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Am J Trop Med Hyg. 2010 May; 82(5): 757.
PMCID: PMC2861395

Dracunculiasis in South Sudan

A Dinka-tribesman came to Marial Lou Hospital, South Sudan, in 2005.

He experienced severe discomfort from a Dracunculus Medinensis (Guinea worm) emerging from his perineum (see Figures 1 and and2).2). The 80-cm-long parasite was successfully extracted.

Figure 1.
Dracunculus Medinensis emerging from patient's perineum. This figure appears in color at www.ajtmh.org.
Figure 2.
Dracunculus Medinensis emerging from patient's perineum. This figure appears in color at www.ajtmh.org.

Persons get Dracunculiasis by drinking water containing water fleas harboring the larvae of the worm. The larvae are released into the water by the adult worm that emerges through the skin of infected people.

Eighty percent of cases today exist in South Sudan. Sudan's civil war officially ended in 2005 after decades of fighting. Following the peace agreement the Southern Sudan Guinea Worm Eradication Program was created in 2006, counting thousands of village volunteers and health staff. The same year an increase of 270% (> 20,000 cases) occurred because of prior underreporting.1 In the first 6 months of 2009 only 1,188 cases were reported. New episodes of violence in South Sudan pose the greatest challenge for again giving Dracunculiasis the upper hand. In the first half of 2009, 23 incidents of insecurity were reported to disrupt program operations.2 Widespread violence will make coherent surveillance and provision of safe drinking water impossible leaving sporadic treatment to medical humanitarian organizations. Keeping peace contains the hope not only of preventing cases but altogether eradicating Dracunculiasis.

Footnotes

Authors' addresses: Christian Fabiansen, Kristaniagade 8, Copenhagen Ø, 2100, E-mail: kd.tenldad@nesnaibaf. Zitta Harboe and Vibeke Christensen, Médecins Sans Frontières-Denmark, Kristianiagade 8, DK-2100 København Ø, Denmark, E-mails: kd.iss@tiz and kd.tenldad@rhcxirb.

References

1. Centers for Disease Control and Prevention (CDC) Progress toward global eradication of dracunculiasis, January 2005–May 2007. MMWR Morb Mortal Wkly RepM. 2007;56:813–817. [PubMed]
2. Centers for Disease Control and Prevention (CDC) Progress toward global eradication of dracunculiasis, January 2008–June 2009. MMWR Morb Mortal Wkly Rep. 2009;58:1123–1125. [PubMed]

Articles from The American Journal of Tropical Medicine and Hygiene are provided here courtesy of The American Society of Tropical Medicine and Hygiene