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CMAJ • February 17, 2004; 170 (4)
© 2004 Canadian Medical Association or its licensors

Review
Synthèse

Dracunculiasis (guinea worm disease)

Chris Greenaway

Chris Greenaway is an Assistant Professor in the Department of Medicine, McGill University, and a staff physician in the Departments of Microbiology and Internal Medicine, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Que. She is a consultant at the McGill Centre for Tropical Diseases and spent 1 year at the Medical Research Council Laboratories in the Gambia, West Africa, doing a research fellowship.

Correspondence to: Dr. Chris Greenaway, Department of Microbiology, Sir Mortimer B. Davis Jewish General Hospital, Rm. G-143, 3755 Cote Ste. Catherine Rd., Montréal QC H3T 1E2; fax 514 340-7578; ca.greenaway{at}mcgill.ca

Abstract

DRACUNCULIASIS (GUINEA WORM DISEASE) IS A PARASITIC disease that is limited to remote, rural villages in 13 sub-Saharan African countries that do not have access to safe drinking water. It is one the next diseases targeted for eradication by the World Health Organization. Guinea worm disease is transmitted by drinking water containing copepods (water fleas) that are infected with Dracunculiasis medinensis larvae. One year after human ingestion of infected water a female adult worm emerges, typically from a lower extremity, producing painful ulcers that can impair mobility for up to several weeks. This disease occurs annually when agricultural activities are at their peak. Large proportions of economically productive individuals of a village are usually affected simultaneously, resulting in decreased agricultural productivity and economic hardship. Eradication of guinea worm disease depends on prevention, as there is no effective treatment or vaccine. Since 1986, there has been a 98% reduction in guinea worm disease worldwide, achieved primarily through community-based programs. These programs have educated local populations on how to filter drinking water to remove the parasite and how to prevent those with ulcers from infecting drinking-water sources. Complete eradication will require sustained high-level political, financial and community support.