Factors Accounting for the Failure to Achieve Eradication of Guinea Worm in the Tamale Municipality

Abstract

The Guinea Worm Eradication Programme (GWEP) began in Tamale Municipality 1989 with the objective o f eradicating the disease in five years or by 1994. This could not be achieved. Further extension o f the program for 2 years was disrupted by an ethnic conflict. Even further extension to the end o f the millennium, year 2000, failed to yield the desired results. The problem of prevalence / endemicity o f the disease persisted. The objective o f the study, which was descriptive, was to probe for factors responsible for the persistence of the disease and make recommendations aimed at improving the programme strategy in order to achieve eradication. Data collection method included the use o f existing records, structured interviews, focus group discussions, and key informant interview. Major findings were: poor programme strategy because the programme was not foolproof. Treatment of dams with Abate were done only in endemic communities; there were no mechanisms in place to identify new and even old but previously unidentified dams; filter coverage was not 100% in all the communities more so in larger communities; monitoring o f dams for the presence or absence of Cyclops - the intermediate host -was only by sampling. Resources committed to the programme were inadequate, including dressing materials for containment and filters for households and farms. Volunteers were dissatisfied with incentives given them and promises made by program managers and politicians that could not be kept. Community members appear to be tired of filtering their drinking water for over a decade. The initial momentum of the programme is lost despite the high level o f awareness of the GWEP and activities of the programme. There is the need to replace the programme strategy with one independent o f the activities o f the people - filtration and early reporting for wound dressing bandaging. Comprehensive dam treatment with Abate and monitoring o f all dams for Cyclops regularly could be the answer. Mechanisms to detect new and old dams must be in place and resources required must be available at all times. Filtration of water and wound bandaging should be considered adjunct to this strategy.