Fighting Disease:  Togo

Eradicating Guinea Worm

Current status: Transmission stopped, December 2006 (read the announcement)
Certification of Dracunculiasis Eradication: Pending

For the most current Guinea worm case reports, read the Guinea Worm Wrap-Up newsletter >

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 thread-like worms, up to 1 meter long. These worms create agonizingly painful blisters in the skin through which they slowly exit the body, preventing the victim from attending school, caring for children, or harvesting crops. Learn more about the historic Carter Center-led campaign to eradicate Guinea worm disease >

In 1992, the national Guinea Worm Eradication Program in Togo began its first search for cases of Guinea worm disease and found 8,179 cases of infection in 584 villages. Since then, The Carter Center worked with the national program to reduce the incidence of Guinea worm disease. These efforts yielded success in December 2006, when the program declared its last case in the village of Kpégno Agoromé.

Togo is the size of the U.S. state of West Virginia, making the short distance between Guinea worm disease-endemic and nonendemic areas a concern when eradication efforts began.

During the Carter Center's involvement in Togo starting in 2002, 17 Guinea worm care centers, or case containment centers, were established. While receiving basic medical attention for their wounds, patients at voluntary, free case containment centers receive education from volunteers on how to prevent the spread of the parasite to others. The program, in partnership with the U.S. Peace Corps volunteers, also conducted multiple, successful educational outreach programs called "Worm Weeks."

The Togo program tried a wide array of health education strategies. Two of the strategies that were effective for all endemic districts were the use of T-shirts and medical bags with the transmission cycle printed on them. Village-based health workers and Guinea worm supervisors use these items to teach the transmission cycle. These combined efforts helped lead to interruption of transmission of the disease in 2007. Read Guinea Worm Eradication in Togo: A Firsthand Account >

Because of the risk of imported cases from other countries, it is crucial for Togo to intensify efforts, especially surveillance, to prevent Guinea worm and to help in the final push to eliminate Guinea worm from West Africa in the next few years.

One of Togo's biggest obstacles to complete elimination of the disease was the migration of infected people to and from Ghana and Togo. Although Ghana halted Guinea worm disease transmission in 2010, it remains imperative that Togo monitors and reports the importation/exportation of Guinea worm cases across its borders as well as in all local districts, whether believed to be endemic or not. Continued dedication of village-based volunteers is essential for Guinea worm eradication to remain a top priority.

Through Togo's efforts, the suffering caused by this debilitating disease has been averted. Wiping out Guinea worm disease positively impacts families, communities, and economies; people can return to work and children can go to school.

Click here to learn more about the Carter Center's Guinea Worm Eradication Program in Togo (in search result format) >