The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform

Donald R. Hopkins - One of the best experts on this subject based on the ideXlab platform.

  • Progress Toward Global Eradication of Dracunculiasis, January 2019-June 2020.
    MMWR. Morbidity and mortality weekly report, 2020
    Co-Authors: Donald R. Hopkins, Adam Weiss, Sharon L. Roy, Sarah Yerian, Sarah G H Sapp
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination. Other interventions to prevent infection include health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). The worldwide eradication campaign began in 1980 at CDC (1). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly (WHA) called for Dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with Dracunculiasis. This report, based on updated health ministry data (4), describes progress made during January 2019-June 2020 and updates previous reports (2,4,5). With only 54 human cases reported in 2019, 19 human cases reported during January 2019-June 2020, and only six countries currently affected by Dracunculiasis (Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon), the achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic concerns, including 2,000 reported animal cases in 2019 and 1,063 animal cases in 2020, mostly in dogs. All national GWEPs remain fully operational, with precautions taken to ensure safety of program staff members and community members in response to the coronavirus disease 2019 (COVID-19) pandemic.

  • progress toward global eradication of Dracunculiasis january 2018 june 2019
    Morbidity and Mortality Weekly Report, 2019
    Co-Authors: Donald R. Hopkins, James Zingeser, Adam Weiss, Sharon L. Roy, Sarah Anne J Guagliardo
    Abstract:

    Dracunculiasis (also known as Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly called for Dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by The Carter Center and supported by the World Health Organization (WHO), CDC, the United Nations Children's Fund, and other partners, began assisting ministries of health in countries with Dracunculiasis. This report, based on updated health ministry data, describes progress to eradicate Dracunculiasis during January 2018-June 2019 and updates previous reports (2,4,5). With only five countries currently affected by Dracunculiasis (Angola, Chad, Ethiopia, Mali, and South Sudan), achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.

  • progress toward global eradication of Dracunculiasis january 2017 june 2018
    Morbidity and Mortality Weekly Report, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, James Zingeser, Adam Weiss, Sharon L. Roy, Sarah Anne J Guagliardo
    Abstract:

    Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for Dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with Dracunculiasis. There is no vaccine or medicine to treat the disease; the GWEP relies on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of water, and provision of safe drinking water (1,2). In 1986, an estimated 3.5 million cases† occurred each year in 20§ African and Asian countries (3,4). This report, based on updated health ministry data (3), describes progress during January 2017-June 2018 and updates previous reports (1,4). In 2017, 30 cases were reported from Chad and Ethiopia, and 855 infected animals (mostly dogs) were reported from Chad, Ethiopia, and Mali, compared with 25 cases and 1,049 animal infections reported in 2016. During January-June 2018, the number of cases declined to three cases each in Chad and South Sudan and one in Angola, with 709 infected animals reported, compared with eight cases and 547 animal infections during the same period of 2017. With only five affected countries, the eradication goal is near, but is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.

  • Dracunculiasis eradication are we there yet
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Sharon L. Roy, Craig P Withers, Dean G Sienko
    Abstract:

    The global Dracunculiasis Eradication Program (DEP) is much closer to its goal of stopping transmission of Dracunculiasis (guinea worm disease) since the previous review in this series was published 5 years ago.1 This article describes the status of the program as of the end of 2017. We described in previous reports the parasite and the strategies and interventions being used to eradicate it.1,2 Dracunculiasis (guinea worm disease) is caused by the nematode parasite Dracunculus medinensis, and it is transmitted to humans in contaminated drinking water containing copepods (water fleas) that harbor infective larvae of the parasite. Recently, the potential infection of humans by eating poorly cooked or cured aquatic animals that have ingested infected copepods has emerged as a possible mode of infection.3 The larvae are expelled into water by adult female worms, and then, after human consumption of copepods or aquatic animals with infective larvae, the adult worms emerge through the skin of infected persons about 1 year after infection. Once the end of the worm has emerged through the skin, the remainder of the worm, up to 1 m long, must be removed. Emergence and removal of the worm is slow, painful, and often disabling due to secondary bacterial infections. Although usually not fatal, the disease has a serious adverse socioeconomic impact on the health, agricultural productivity, and school attendance of affected populations. Without medical care, persons are incapacitated for periods averaging 3 months. In the past, more than one-half of a village’s population might have been affected simultaneously during the main harvest or planting season. Until significant numbers of infections with D. medinensis were discovered in dogs in Chad in 2012, humans were the only known reservoir of infection. Individual infections last only 1 year, but people do not develop immunity to the parasite. There is no effective treatment or vaccine; however, the infection may be prevented by 1) educating villagers about the origin of the disease, 2) preventing infected persons and animals from entering sources of drinking water, 3) filtering all drinking water through a finely woven cloth that removes the copepods, 4) applying Abate larvicide (temphos; BASF Corp., Florham Park, NJ) to kill the copepods in ponds or other stagnant sources of drinking water, and 5) providing clean drinking water from safe sources, such as protected hand-dug or borehole wells. The global eradication campaign began at the Centers for Disease Control and Prevention (CDC) in 1980. It was adopted as a subgoal of the International Drinking Water Supply and Sanitation Decade (1981–1990), and it has been led since 1986 by The Carter Center, which is at the head of a coalition that includes the ministries of health of the endemic countries, the CDC, the World Health Organization (WHO), and the United Nations Children’s Fund as major partners and thousands of village volunteers and supervisory health staff. The coalition is supported by numerous donor agencies, governments, foundations, and other institutions. When The Carter Center began leading the global campaign after the CDC, there were an estimated 3.5 million cases of Dracunculiasis worldwide.4 At the World Health Assembly (WHA) in 2004, ministers of health set a target to stop transmission of Dracunculiasis by the end of 2009.5 When that target date was not met, partly because of the ongoing civil war in Sudan and unexpected outbreaks in Chad, Ethiopia, and Mali, the global initiative resolved to interrupt transmission as soon as possible.

  • progress toward global eradication of Dracunculiasis january 2016 june 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on a lower limb (1). Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination,* and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with endemic Dracunculiasis. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2016 has declined by >99%, and cases are confined to three countries with endemic disease. This report updates published (3-4) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2016-June 2017. In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015 (Table 1). The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases. During the first 6 months of 2017, the overall number of cases declined to eight, all in Chad, from 10 cases in three countries (Chad [four], South Sudan [four] and Ethiopia [two]) during the same period of 2016. Continued active surveillance, aggressive detection, and appropriate management of cases are essential eradication program components; however, epidemiologic challenges, civil unrest, and insecurity pose potential barriers to eradication.

Ernesto Ruiztiben - One of the best experts on this subject based on the ideXlab platform.

  • investigation of Dracunculiasis transmission among humans chad 2013 2017
    American Journal of Tropical Medicine and Hygiene, 2021
    Co-Authors: Eugene W Liu, Ernesto Ruiztiben, Anita D Sircar, Kolio Matchanga, Ada Mbang Mahamat, Neloumta Ngarhor, Philip Tchindebet Ouakou, Hubert Zirimwabagabo, Dieudonne Sankara, Ryan E Wiegand
    Abstract:

    Dracunculiasis, slated for global eradication, typically is acquired by drinking stagnant water containing microscopic crustaceans (copepods) infected with Dracunculus medinensis larvae, causing clusters of case persons with worms emerging from the skin. Following a 10-year absence of reported cases, 9-17 sporadic human cases with few epidemiologic links have been reported annually in Chad since 2010; dog infections have also been reported since 2012. We conducted an investigation of human cases in Chad to identify risk factors. We conducted a case-control study using a standardized questionnaire to assess water and aquatic animal consumption, and links to dog infections. Case persons had laboratory-confirmed D. medinensis during 2013-2017. Each case person was matched to one to three controls without history of disease by age, gender, and residency in the village where the case person was likely infected. We estimated odds ratios (ORs) using simple conditional logistic regression. We enrolled 25 case persons with 63 matched controls. Dracunculiasis was associated with consumption of untreated water from hand-dug wells (OR: 13.4; 95% CI: 1.7-108.6), but neither with consumption of aquatic animals nor presence of infected dogs in villages. Unsafe water consumption remains associated with Dracunculiasis. Education of populations about consuming safe water and using copepod filters to strain unsafe water should continue and expand, as should efforts to develop and maintain safe drinking water sources. Nevertheless, the peculiar epidemiology in Chad remains incompletely explained. Future studies of dogs might identify other risk factors.

  • progress toward global eradication of Dracunculiasis january 2017 june 2018
    Morbidity and Mortality Weekly Report, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, James Zingeser, Adam Weiss, Sharon L. Roy, Sarah Anne J Guagliardo
    Abstract:

    Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for Dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with Dracunculiasis. There is no vaccine or medicine to treat the disease; the GWEP relies on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of water, and provision of safe drinking water (1,2). In 1986, an estimated 3.5 million cases† occurred each year in 20§ African and Asian countries (3,4). This report, based on updated health ministry data (3), describes progress during January 2017-June 2018 and updates previous reports (1,4). In 2017, 30 cases were reported from Chad and Ethiopia, and 855 infected animals (mostly dogs) were reported from Chad, Ethiopia, and Mali, compared with 25 cases and 1,049 animal infections reported in 2016. During January-June 2018, the number of cases declined to three cases each in Chad and South Sudan and one in Angola, with 709 infected animals reported, compared with eight cases and 547 animal infections during the same period of 2017. With only five affected countries, the eradication goal is near, but is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.

  • Dracunculiasis eradication are we there yet
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Sharon L. Roy, Craig P Withers, Dean G Sienko
    Abstract:

    The global Dracunculiasis Eradication Program (DEP) is much closer to its goal of stopping transmission of Dracunculiasis (guinea worm disease) since the previous review in this series was published 5 years ago.1 This article describes the status of the program as of the end of 2017. We described in previous reports the parasite and the strategies and interventions being used to eradicate it.1,2 Dracunculiasis (guinea worm disease) is caused by the nematode parasite Dracunculus medinensis, and it is transmitted to humans in contaminated drinking water containing copepods (water fleas) that harbor infective larvae of the parasite. Recently, the potential infection of humans by eating poorly cooked or cured aquatic animals that have ingested infected copepods has emerged as a possible mode of infection.3 The larvae are expelled into water by adult female worms, and then, after human consumption of copepods or aquatic animals with infective larvae, the adult worms emerge through the skin of infected persons about 1 year after infection. Once the end of the worm has emerged through the skin, the remainder of the worm, up to 1 m long, must be removed. Emergence and removal of the worm is slow, painful, and often disabling due to secondary bacterial infections. Although usually not fatal, the disease has a serious adverse socioeconomic impact on the health, agricultural productivity, and school attendance of affected populations. Without medical care, persons are incapacitated for periods averaging 3 months. In the past, more than one-half of a village’s population might have been affected simultaneously during the main harvest or planting season. Until significant numbers of infections with D. medinensis were discovered in dogs in Chad in 2012, humans were the only known reservoir of infection. Individual infections last only 1 year, but people do not develop immunity to the parasite. There is no effective treatment or vaccine; however, the infection may be prevented by 1) educating villagers about the origin of the disease, 2) preventing infected persons and animals from entering sources of drinking water, 3) filtering all drinking water through a finely woven cloth that removes the copepods, 4) applying Abate larvicide (temphos; BASF Corp., Florham Park, NJ) to kill the copepods in ponds or other stagnant sources of drinking water, and 5) providing clean drinking water from safe sources, such as protected hand-dug or borehole wells. The global eradication campaign began at the Centers for Disease Control and Prevention (CDC) in 1980. It was adopted as a subgoal of the International Drinking Water Supply and Sanitation Decade (1981–1990), and it has been led since 1986 by The Carter Center, which is at the head of a coalition that includes the ministries of health of the endemic countries, the CDC, the World Health Organization (WHO), and the United Nations Children’s Fund as major partners and thousands of village volunteers and supervisory health staff. The coalition is supported by numerous donor agencies, governments, foundations, and other institutions. When The Carter Center began leading the global campaign after the CDC, there were an estimated 3.5 million cases of Dracunculiasis worldwide.4 At the World Health Assembly (WHA) in 2004, ministers of health set a target to stop transmission of Dracunculiasis by the end of 2009.5 When that target date was not met, partly because of the ongoing civil war in Sudan and unexpected outbreaks in Chad, Ethiopia, and Mali, the global initiative resolved to interrupt transmission as soon as possible.

  • progress toward global eradication of Dracunculiasis january 2016 june 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on a lower limb (1). Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination,* and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with endemic Dracunculiasis. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2016 has declined by >99%, and cases are confined to three countries with endemic disease. This report updates published (3-4) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2016-June 2017. In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015 (Table 1). The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases. During the first 6 months of 2017, the overall number of cases declined to eight, all in Chad, from 10 cases in three countries (Chad [four], South Sudan [four] and Ethiopia [two]) during the same period of 2016. Continued active surveillance, aggressive detection, and appropriate management of cases are essential eradication program components; however, epidemiologic challenges, civil unrest, and insecurity pose potential barriers to eradication.

  • progress toward global eradication of Dracunculiasis january 2015 june 2016
    Morbidity and Mortality Weekly Report, 2016
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from drinking contaminated water, the worm emerges through the skin, usually on the leg. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination (1), and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, began assisting ministries of health in countries where Dracunculiasis was endemic. In 1986, an estimated 3.5 million cases were occurring each year in 20 countries in Africa and Asia (1,2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, substantial progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2015 has been reduced by >99%, and cases are confined to four countries with endemic disease. This report updates published (3-5) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2015-June 2016. In 2015, a total of 22 cases were reported from four countries (Chad [nine cases], Mali [five], South Sudan [five], and Ethiopia [three]), compared with 126 cases reported in 2014 from the same four countries (Table 1). The overall 83% reduction in cases from 2014 to 2015 is the largest such annual overall reduction ever achieved during this global campaign. During the first 6 months of 2016, however, cases increased 25% compared with the same period in 2015. Continued active surveillance and aggressive detection and appropriate management of cases are essential eradication program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.

Sharon L. Roy - One of the best experts on this subject based on the ideXlab platform.

  • Progress Toward Global Eradication of Dracunculiasis, January 2019-June 2020.
    MMWR. Morbidity and mortality weekly report, 2020
    Co-Authors: Donald R. Hopkins, Adam Weiss, Sharon L. Roy, Sarah Yerian, Sarah G H Sapp
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination. Other interventions to prevent infection include health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). The worldwide eradication campaign began in 1980 at CDC (1). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly (WHA) called for Dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with Dracunculiasis. This report, based on updated health ministry data (4), describes progress made during January 2019-June 2020 and updates previous reports (2,4,5). With only 54 human cases reported in 2019, 19 human cases reported during January 2019-June 2020, and only six countries currently affected by Dracunculiasis (Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon), the achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic concerns, including 2,000 reported animal cases in 2019 and 1,063 animal cases in 2020, mostly in dogs. All national GWEPs remain fully operational, with precautions taken to ensure safety of program staff members and community members in response to the coronavirus disease 2019 (COVID-19) pandemic.

  • progress toward global eradication of Dracunculiasis january 2018 june 2019
    Morbidity and Mortality Weekly Report, 2019
    Co-Authors: Donald R. Hopkins, James Zingeser, Adam Weiss, Sharon L. Roy, Sarah Anne J Guagliardo
    Abstract:

    Dracunculiasis (also known as Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly called for Dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by The Carter Center and supported by the World Health Organization (WHO), CDC, the United Nations Children's Fund, and other partners, began assisting ministries of health in countries with Dracunculiasis. This report, based on updated health ministry data, describes progress to eradicate Dracunculiasis during January 2018-June 2019 and updates previous reports (2,4,5). With only five countries currently affected by Dracunculiasis (Angola, Chad, Ethiopia, Mali, and South Sudan), achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.

  • progress toward global eradication of Dracunculiasis january 2017 june 2018
    Morbidity and Mortality Weekly Report, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, James Zingeser, Adam Weiss, Sharon L. Roy, Sarah Anne J Guagliardo
    Abstract:

    Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for Dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with Dracunculiasis. There is no vaccine or medicine to treat the disease; the GWEP relies on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of water, and provision of safe drinking water (1,2). In 1986, an estimated 3.5 million cases† occurred each year in 20§ African and Asian countries (3,4). This report, based on updated health ministry data (3), describes progress during January 2017-June 2018 and updates previous reports (1,4). In 2017, 30 cases were reported from Chad and Ethiopia, and 855 infected animals (mostly dogs) were reported from Chad, Ethiopia, and Mali, compared with 25 cases and 1,049 animal infections reported in 2016. During January-June 2018, the number of cases declined to three cases each in Chad and South Sudan and one in Angola, with 709 infected animals reported, compared with eight cases and 547 animal infections during the same period of 2017. With only five affected countries, the eradication goal is near, but is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.

  • Dracunculiasis eradication are we there yet
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Sharon L. Roy, Craig P Withers, Dean G Sienko
    Abstract:

    The global Dracunculiasis Eradication Program (DEP) is much closer to its goal of stopping transmission of Dracunculiasis (guinea worm disease) since the previous review in this series was published 5 years ago.1 This article describes the status of the program as of the end of 2017. We described in previous reports the parasite and the strategies and interventions being used to eradicate it.1,2 Dracunculiasis (guinea worm disease) is caused by the nematode parasite Dracunculus medinensis, and it is transmitted to humans in contaminated drinking water containing copepods (water fleas) that harbor infective larvae of the parasite. Recently, the potential infection of humans by eating poorly cooked or cured aquatic animals that have ingested infected copepods has emerged as a possible mode of infection.3 The larvae are expelled into water by adult female worms, and then, after human consumption of copepods or aquatic animals with infective larvae, the adult worms emerge through the skin of infected persons about 1 year after infection. Once the end of the worm has emerged through the skin, the remainder of the worm, up to 1 m long, must be removed. Emergence and removal of the worm is slow, painful, and often disabling due to secondary bacterial infections. Although usually not fatal, the disease has a serious adverse socioeconomic impact on the health, agricultural productivity, and school attendance of affected populations. Without medical care, persons are incapacitated for periods averaging 3 months. In the past, more than one-half of a village’s population might have been affected simultaneously during the main harvest or planting season. Until significant numbers of infections with D. medinensis were discovered in dogs in Chad in 2012, humans were the only known reservoir of infection. Individual infections last only 1 year, but people do not develop immunity to the parasite. There is no effective treatment or vaccine; however, the infection may be prevented by 1) educating villagers about the origin of the disease, 2) preventing infected persons and animals from entering sources of drinking water, 3) filtering all drinking water through a finely woven cloth that removes the copepods, 4) applying Abate larvicide (temphos; BASF Corp., Florham Park, NJ) to kill the copepods in ponds or other stagnant sources of drinking water, and 5) providing clean drinking water from safe sources, such as protected hand-dug or borehole wells. The global eradication campaign began at the Centers for Disease Control and Prevention (CDC) in 1980. It was adopted as a subgoal of the International Drinking Water Supply and Sanitation Decade (1981–1990), and it has been led since 1986 by The Carter Center, which is at the head of a coalition that includes the ministries of health of the endemic countries, the CDC, the World Health Organization (WHO), and the United Nations Children’s Fund as major partners and thousands of village volunteers and supervisory health staff. The coalition is supported by numerous donor agencies, governments, foundations, and other institutions. When The Carter Center began leading the global campaign after the CDC, there were an estimated 3.5 million cases of Dracunculiasis worldwide.4 At the World Health Assembly (WHA) in 2004, ministers of health set a target to stop transmission of Dracunculiasis by the end of 2009.5 When that target date was not met, partly because of the ongoing civil war in Sudan and unexpected outbreaks in Chad, Ethiopia, and Mali, the global initiative resolved to interrupt transmission as soon as possible.

  • progress toward global eradication of Dracunculiasis january 2016 june 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on a lower limb (1). Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination,* and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with endemic Dracunculiasis. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2016 has declined by >99%, and cases are confined to three countries with endemic disease. This report updates published (3-4) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2016-June 2017. In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015 (Table 1). The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases. During the first 6 months of 2017, the overall number of cases declined to eight, all in Chad, from 10 cases in three countries (Chad [four], South Sudan [four] and Ethiopia [two]) during the same period of 2016. Continued active surveillance, aggressive detection, and appropriate management of cases are essential eradication program components; however, epidemiologic challenges, civil unrest, and insecurity pose potential barriers to eradication.

Craig P Withers - One of the best experts on this subject based on the ideXlab platform.

  • Dracunculiasis eradication are we there yet
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Sharon L. Roy, Craig P Withers, Dean G Sienko
    Abstract:

    The global Dracunculiasis Eradication Program (DEP) is much closer to its goal of stopping transmission of Dracunculiasis (guinea worm disease) since the previous review in this series was published 5 years ago.1 This article describes the status of the program as of the end of 2017. We described in previous reports the parasite and the strategies and interventions being used to eradicate it.1,2 Dracunculiasis (guinea worm disease) is caused by the nematode parasite Dracunculus medinensis, and it is transmitted to humans in contaminated drinking water containing copepods (water fleas) that harbor infective larvae of the parasite. Recently, the potential infection of humans by eating poorly cooked or cured aquatic animals that have ingested infected copepods has emerged as a possible mode of infection.3 The larvae are expelled into water by adult female worms, and then, after human consumption of copepods or aquatic animals with infective larvae, the adult worms emerge through the skin of infected persons about 1 year after infection. Once the end of the worm has emerged through the skin, the remainder of the worm, up to 1 m long, must be removed. Emergence and removal of the worm is slow, painful, and often disabling due to secondary bacterial infections. Although usually not fatal, the disease has a serious adverse socioeconomic impact on the health, agricultural productivity, and school attendance of affected populations. Without medical care, persons are incapacitated for periods averaging 3 months. In the past, more than one-half of a village’s population might have been affected simultaneously during the main harvest or planting season. Until significant numbers of infections with D. medinensis were discovered in dogs in Chad in 2012, humans were the only known reservoir of infection. Individual infections last only 1 year, but people do not develop immunity to the parasite. There is no effective treatment or vaccine; however, the infection may be prevented by 1) educating villagers about the origin of the disease, 2) preventing infected persons and animals from entering sources of drinking water, 3) filtering all drinking water through a finely woven cloth that removes the copepods, 4) applying Abate larvicide (temphos; BASF Corp., Florham Park, NJ) to kill the copepods in ponds or other stagnant sources of drinking water, and 5) providing clean drinking water from safe sources, such as protected hand-dug or borehole wells. The global eradication campaign began at the Centers for Disease Control and Prevention (CDC) in 1980. It was adopted as a subgoal of the International Drinking Water Supply and Sanitation Decade (1981–1990), and it has been led since 1986 by The Carter Center, which is at the head of a coalition that includes the ministries of health of the endemic countries, the CDC, the World Health Organization (WHO), and the United Nations Children’s Fund as major partners and thousands of village volunteers and supervisory health staff. The coalition is supported by numerous donor agencies, governments, foundations, and other institutions. When The Carter Center began leading the global campaign after the CDC, there were an estimated 3.5 million cases of Dracunculiasis worldwide.4 At the World Health Assembly (WHA) in 2004, ministers of health set a target to stop transmission of Dracunculiasis by the end of 2009.5 When that target date was not met, partly because of the ongoing civil war in Sudan and unexpected outbreaks in Chad, Ethiopia, and Mali, the global initiative resolved to interrupt transmission as soon as possible.

  • Dracunculiasis eradication and now south sudan
    American Journal of Tropical Medicine and Hygiene, 2013
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Craig P Withers, Sharon L. Roy
    Abstract:

    This report summarizes the status of the global Dracunculiasis Eradication Program as of the end of 2012. Dracunculiasis (Guinea worm disease) has been eliminated from 17 of 21 countries where it was endemic in 1986, when an estimated 3.5 million cases occurred worldwide. Only 542 cases were reported from four countries in 2012, and 103 villages still had indigenous transmission. Most remaining cases were reported from the new Republic of South Sudan, whereas Chad, Ethiopia, and Mali each reported 10 cases or less. Political instability and insecurity in Mali may become the main obstacles to interrupting Dracunculiasis transmission forever.

  • nigeria s triumph Dracunculiasis eradicated
    American Journal of Tropical Medicine and Hygiene, 2010
    Co-Authors: Emmanuel S Miri, Ernesto Ruiztiben, Donald R. Hopkins, Oladele O Kale, Ifeoma Anagbogu, Craig P Withers, L D Edungbola, Adamu S Keana, Lola K Sadiq, E I Braide
    Abstract:

    This report describes how Nigeria, a country that at one time had the highest number of cases of Dracunculiasis (Guinea worm disease) in the world, reduced the number of cases from more than 653,000 in 1988 to zero in 2009, despite numerous challenges. Village-based volunteers formed the foundation of the program, which used health education, cloth filters, vector control, advocacy for safe water, voluntary isolation of patients, and monitored program interventions and cases reported monthly. Other factors in the program's success were strong governmental support, advocacy by a former head of state of Nigeria, technical and financial assistance by The Carter Center, the U.S. Centers for Disease Control and Prevention, the United Nations Children's Fund, the World Health Organization, and many other partners and donors. The estimated cost of the Nigerian program during 1988-2009 is $37.5 million, not including funding for water supply projects or salaries of Nigerian governmental workers.

  • nigeria s war on terror fighting Dracunculiasis onchocerciasis lymphatic filariasis and schistosomiasis at the grassroots
    American Journal of Tropical Medicine and Hygiene, 2009
    Co-Authors: Ngozi A Njepuome, Donald R. Hopkins, Frank O Richards, Ifeoma Anagbogu, Patricia Ogbu Pearce, Mustapha Muhammed Jibril, Chukwu Okoronkwo, Olayemi T Sofola, Craig P Withers, Ernesto Ruiztiben
    Abstract:

    Africa's populous country, Nigeria, contains or contained more cases of Dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (Dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world for the same diseases. After beginning village-based interventions against Dracunculiasis 20 years ago and confronting onchocerciasis a few years later, Nigeria has nearly eliminated Dracunculiasis and has provided annual mass drug administration for onchocerciasis to over three quarters of that at-risk population for 7 years. With assistance from The Carter Center, Nigeria began treating lymphatic filariasis and schistosomiasis in two and three states, respectively, over the past decade, while conducting pioneering operational research as a basis for scaling up interventions against those diseases, for which much more remains to be done. This paper describes the status of Nigeria's struggles against these four neglected tropical diseases and discusses challenges and plans for the future.

  • Dracunculiasis eradication neglected no longer
    American Journal of Tropical Medicine and Hygiene, 2008
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Philip Downs, Craig P Withers, Sharon L. Roy
    Abstract:

    This report summarizes the status of the global Dracunculiasis Eradication Program as of early 2008. By the end of 2007, Dracunculiasis (Guinea worm disease) transmission had been eliminated from 15 of the 20 countries where the disease was endemic in 1986, only 9,585 cases were reported worldwide, and 2,016 villages still had indigenous cases of the disease. Two of the remaining affected countries (Nigeria and Niger) reported < 100 cases in 2007 and are on the verge of eliminating Dracunculiasis if they have not stopped transmission already. Sudan, Ghana, and Mali are addressing their final challenges to interrupting all remaining transmission by the end of 2009.

Mark L. Eberhard - One of the best experts on this subject based on the ideXlab platform.

  • Dracunculiasis eradication are we there yet
    American Journal of Tropical Medicine and Hygiene, 2018
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Adam Weiss, Mark L. Eberhard, Sharon L. Roy, Craig P Withers, Dean G Sienko
    Abstract:

    The global Dracunculiasis Eradication Program (DEP) is much closer to its goal of stopping transmission of Dracunculiasis (guinea worm disease) since the previous review in this series was published 5 years ago.1 This article describes the status of the program as of the end of 2017. We described in previous reports the parasite and the strategies and interventions being used to eradicate it.1,2 Dracunculiasis (guinea worm disease) is caused by the nematode parasite Dracunculus medinensis, and it is transmitted to humans in contaminated drinking water containing copepods (water fleas) that harbor infective larvae of the parasite. Recently, the potential infection of humans by eating poorly cooked or cured aquatic animals that have ingested infected copepods has emerged as a possible mode of infection.3 The larvae are expelled into water by adult female worms, and then, after human consumption of copepods or aquatic animals with infective larvae, the adult worms emerge through the skin of infected persons about 1 year after infection. Once the end of the worm has emerged through the skin, the remainder of the worm, up to 1 m long, must be removed. Emergence and removal of the worm is slow, painful, and often disabling due to secondary bacterial infections. Although usually not fatal, the disease has a serious adverse socioeconomic impact on the health, agricultural productivity, and school attendance of affected populations. Without medical care, persons are incapacitated for periods averaging 3 months. In the past, more than one-half of a village’s population might have been affected simultaneously during the main harvest or planting season. Until significant numbers of infections with D. medinensis were discovered in dogs in Chad in 2012, humans were the only known reservoir of infection. Individual infections last only 1 year, but people do not develop immunity to the parasite. There is no effective treatment or vaccine; however, the infection may be prevented by 1) educating villagers about the origin of the disease, 2) preventing infected persons and animals from entering sources of drinking water, 3) filtering all drinking water through a finely woven cloth that removes the copepods, 4) applying Abate larvicide (temphos; BASF Corp., Florham Park, NJ) to kill the copepods in ponds or other stagnant sources of drinking water, and 5) providing clean drinking water from safe sources, such as protected hand-dug or borehole wells. The global eradication campaign began at the Centers for Disease Control and Prevention (CDC) in 1980. It was adopted as a subgoal of the International Drinking Water Supply and Sanitation Decade (1981–1990), and it has been led since 1986 by The Carter Center, which is at the head of a coalition that includes the ministries of health of the endemic countries, the CDC, the World Health Organization (WHO), and the United Nations Children’s Fund as major partners and thousands of village volunteers and supervisory health staff. The coalition is supported by numerous donor agencies, governments, foundations, and other institutions. When The Carter Center began leading the global campaign after the CDC, there were an estimated 3.5 million cases of Dracunculiasis worldwide.4 At the World Health Assembly (WHA) in 2004, ministers of health set a target to stop transmission of Dracunculiasis by the end of 2009.5 When that target date was not met, partly because of the ongoing civil war in Sudan and unexpected outbreaks in Chad, Ethiopia, and Mali, the global initiative resolved to interrupt transmission as soon as possible.

  • progress toward global eradication of Dracunculiasis january 2016 june 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on a lower limb (1). Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination,* and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with endemic Dracunculiasis. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2016 has declined by >99%, and cases are confined to three countries with endemic disease. This report updates published (3-4) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2016-June 2017. In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015 (Table 1). The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases. During the first 6 months of 2017, the overall number of cases declined to eight, all in Chad, from 10 cases in three countries (Chad [four], South Sudan [four] and Ethiopia [two]) during the same period of 2016. Continued active surveillance, aggressive detection, and appropriate management of cases are essential eradication program components; however, epidemiologic challenges, civil unrest, and insecurity pose potential barriers to eradication.

  • progress toward global eradication of Dracunculiasis january 2015 june 2016
    Morbidity and Mortality Weekly Report, 2016
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy, Adam Weiss
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from drinking contaminated water, the worm emerges through the skin, usually on the leg. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination (1), and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, began assisting ministries of health in countries where Dracunculiasis was endemic. In 1986, an estimated 3.5 million cases were occurring each year in 20 countries in Africa and Asia (1,2). Since then, although the goal of eradicating Dracunculiasis has not been achieved, substantial progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2015 has been reduced by >99%, and cases are confined to four countries with endemic disease. This report updates published (3-5) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication during January 2015-June 2016. In 2015, a total of 22 cases were reported from four countries (Chad [nine cases], Mali [five], South Sudan [five], and Ethiopia [three]), compared with 126 cases reported in 2014 from the same four countries (Table 1). The overall 83% reduction in cases from 2014 to 2015 is the largest such annual overall reduction ever achieved during this global campaign. During the first 6 months of 2016, however, cases increased 25% compared with the same period in 2015. Continued active surveillance and aggressive detection and appropriate management of cases are essential eradication program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.

  • progress toward global eradication of Dracunculiasis january 2014 june 2015
    Morbidity and Mortality Weekly Report, 2015
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on the lower limb. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate Dracunculiasis worldwide began in 1980 at CDC. In 1986, the World Health Assembly called for Dracunculiasis elimination, and the global Guinea Worm Eradication Program, led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, began assisting ministries of health in countries where Dracunculiasis was endemic. In 1986, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia. Since then, although the goal of eradicating Dracunculiasis has not been achieved, considerable progress has been made. Compared with the 1986 estimate, the annual number of reported cases in 2015 has been reduced by 99% and cases are confined to four endemic countries. This report updates published and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication from January 2014 through June 2015. During 2014, a total of 126 cases were reported from four countries (Chad [13 cases], Ethiopia [three], Mali [40], and South Sudan [70]), compared with 148 cases reported in 2013, from the same four countries. The overall 15% reduction in cases during 2013–2014 was less than that experienced in recent years, but the rate of decline increased again to 70% in the first 6 months of 2015 compared with the same period during 2014. Continued active surveillance with aggressive detection and appropriate management of cases are essential program components; however, epidemiologic challenges and civil unrest and insecurity pose potential barriers to eradication.

  • progress toward global eradication of Dracunculiasis january 2013 june 2014
    Morbidity and Mortality Weekly Report, 2014
    Co-Authors: Donald R. Hopkins, Ernesto Ruiztiben, Mark L. Eberhard, Sharon L. Roy
    Abstract:

    Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm will emerge through the skin, usually on the lower limb. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. In 1986, the World Health Assembly called for Dracunculiasis elimination (1). The global Guinea Worm Eradication Program, supported by The Carter Center, World Health Organization (WHO), UNICEF, CDC, and other partners, began assisting ministries of health of countries in which Dracunculiasis is endemic in meeting this goal. At that time, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia (1,2). This report updates published (3–5) and unpublished surveillance data reported by ministries of health and describes progress toward Dracunculiasis eradication. A total of 148 cases were reported in 2013 from five countries (in order of prevalence: South Sudan, Chad, Mali, Ethiopia, and Sudan) compared with 542 cases in 2012 from four countries (South Sudan, Chad, Mali, and Ethiopia). The disease remains endemic in four countries in 2014 (South Sudan, Chad, Mali, and Ethiopia), but the overall incidence is falling faster in 2013 compared with 2012 (by 73%) and continues to fall faster in the first 6 months of 2014 (by 71%) compared with the same period in 2013. Failures in surveillance and containment, lack of clean drinking water, insecurity in Mali and parts of South Sudan, and an unusual epidemiologic pattern in Chad (6) are the main remaining challenges to Dracunculiasis eradication.