Dracunculiasis eradication: beginning of the end.

Beginning with the International Drinking Water Supply and Sanitation Decade (1981-1990), an increasingly broad coalition of international and bilateral agencies, organizations, private companies, and other institutions have joined forces to eradicate dracunculiasis (Guinea worm disease). From an estimated annual incidence of 10 million persons just before the campaign began, the remaining incidence of cases is now less than two million. More than 23,000 villages are known to be endemic. All 18 countries where the disease is still endemic have completed or begun nationwide searches to identify endemic villages, except Kenya. Dracunculiasis is nearly eradicated in Asia, where Pakistan found only 23 cases in 1992, and India found 1,081 cases. Cameroon and Senegal are close to achieving eradication in Africa, where the two formerly highest endemic countries, Nigeria and Ghana, reduced their combined total of cases from approximately 820,000 in 1989 to less than 240,000 in 1992. Much remains to be done, however, in francophone West Africa and especially in East Africa. The most serious current obstacles to eradicating dracunculiasis by 1995 are the civil war in Sudan, apathy of some national and international health officials, and inadequate funding for the campaign.

Dracunculiasis eradication: March 1994 update.

Substantial progress has been realized in the global campaign to eradicate dracunculiasis by the end of 1995 since a previous review of the subject was published in this journal a year ago. All known endemic countries are now engaged in the eradication effort, and one or more control measures are now in place in 93% of endemic villages. Despite improved surveillance for the disease, the number of reported cases of the disease has been reduced by 41% (to about 221,000), and the number of known endemic villages has been reduced by 28% (to about 16,500) in the past year. Priorities for national eradication programs in 1994 include increasing the use of vector control and intensifying the case containment strategy in endemic villages. It is still possible to achieve the eradication target of December 1995, but greatly intensified efforts this year will be required to do so.

Nutritional status of preschool children in Togo, 1976-77.

Survey teams visited 163 rural villages and 41 urban quarters in Togo and collected data on weight, height, arm circumference, age, and pedal oedema from 6120 children aged 6-72 months. Haemoglobin levels were determined for one-fifth of the survey children. When 80% of the reference median weight-for-height was used as the cut-off point, the prevalence of acute undernutrition was 2.0%. When 90% of the reference median height-for-age was used as the cut-off point, the prevalence of chronic undernutrition was 19.1%. The prevalence of both types of undernutrition was significantly higher in the northern rural regions, with the lowest prevalence in the urban areas. The prevalence of anaemia was 58.6%, with the highest prevalence in the northern regions. Anthropometric data on socioeconomically privileged preschool children were collected and compared with those for the survey children and the reference population. The socioeconomically privileged preschool group of Togolese children had a nutritional status substantially better than that of the survey children and nearly equivalent to that of the American reference population. The survey method was economical in terms of money, time, and personnel. The methodology employed rapidly provided objective data on the extent and distribution of protein-energy undernutrition and anaemia in the preschool children of Togo.