Fighting Disease:  Uganda

Eradicating Guinea Worm

Current Status: Transmission Stopped, July 2003 (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 threadlike 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 >

Invited by the Ugandan government, The Carter Center began working in 1991 with the Ministry of Health to establish one of the first African Guinea worm eradication programs. When the first active search was conducted, more than 120,000 cases of this debilitating and painful disease were found in more than 2,600 villages in 17 districts in the northern half of the country. The areas most severely affected by Guinea worm were three northeastern districts: Kitgum, Moroto, and Kotido.

In many of Uganda's districts, access to safe water has been a priority issue. For example, in Kitgum, the most endemic district, only 37 percent of the population had access to safe water in 1991. The remaining 63 percent had little or no choice but to possibly consume Guinea-worm-infected water. Because there are no vaccines or medicines to prevent or cure Guinea worm disease, nylon filters to strain out the infected larvae from drinking water must be used at all times to stop transmission of the disease.

Each endemic health district in Uganda has been given resident and assistant health educators to help promote Guinea worm disease prevention. As well, every endemic village has a trained community volunteer who provides additional health education. All households in endemic villages received nylon filters and replacement filters free of charge.

By 1997, only 1,251 cases were reported, and the disease had been eliminated from 13 of the 16 formerly endemic districts. In addition, Kitgum was no longer the most endemic district. Of the 392 endemic villages that year, 181 established at least one safe source of drinking water. This was partly due to the drilling of borehole wells in the districts of Kotido and Moroto.

A cash reward system was introduced in the Arua, Gulu, and Kitgum districts. In Kitgum, rewards helped the program to discover cases imported from Sudan in villages previously considered to be nonendemic.

Uganda's hard work has paid off; the country has not reported a single indigenous case of Guinea worm disease since July of 2003. Uganda and other nations bordering South Sudan will continue to be at risk for disease until the Guinea worm is eliminated from South Sudan. Countries that have reported zero cases for more than a year but neighbor South Sudan, such as Kenya and Uganda, have not received official certification. Until surveillance is improved and imported cases from South Sudan are reduced, these countries, including Uganda, will not be considered for certification in the near future. It therefore remains imperative to monitor and report the exportation of Guinea worm cases from South Sudan to neighboring countries. Once this milestone is achieved, Uganda will have officially eliminated the disease.

The Carter Center remains committed to building hope and stopping the spread of Guinea worm disease worldwide.

Read about the Carter Center's 2006 Guinea Worm Eradication Awards Ceremony, honoring Benin, Central African Republic, Mauritania, Uganda >

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

The Sudan-Uganda Guinea Worm Connection:
Eliminating Guinea worm disease from South Sudan, the most Guinea-worm-endemic country in the world, remains critical to achieving global elimination. The political violence and instability in South Sudan have served as the single greatest obstacle to Guinea worm eradication.