Tonj E 104 * provisional Pagil, Ayod 93 Payams in Kapoeta = 2,856 (78%) of cases in top 17 payams Table 2 Number of Cases Contained and Number Reported by Month during 2007* (Countries arranged in descending order of cases in 2006) COUNTRIES NUMBER OF CASES CONTAINED / NUMBER OF CASES REPORTED REPORTING % CASES JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL* CONT. 32 41 72 280 612 663 439 370 318 92 34 0 2953 / / / / / / / / / / / / / SUDAN 243 181 241 527 1126 1392 1019 624 492 152 63 8 6068 49 812 631 442 248 233 185 91 38 14 22 56 64 2836 / / / / / / / / / / / / / GHANA 1005 732 478 293 272 241 110 41 19 29 68 70 3358 84 0 0 1 0 0 1 5 29 35 15 20 4 110 / / / / / / / / / / / / / MALI 0 0 1 0 0 1 7 120 68 27 79 10 313 35 3 0 0 0 1 0 1 0 2 4 2 0 13 / / / / / / / / / / / / / NIGER 3 0 0 0 1 0 1 0 3 4 2 0 14 93 7 9 1 0 0 0 0 0 0 0 6 21 44 / / / / / / / / / / / / / NIGERIA 32 9 1 0 0 0 0 0 0 1 7 23 73 60 0 1 0 0 0 0 0 0 0 0 0 0 1 / / / / / / / / / / / / / TOGO 0 1 0 1 0 0 0 0 0 0 0 0 2 50 1 0 0 0 0 0 0 0 0 0 0 0 1 / / / / / / / / / / / / / BURKINA FASO 2 0 0 0 0 0 0 0 0 0 0 1 3 33 0 0 0 0 0 0 0 0 0 0 0 0 0 / / / / / / / / / / / / / COTE D'IVOIRE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 / / / / / / / / / / / / / ETHIOPIA 0 0 0 0 0 3 0 0 0 0 0 0 3 0 0 0 1 0 1 0 0 1 0 1 0 0 4 / / / / / / / / / / / / / UGANDA 0 0 1 0 1 0 0 1 0 1 0 0 4 100 855 682 517 528 847 852 536 438 369 134 118 89 5965 / / / / / / / / / / / / / TOTAL* 1285 923 722 821 1400 1637 1137 786 582 214 219 112 9838 61 % CONTAINED 67 74 72 64 61 52 47 56 63 63 54 79 61 #DIV/0! % CONT. 79 86 93 84 86 77 82 42 57 68 54 86 80 OUTSIDE SUDAN #DIV/0! * provisional Shaded cells denote months when zero indigenous cases were reported. Numbers indicate how many imported cases were reported and contained that month. Figure 3 M a l i (313) GUINEA WORM RACE: 2007* G h a n a ( 3 ,3 5 8 ) Ni geria (73) 0 C a s e s S u Niger (11) dan (6, 0 68) Burkina Faso Cote d’Ivoire Ethiopia Togo * I nd ig en ou s C a s e s o n ly Figure 4 Distribution of 9,823 Indigenous Cases of Dracunculiasis Reported during 2007* Number of cases 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 Sudan 6,068 Ghana 3,358 Mali 313 Nigeria 73 Niger 11 Togo 0 2006^ Burkina Faso 0 2006^ Cote d'Ivoire 0 2006^ Ethiopia 0 2006^ Benin 0 2004^ Mauritania 0 2004^ Uganda 0 2003^ Cent. African Rep. 0 2001^ * Provisional. Excludes 15 cases exported from one country to Chad 0 1998^ another. Cameroon 0 1997^ ^ Year last indigenous case reported. Yemen 0 1997^ Senegal 0 1997^ Pakistan and India certified free of disease in1996 India 0 1996^ and 2000, respectively, Senegal and Yemen in 2004, and Cameroon and Central African Republic in 2007. Kenya 0 1994^ Pakistan 0 1993^ Figure 5 Number of Indigenous Cases Reported During the Specified Period in 2006 and 2007*, and Percent Change in Cases Reported Country Indigenous Cases % CHANGE 2006 - 2007 Reported 2006 2007 -100% -50% 0% 50% 100% Togo 25 0 -100% Cote d'Ivoire 5 0 -100% Ethiopia 1 0 -100% Burkina Faso 3 0 -100% Niger 108 11 -90% Sudan 20582 6068 -71% Ghana 4134 3358 -19% Mali 323 313 -3% 356% Nigeria 16 73 Total 25197 9823 -61% All countries, excluding 481 397 -17% Sudan and Ghana 129 Overall % change outside of Sudan = -19% * Provisional Table 3 Number of Cases Contained and Number Reported by Month during 2008* (Countries arranged in descending order of cases in 2007) COUNTRIES NUMBER OF CASES CONTAINED / NUMBER OF CASES REPORTED REPORTING % CASES JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL* CONT. 0 SUDAN / / / / / / / / / / / / / 0 #DIV/0! 60 60 GHANA / / / / / / / / / / / / / 73 73 82 1 1 MALI / / / / / / / / / / / / / 1 1 100 28 28 NIGERIA / / / / / / / / / / / / / 28 28 100 0 1 1 NIGER / / / / / / / / / / / / / 0 1 1 100 89 1 90 TOTAL* / / / / / / / / / / / / / 102 1 103 87 % CONTAINED 87 100 #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! 87 #DIV/0! % CONT.
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