title: Guinea worm infection in northern Nigeria: reflections on a disease approaching eradication.
abstract: Global eradication of the guinea worm (Dracunculus medinensis) is near, although perhaps delayed a little by the discovery of a transmission cycle in dogs. It is therefore an appropriate time to reflect on the severe impact of this infection on the life of the communities where it was endemic prior to the start of the global eradication programme in 1981. From 1971 to 1974, we conducted a series of unpublished studies on guinea worm in a group of villages in Katsina State, northern Nigeria, where the infection was highly endemic. These studies demonstrated the high rate of infection in affected communities, the frequent recurrence of the infection in some subjects and the long-standing disability that remained in some infected individuals. Immunological studies showed a high level of immediate hypersensitivity to adult worm and larval antigens but a downregulation of Th1-type T-cell responses to worm antigens. Freeing communities such as those described in this article from the scourge of guinea worm infection for good will be an important public health triumph.
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.|Malumfashi Endemic Diseases Research Project, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.affiliation: Malumfashi Endemic Diseases Research Project, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Alice
authors.initials: A
authors.lastname: Greenwood
authors.affiliation: Malumfashi Endemic Diseases Research Project, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bradley
mesh_terms: D000818:Animals; D000941:Antigens; D017281:Cost of Illness; D006233:Persons with Disabilities; D004285:Dogs; D015536:Down-Regulation; D004320:Dracunculiasis / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D004321:Dracunculus Nematode; D019353:Endemic Diseases; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D012008:Recurrence; D018417:Th1 Cells
chemical_list: D000941:Antigens
keywords: eradication; erradicación; guinea worm; gusano de Guinea; immunologie; immunology; inmunología; morbidity; morbidité; morbilidad; vers de Guinée; éradication