NIGERIA-HEALTH: The Guinea Worm Fights Back

By Toye Olori Reprint | | Print |

Toye Olori

ABAKALIKI, Nigeria, Sep 11 1997 (IPS) - Nigeria had all but eradicated the Guinea Worm disease by the end of last year, but it has had to face a resurgence of the debilitating ailment in the first half of 1997.

About 50 cases were reported in Abakaliki, a south-eastern town of about 100,000 people, in the first semester of 1997, whereas the total for the whole of 1996 was 70, according to statistics from the South Eastern Zone of the Nigeria Guinea Worm Eradication Programme (NIGEP).

The entire southeast shows a similar progression, NIGEP figures show. The zone recorded 3,843 cases in the first half of this year as against 4,694 cases in the whole of 1996.

“Dwindling political will and financial commitments by the state and local governments have led to a decrease in funding from donor organisations and a resultant fall in eradication activities,” a NIGEP official told IPS.

“Due to frustrations because of the nonchalant attitudes of local and state-government chairmen, and since Nigeria is being treated as a pariah nation, donors are sort of shying away from putting more money into the eradication programme in the country,” added the official, who declined his name for publication.

He exlained that because of the lack of political will and dwindling funding, broken-down handpumps have remained unrepaired, leading to a scarcity of potable water in endemic areas and a subsequent re-emergence of the ailment.

The Guinea worm, a parasite that lives in water, is most common in West and East Africa, and parts of Asia. It is spread by tiny water fleas that swallow the worm’s larvae. These develop inside the insect and are released into the human body when people drink water containing the fleas.

The white threadlike worms continue growing in the body and can reach a length of 120 cm. A year after infection, the adults release their larvae into a large, painful blister usually on the host’s legs and arms. When the limbs are immersed in water, the larvae escape and the cycle of infection continues.

NIGEP was inaugurated in 1988 with the aim of totally wiping out the disease from the country by December 31, 1995. To this end, an administrative structure was set up comprising a National Steering Committee, a National Task Force, State Task Forces and Operational Zones with Zonal Facilitators.

Village-based health workers were trained and equipped for surveillance and intervention in endemic villages while three annual case searches were conducted, after which monthly surveillance and reporting began in 1992.

All this has helped reduce the incidence of the ailment, but the gains made in the past eight years are now being eroded.

“Although Nigeria has recorded 98-percent eradication since intervention began in 1988, from 653,620 cases to 12,282 cases last year, the remaining two percent has proved difficult to contain,” Prof. Eka Braide, facilitator of the South-Eastern Zone, told a meeting of NIGEP officials on Monday in the east central town of Makurdi.

Nigeria is divided into four operational zones under the eradication programme and at least two have recorded significant increases: the South East began this year with 657 affected villages. Since then, there have been another 113, 79 percent of which had been free of Guinea Worm in the past. In the North East, there were 1,813 cases in the whole of 1996 but 1,657 in the first half of 1997.

According to Braide, field monitoring visits revealed that the increases were a direct result of inadequate monitoring of NIGEP activities at the grassroots. The dismissal of members of task forces set up by states and local governments “and unavailability of vehicles have also compounded the problem of monitoring, supervision and movement of supplies,” she said.

Braide also attributed the re-emergence of Guinea Worm cases to a lack of support from state and local-government chairmen in some endemic areas. However, local government heads in these areas have now mapped out new strategies to ensure that the parasite is reduced and eventually eradicated.

These include increased budgetary allocations for the provision of safe water, the inauguration of village task forces comprising professionals, market vendors, the media and opinion leaders to review efforts and provide incentives for village- based health workers to enhance motivation.