Dracunculiasis (Guinea worm disease) is a preventable waterborne parasitic disease that affects the poorest people living in remote rural areas in sub-Saharan African countries, who do not have access to safe drinking water. The Guinea Worm Eradication Program (GWEP), a 25-year old campaign to rid the world of Guinea Worm disease has now reached its final stage accelerating to zero cases in all endemic countries. During the 19th and 20th centuries, dracunculiasis was common in much of Southern Asia and the African continent. The overall number of cases has been reduced tremendously by ≥ 99%, from the 3.32 million cases estimated to have occurred in 1986 in Africa to only 1797 cases reported in 2010 reported in only five countries (Sudan, Mali, Ethiopia, Chad and Ghana) and Asia free of the disease. This achievement is unique in its kind - the only previously eradicated disease is smallpox, a viral infection for which vaccination was possible - and it has been achieved through primary community-based prevention and health education programs. Most efforts need to be taken in two countries, South Sudan, (comprising 94% or 1698 out of 1797 of the cases reported world-wide in 2010) and Mali because of frequent movements of nomads in a vast area inside and outside Mali’s borders. All factors favourable to dracunculiasis eradication are available including adequate financial resources, community and political support and high levels of advocacy. Thus there is no reason that this disabling parasitic disease cannot be eradicated soon before surprises arise such as new civil conflicts in currently endemic countries.Objective (for the editor only) The aim of this review, besides describing the life cycle of the parasite, the clinical symptoms and its epidemiology, is to provide an updated short but comprehensive overview of the Guinea Worm Eradication Program (GWEP) conducted by a coalition of organizations, agencies, governments, corporations and other partners. Furthermore, we will discuss several strategies for eradication and the progress made so far, including possible pitfalls in the final stage of the campaign to eradicate this ancient plague of mankind. Abbreviations WHO: World Health OrganizationWHA: World Health AssemblyGWD: Guinea worm disease/ DracunculiasisGWEP: (Global) Guinea worm eradication program Introduction Dracunculiasis (Guinea worm disease, GWD) is a parasitic disease caused by the nematode (roundworm) Dracunculus medinensis. This worm is known to parasite on human since at least ancient Egypt, where it has been identified in 3000-year-old Egyptian mummies1. The disease affects the poorest populations, often in remote rural areas, who do not have access to safe drinking water. Most endemic areas now are conflict zones or is insecure; this constitute a major challange to roll out full interventions to interrupt transmission of dracunculiasis.Therefore, dracunculiasis is both a disease of poverty and a cause of poverty. With sometimes more than half of a village population being affected, it significantly affects agricultural productivity, school attendance and maternal and child health2. Although this neglected tropical disease has a low mortality, morbidity is considerably high causing huge disabilities which are physically and economically devastating3;4. Since the start of the Dracunculiasis Eradication Program (GWEP) -25 years ago- conducted by several organizations such as the Carter Center, Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization, Ministries of Health of affected countries, and numerous other non-governmental organizations, enormous progress has been made5. The overall number of cases has been reduced tremendously by more than 99% from the 3.5 million cases estimated to have occurred in 1986 in 20 different countries in Africa and Asia, to 1797 cases reported in only 5 African countries in 2010, with most cases (94%) reported in Southern Sudan6;7 (fig. 1). In additi
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