title: Not every worm wrapped around a stick is a guinea worm: a case of Onchocerca volvulus mimicking Dracunculus medinensis.
abstract: BACKGROUND
  Despite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence. This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. This paper presents fieldwork carried out to investigate a guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis.
  
  
  METHODS
  The investigation included a field visit to the subsistence farming community where the rumor was reported. During the visit, interviews were conducted with health staff who managed the case and the elderly farmer from whom the worm was retrieved. An investigation of any potential missed guinea worm cases was also conducted through interviews with community residents and reviews of the health facility's medical records. This was combined with laboratory analyses of water samples from the community's water sources and the retrieved worm which was removed from the patient via wrapping it around a stick.
  
  
  RESULTS
  Microscopy and molecular analyses of the retrieved worm revealed a female Onchocerca volvulus whose expulsion strongly mimicked guinea worm. In addition to presenting findings of our investigation, this paper discusses distinguishing elements between the two parasites and gives an overview of guinea worm eradication efforts in Cameroon as well as current challenges to the worm's eradication globally.
  
  
  CONCLUSIONS
  The investigation findings suggest the evolving Onchocerca volvulus worm tropisms' adaptive survival behavior worth further investigation. Strategies used to successfully control guinea worm in Cameroon could be adapted for Onchocerca volvulus control.
authors.affiliation: Ministry of Public Health, Yaoundé, Cameroon. mbongeta@yahoo.fr.|Building Bridges Cameroon (BBCAM), Yaoundé, Cameroon. mbongeta@yahoo.fr.|, P.O Box 547, Buea, Cameroon. mbongeta@yahoo.fr.
authors.forename: Eta Ngole
authors.initials: EN
authors.lastname: Mbong
authors.affiliation: WHO Country Office, Yaoundé, Cameroon. sumegerald@gmail.com.
authors.forename: Gerald Etapelong
authors.initials: GE
authors.lastname: Sume
authors.affiliation: Ministry of Public Health, Yaoundé, Cameroon. floberto_danyou@yahoo.com.
authors.forename: Flaubert
authors.initials: F
authors.lastname: Danbe
authors.affiliation: Ministry of Public Health, Yaoundé, Cameroon. kumwalters@yahoo.co.uk.
authors.forename: Walter Kang
authors.initials: WK
authors.lastname: Kum
authors.affiliation: Building Bridges Cameroon (BBCAM), Yaoundé, Cameroon. obenvalie@yahoo.com.
authors.forename: Valeri Oben
authors.initials: VO
authors.lastname: Mbi
authors.affiliation: Ministry of Public Health, Yaoundé, Cameroon. bitaandre@yahoo.fr.
authors.forename: André Arsène Bita
authors.initials: AA
authors.lastname: Fouda
authors.affiliation: Ministry of Public Health, Yaoundé, Cameroon. camatem@yahoo.fr.
authors.forename: Peter
authors.initials: P
authors.lastname: Atem
mesh_terms: D000368:Aged; D000818:Animals; D002163:Cameroon / Q000453:epidemiology; D003937:Diagnosis, Differential; D004320:Dracunculiasis / Q000453:epidemiology; D004321:Dracunculus Nematode / Q000302:isolation & purification; D000072480:Farms; D005260:Female; D006801:Humans; D017181:Onchocerca volvulus / Q000302:isolation & purification*; D009855:Onchocerciasis / Q000453:epidemiology / Q000469:parasitology*; D014195:Travel; D014867:Water / Q000469:parasitology
chemical_list: D014867:Water