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Geographic Distribution

Fig. 27.1 Geographic distribution of dracunculiasis (guinea worm infection) as of 1995. By 1999 the few remaining endemic foci in India, Pakistan, and Arabia had been essentially eradicated.

The principal endemic foci of the guinea worm in the past have been in tropical Africa, Arabia, the Middle East, Pakistan and India. As noted earlier, because of the success of the WHO programs to eradicate dracunculiasis in the past two decades, the disease is now largely confined to the Sudan and throughout the Nile Valley south into Uganda, and in several localized areas of endemicity in West Africa from Mauritania to Cameroon, including populous Nigeria. Computer-assisted database management and mapping technology has been used in recent years to pinpoint the location of each endemic village where transmission of the disease still occurs. The resulting map shows a wide band across tropical Africa with 17 remaining endemic countries, from Senegal in the west to Kenya and Ethiopia in the east (Fig. 27.1). In addition to the countries listed above, scattered areas of infection are also found in Guinea, Ghana, Ivory Coast, Benin, Burkina Faso, and Egypt. While previously hyperendemic in India, the disease has essentially disappeared there, as well as in other countries of Asia and the Middle East.

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