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 of eradicating the disease in five years or by 1994. This could not be achieved. Further extension of the program for 2 years was disrupted by an ethnic conflict. Even further extension to the end of the millennium, year 2000, failed to yield the desired results. The problem of prevalence / endemicity of the disease persisted. The objective of 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 of existing records, structured interviews, focus group discussions, and key informant interview. Major findings were: poor programme strategy because the programme was not foolproof. Treatmentof 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 of 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 of awareness of the GWEP and activities of the programme. There is the need to replace the programme strategy with one independentof the activities of the people - filtration and early reporting for wound dressing bandaging. Comprehensive dam treatment with Abate and monitoring of 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.