An Evaluation of Dracunculiasis and Intervention Strategies Adopted for its Eradication in Borno State, Nigeria.

Abstract

Interventions adopted for the eradication of dracunculiasis in Borno State were evaluated between July 2003 and June 2004 to assess the feasibility of the 2009 target date set for the eradication of guinea worm. Data on cases in Nigeria; North east zone, and Borno State from 1995 - 2007 were obtained from Nigeria Guinea Worm Eradication Programme. Primary data on the cases occurring during the 2003/2004 were obtained through active surveillance. The various intervention strategies were ascertained through direct inspection of the facilities. Knowledge, Attitudes, Practices and Beliefs, (KAP), of members of the affected communities were carried out through administration of questionnaire. Studies on vector density, infectivity and impact of Abate on cyclops were also carried out. Results showed that in Nigeria, during the period under review, cases reduced from 16,374 in 1995 to 12,282 in 1996; rose to 13,417 in 1998 and then declined to 73 in 2007. In the North east zone, cases dropped from 2,794 in 1995 to 2,134 in 1996, rose to 4,077 in1998 and dropped to 0 in 2007. In Borno State, cases rose from 587 in 1995 to 2,053 in 1998 before declining to 0 in 2007. During the 2003/2004 survey, 5(55.55%) Local Government Areas out of the 9 and 12(8.1%) villages out of the 148 studied were still endemic. Thirty-four (0.01%) out of 310,092 persons examined were infected. All age groups in the male category were infected while only age groups 0-40 in the female category were infected. More males (25; 0.02%) than females (9; 0.01%) were infected although there was no significant difference (P>0.05) in infection rate between the sexes. Twenty-six (76.5%) out of the 34 cases were people who still depended on pond water. Farmers, (17; 0.02%)) and nomads (2; 0.04%) had higher infection rates than other occupational groups but showed no significant difference (P>0.05). Twenty-six (76.5%) cases were contained while 8(23.5%) were not. One (2.94%) imported case was encountered. The 34 cases were observed between July and November with September recording 12(35.29%) while November recorded the least (2; 5.88%). The status of intervention strategies showed that Health Education, filter usage, Abate application, Case Containment Strategy and Village-Based-Health-Workers were operational in all the study villages. There were 55 functional hand-dug-wells, 3 boreholes and 5 Case Containment Centres. KAP studies revealed that persons in affected communities became aware of the disease’s transmission, treatment, prevention, and control. Vector studies showed that 25(0.35%) out of the 7,052 cyclops examined were infected with Dracunculus medinensis larvae. Infection rates were observed between July and November 2003 with the highest in September (11).The impact of Temephos on cyclops density showed that the cyclops densities before application of Abate were twice higher than the figures two weeks after application and just slightly higher than or equal to the figures obtained 4 weeks after. The outcomes of the study showed that increased health education, funding, partnership between local, state, federal governments and endemic communities can enhance eradication globally.