Prevention is proving better than cure yet again. The parasitic Guinea worm 鈥� which grows up to 60 centimetres long and is usually extracted painfully by hand 鈥� faces eradication by 2009. And that鈥檚 without the aid of drugs. Instead, millions of Africans broke the cycle of infection by following a global prevention campaign led by the Carter Center in Atlanta, Georgia.
Guinea worms mainly infect people who drink water contaminated with fleas that carry the worm larvae. These grow in the body, but must re-emerge to reach water and complete their life cycle by producing more larvae.
The eradication programme, started in 1980, involves village-based surveillance to prevent the worm spreading. In Uganda, for example, elderly villagers serve as 鈥減ond caretakers鈥�, preventing people with emerging worms from entering the water, and fetching water for them instead.
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鈥淧ond caretakers prevent people with emerging worms from entering the water鈥�
鈥淚t鈥檚 a really great example of old-fashioned public health measures without the usual burden of money and drugs,鈥� says Michele Barry at Yale University School of Medicine in New Haven, Connecticut. 鈥淚t will be the first parasitic disease to be eradicated.鈥�
The disease has tumbled from 3.5 million cases worldwide in 1986 to just 25,217 in 2006, Barry reports in The New England Journal of Medicine (vol 356, p 2561). She praises the extremely low cost of the programme. At just $225 million over 20 years, it鈥檚 a fraction of the funding poured into major diseases, such as malaria.
