Dracunculiasis--the saddle is virtually ended.

Dracunculiasis is a preventable parasitic disease that for many years has affected poor communities without a safe portable water supply. Transmission is basically limited among the nomadic in remote rural settings. Most countries, including Asia, are declared free from the Guinea worm disease restraining the burden of transmission to Africa especially Sudan, Ghana, Mali, Nigeria and Niger. This review focuses mainly on the progress made so far by the Global Guinea Worm Eradication Programme championed by the Carter Center, Centers for Disease Control and Prevention, World Health Organisation, The United Nations Children's Fund and the individual efforts of endemic nations through their National Guinea Worm Eradication Programme aimed towards total global Guinea worm eradication.

"Serpent" in the breast.

BACKGROUND: Dracunculus medinensis better known as guinea worm is the longest nematode infecting humans. Mature female worms migrate along subcutaneous tissue to reach the skin below the knee forming a painful ulcerating blister. Calcified male worm can occasionally be found in the retro peritoneum. Finding of a calcified worm in the breast tissue is very rare. We report a case of a fit and well African lady who was found to have a calcified guinea worm in the breast on a mammographic examination for investigation of a breast lump. METHODS: A 51 years old female, presented in the surgical outpatient clinic with a painless irregular lump under the right nipple on clinical examination. There were no skin changes, nipple discharge or axillary lymphadenopathy. Mammogram showed a calcified Guinea worm. RESULTS: No treatment was offered and a repeat mammogram after one year showed the same findings. She was discharged from the clinic without any follow up and will be screened routinely as per national guidelines CONCLUSION: Guinea worm can be included in the differential diagnosis of the breast lump especially in the endemic areas although the finding remains very rare.

Failure of thiabendazole and metronidazole in the treatment and suppression of guinea worm disease.

Guinea worm disease is endemic in West Africa. In 1973 a field drug trial was conducted to compare effectiveness, cost, and side-effects of thiabendazole and metronidazole in treating active guinea worm disease and preventing latent worms from emerging. A mass chemotherapy campaign was planned to follow the drug trial. Only 15.5% of the treated patients expelled the worm completely, and in 28.4% of the cases worms continued to appear. Both drugs were equally unsatisfactory in their anti-helminthic effect. Consequently, our efforts to control guinea worm have shifted from chemotherapy to chemical control of cyclops and improvement of rural water supplies.