Research Article: What It Means to Be Guinea Worm Free: An Insider’s Account from Ghana’s Northern Region

Date Published: May 19, 2018

Publisher: The American Society of Tropical Medicine and Hygiene

Author(s): Adam J. Weiss, Torben Vestergaard Frandsen, Ernesto Ruiz-Tiben, Donald R. Hopkins, Franklin Aseidu-Bekoe, David Agyemang.


Despite several periods of stagnating guinea worm disease (GWD) incidence in Ghana during its national eradication campaign in the 1990s and early 2000s, the last reported case of GWD was in May 2010. In July 2011, Ghana celebrated the interruption of guinea worm (GW) transmission. Although it has been established that GWD causes disability, pain, and socioeconomic hardship, there is a dearth of population-based evidence collected in post-GW–endemic countries to document the value attributed to GWD eradication by residents in formerly endemic communities. Given Ghana’s recent history of GWD and a concentrated burden of the disease in its Northern Region, a pattern which remained true through to the final stage of the eradication campaign, seven villages in the Northern Region were targeted for a retrospective, cross-sectional study to detail the perceptions, attitudes, and beliefs about the impact of eradication of GWD in northern Ghana. The study revealed that respondents from the sampled communities felt GW eradication improved their socioeconomic conditions, as the impact of infection prohibited the pursuit of individual and social advancement. The value residents placed on the absence of GWD highlights both the impact infection had on the pursuit of social and economic advancement and the newfound ability to be disease-free and productive. Of the 143 respondents, 133 had GWD in the past and were incapacitated for an average of 6 weeks annually per GW infection, with each infected person affected nearly four times in his or her lifetime.

Partial Text

Dracunculus medinensis, commonly referred to as guinea worm (GW), is a nematode parasite that typically affects only human beings.1,2 Also known as the fiery serpent because of the generalized burning sensation one feels when the worm is about to emerge, GW is referenced in the bible and has been recovered from mummies in Ancient Egypt nearly 3,000 years old.1 The genesis of the idea to eradicate guinea worm disease (GWD) had its origin at the Centers for Disease Control and Prevention in 1980 following the success of the smallpox eradication campaign.3

In October 2013, a total of 143 head of household interviews were conducted in six of the seven targeted towns and villages. Issape, in the Central Gonja district, could not be visited because of inaccessibility caused by flooding after heavy rains. In addition, 18 FGDs were conducted involving 400 residents across all age groups, including two schools in Tamale town.

Although interruption of GWD transmission nationwide in Ghana satisfies the definition of a public health success, this study provides an account of how the eradication of GWD was perceived in northern Ghana. This survey is the first known attempt to collect population-based evidence from residents of affected communities in a country formerly affected by endemic GWD to document residents’ perception of value attributed to GWD eradication.




Leave a Reply

Your email address will not be published.