Fighting Disease:  Chad

Eradicating Guinea Worm Disease

Current Status:Transmission stopped, 1998; isolated outbreak 2010 – 2011
Certification of Dracunculiasis Eradication: 1998

Dracunculiasis, or Guinea worm disease, is a preventable parasitic infection contracted when a person ingests drinking water from stagnant sources containing copepods (commonly referred to as water fleas) that harbor infective Guinea worm larvae. Inside a person's body, the larvae grow for a year, becoming thin threadlike worms up to 1 meter long. These worms create agonizingly painful blisters in the skin and must be extracted manually, a slow and painful process, which prevents victims from attending school, caring for children, or farming. Learn more about the historic Carter Center-led campaign to eradicate Guinea worm disease >

In July 2010, during a World Health Organization precertification mission to Chad, an outbreak of Guinea worm disease was discovered. Chad had not reported any indigenous cases of the disease in more than 10 years. The origin of this outbreak remains uncertain. Ten confirmed cases of Guinea worm disease were reported from eight villages in 2010 and 10 additional cases were reported from nine different villages in 2011. None of the cases from 2011 were linked (time or place) to cases in 2010. Investigation of these cases is ongoing. During 2011, Chad's Ministry of Public Health formally requested The Carter Center assist their Guinea Worm Eradication Program to implement a surveillance system encompassing all villages in areas associated with cases in 2010 and 2011. As of May 2012, the Ministry of Public Health and Carter Center-trained staff were active in 726 villages in these areas. This surveillance system relies on trained village volunteers (one male and one female per village) to search for cases weekly and to respond immediately by preventing the patient from contaminating sources of drinking water, providing free first aid to the patient, and to report immediately such cases to public health authorities. Cadres of supervisors monitor village volunteer activities and provide technical support weekly. Nationwide, local radio stations, posters, and person-to-person networks are leveraged to publicize a monetary reward for information leading to confirmation of a case of Guinea worm disease.  For more information on the isolated outbreak in Chad, and current worldwide case reports, read the latest Guinea Worm Wrap-Up newsletter >

Elimination Activities from 1993 – 2000
In 1993, when Guinea worm elimination efforts began in Chad, a total of 1,231 cases of Guinea worm disease were found in a national case search. Six of Chad's nine national provinces were endemic for the disease, including 106 villages. The strategy for interrupting transmission of Guinea worm disease in Chad consisted of several components, focused primarily on educating residents about the origin of the disease and how to prevent it.  As in other endemic countries, The Carter Center provided technical and financial assistance to the national eradication effort.

The program changed behavior, mobilized communities to improve the safety of their local water sources, and taught people how to prevent contamination of their water sources by always filtering drinking water. Approaches introduced to the communities have included: education on proper use of and distribution of nylon filters to strain out the intermediate host; safe, monthly treatments of stagnant ponds with ABATE® larvicide (donated by BASF Corporation); direct advocacy with water organizations to provide safe drinking water to all affected communities. Village volunteers were trained, supplied, and supervised by the program to carry out monthly surveillance and interventions.

In Chad, in addition to these measures, messages on Guinea worm eradication were prepared in national languages and broadcast by radio. Bolts of cloth with a Guinea worm eradication slogan, donated by The Carter Center, were distributed to program staff and village health workers for the purpose of publicizing the program and motivating those concerned. These efforts came to fruition in 1997, when Chad stopped transmission of Guinea worm disease (12 consecutive months of zero indigenous reported cases). This historic accomplishment positively benefited the entire country, as more children could attend school and more adults could return to work.

The Carter Center held a special ceremony in Atlanta in 2000 to honor Chad, Senegal, Cameroon, Yemen, Pakistan, India, and Kenya for reaching a major milestone in their elimination efforts by stopping Guinea worm disease transmission.

Read Nations Celebrate Progress Against Guinea Worm (The Carter Center News, July-December 2000, p.6, PDF) >

Learn more about the Carter Center's Guinea Worm Eradication Program in Chad (in search result format) >