Cahiers d'études et de recherches francophones / Santé


Dracunculiasis: the end of a scourge Volume 3, issue 2, Mars-Avril 1993

chargé de recherche à l’ORSTOM, chef du service de parasitologie, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun.
  • Page(s) : 77-86
  • Published in: 1993

Dracunculiasis was first described in the 15th century BC. The disease is widely distributed in Africa and is most common in isolated and poor communities. The causative worm is transmitted by drinking-water containing cyclops. These small crustaceans become infected by swallowing larvae expelled from human ulcers. Inflammatory, infectious and mechanical complications are observed in more than 50 % of cases. In rural endemic communities, dracunculiasis is the major cause of incapacity. Although mutual assistance and coping methods are used to alleviate losses of productivity, the economic impact is considerable. School absenteeism is also important. In heavily infected villages, absenteeism is excacerbated by replacement of the sick. A baseline survey and the establishment of a national surveillance system are the first steps in overcoming such diseases, but implementation depends on the local context and control of water sources is essential. The rural water supply system is the most suitable for intervention. Appropriate technologies can provide safe water through bore-hole wells, draw wells, water collectors, reservoirs and sand filters. Vector control should be used in selected situations and considered complementary. The main difficulty is in changing ancestral habits and cultural beliefs. The author emphasizes the need for health education programs. Community-based strategies, e.g. case containment and medical treatment provided by village workers are regarded as the most durable. The WHO has a declared goal of eradicating dracunculiasis.