Working Towards Dracunculiasis Eradication in Ethiopia

Last April, 25-year-old Obang Odol Okello became infected with dracunculiasis, also known as Guinea worm disease. According to Thomson Reuters Foundation News, the father of two, who lives in Ethiopia, experienced pain, burning sensations, and difficulty walking. As he dealt with this, he also struggled to farm or protect his crops, placing himself and his family in a difficult situation. Now, the man is just one of the many members of rural Ethiopian communities working to eradicate dracunculiasis in the country.

Guinea Worm Disease (Dracunculiasis)

According to the World Health Organization (WHO), dracunculiasis, or Guinea worm disease, is:

caused by the parasitic worm Dracunculus medinensis or “Guinea-worm,” [the] largest of the tissue parasite affecting humans. The adult female, which carries about 3 million embryos, can measure 600 to 800mm in length and 2mm in diameter.

This neglected tropical disease (NTD) occurs when people ingest stagnant water contaminated with Guinea worm larvae. Within the stomach, these larvae mate. Later, when the Guinea worm female is matured, it creates a painful skin lesion through which it emerges. Because this lesion causes burning, some people attempt to soothe the burn by placing the infected area within a water source. But as the WHO continues:

This also induces a contraction of the female worm at the base of the ulcer causing the sudden expulsion of hundreds of thousands of first stage larvae into the water. They move actively in the water, where they can live for a few days.

However, if the larvae infect water fleas, they can continue to become more infectious and, once ingested, can cause dracunculiasis in more humans. While this condition is usually not fatal, symptoms can be severe and long-lasting. These symptoms include:

  • Fever
  • Nausea and vomiting
  • A painful lesion, usually on the feet
  • Allergic reactions
  • Additional bacterial infections
  • Skin redness and inflammation
  • Joint infections
  • Lockjaw
  • Pruritus (intense itching)
  • Blistering
  • Ulcers

While dracunculiasis used to be more prevalent, this prevalence is falling. In 2020, only 27 human cases were reported, with many in either Chad or Ethiopia.

Eradication Plan

If dracunculiasis was eradicated, it would become only the 2nd disease in human history to achieve this milestone. The first eradicated disease was smallpox. Currently, the move towards eradication is a WHO goal, which the organization hopes to achieve by 2030.

In Ethiopia, dracunculiasis eradication depends on assistance from larger organizations, such as the Carter Center, as well as community involvement. Obang Odol Okello, for example, travels throughout the community to encourage people to use cloth and pipe water filters. Alternately, Okello Aballa Ognum visits ponds and treats them with chemicals. This is designed to combat the water fleas which carry Guinea worm larvae. While this is a good first step, the community is also informed about filtration. Even if the pond water is treated, it still must be filtered.

Altogether, access to clean drinking water is crucial for combatting dracunculiasis infections. But beyond that, community involvement is key. According to Adam Weiss of the Carter Center:

The places where [the dracunculiasis eradication program] has been the most successful…are where there were dynamic community leaders [and] volunteers.

If community members in rural communities can work together to provide education around water supplies, and also to treat ponds, their communities are in better positions. Organizations like the WHO and Carter Center should also participate in supporting and investing in these communities.

Research

To combat dracunculiasis infections, more research is also needed. In particular, researchers should focus on dracunculiasis infections in animals. For example, the infection has been discovered in baboons and even dogs. Understanding how animals contribute to the spread of Guinea worm larvae will ultimately benefit the push towards eradication.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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