Guinea worm wrap-up ; # 123, May 20, 2002
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  • English

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    • Journal Article:
      Guinea worm wrap-up
    • Description:
      Togo increasing its interventions

      Following an explosive outbreak of dracunculiasis cases in the village of Kpatala, in Ogou District, late in 2001, Togo’s Guinea Worm Eradication Program continues to strengthen interventions against the disease. The outbreak of 304 cases in Kpatala (population~3000) included 60% of all (508) cases in Ogou District, and 22% of all 1,354 cases in Togo in 2001. Kpatala is located only 15 kilometers (9 miles) on a direct road from the Beninois commune of Tchetti, which also suffered an unexpected outbreak (108 cases) late last year in four closely grouped localities, that included 72% of the 151 indigenous cases reported in all of Benin in 2001. The two villages share the same ethnic groups and some of the same extended families. At least eight of the 21 cases of dracunculiasis that were imported into Benin in 2001 came from Kpatala.

      The latest status of interventions in the 12 highest endemic districts of Togo is summarized in Table 1 (Togo has 30 districts). These 12 districts included 345 of the 351 cases reported in all of Togo in January-April 2002; the top three districts reported 76% of all the cases so far this year. The percentage of villages with filters in all households reflects only new or replacement filters distributed so far in 2002—a process that should be completed by the end of May. A few hundred pipe filters are also being distributed to test their acceptability. The list of health education activities includes some interventions (e.g., “Worm Weeks”) that were conducted after July 2001. By July this year, the program will begin systematic spot-checking of a sample of villages where Abate is being used, to help improve the quality, completeness and timeliness of that intervention. Togo has reportedly contained 70% of all cases so far in 2002, compared to 62% in 2001. The program is also working with the country’s primary health care system to establish 13 “containment houses,” beginning in August 2001, where patients are voluntarily treated and housed in clinics, local hospitals, or specially constructed temporary facilities (where necessary) to facilitate complete interruption of transmission. An increasing proportion of cases is expected to be contained in this manner, beginning in the current low transmission season (April-September). With support from The Carter Center/Global 2000, U.S. Peace Corps also will help to conduct four more “Worm Weeks” of intensive interventions in eight high priority districts, including in Kpatala, in July-September 2002, as well as increased mass health education (radio, theater, etc.) and construction of hand dug wells by residents of endemic villages. Five Peace Corps Volunteers are working with the program full-time in Ogou, Ave, and Agou Districts. Plan International and UNICEF are providing new and rehabilitating old wells and hand pumps in some endemic villages. The Carter Center provided 15.5 person-months of in-country technical assistance in 2001, and is providing 29.5 person-months of assistance in 2002.

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