Dracunculiasis (dracontiasis, guinea worm disease) is caused
by infection of subcutaneous and connective tissues with the guinea worm Dracunculus
medinensis. Humans are the only known reservoir. Once a
scourge affecting thousands of people around the world, the range
of this organism has been greatly reduced as a result of a global
eradication program spearheaded by the Carter Center’s Global
2000 program. After an estimated 3.5 million cases in 1986, 25,217
cases were reported in 2006.1Over 180 countries
have now been certified as free of guinea worm by the World Health
Organization. Currently, the Carter Center and the Centers for Disease Control
and Prevention (CDC) estimate that the incidence of guinea worm
infection fell by 95% between 1986 and 1996 such that it
is now estimated that there are fewer than 10,000 cases, which are
limited to five African countries—Sudan, Ghana, Nigeria,
Niger, and Mali. Sudan alone accounts for more than two thirds of
the total cases reported worldwide. Virtually all cases occur in
rural, isolated areas. The economic impact of infection is significant,
with adults losing about 100 days of work and children missing 25% of
school when symptomatic.2,3