Guinea Worm Eradication Program - Articles by Carter Center Experts

September 2024
Slaying the Serpent: A Research Agenda to Expand Intervention Development and Accelerate Guinea Worm Eradication Efforts
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Maryann G. Delea, Alexandra Sack, Obiora A. Eneanya, Elizabeth Thiele, Sharon L. Roy, Dieudonne Sankara, Kashef Ijaz, Donald R. Hopkins, Adam J. Weiss
Description: Dracunculiasis, also known as Guinea worm disease, is targeted to become the second human disease and first parasitic infection to be eradicated. The global Guinea Worm Eradication Program (GWEP), through community-based interventions, reduced the burden of disease from an estimated 3.5 million cases per year in 1986 to only 13 human cases in 2022. Despite progress, in 2012 Guinea worm disease was detected in domesticated dogs and later in domesticated cats and baboons. Without previous development of any Guinea worm therapeutics, diagnostic tests to detect pre-patent Guinea worm infection, or environmental surveillance tools, the emergence of Guinea worm disease in animal hosts—a threat to eradication—motivated an assessment of evidence gaps and research opportunities. This gap analysis informed the refinement of a robust research agenda intended to generate new evidence and identify additional tools for national GWEPs and to better align the global GWEP with a 2030 Guinea worm eradication certification target. This paper outlines the rationale for the development and expansion of the global GWEP Research Agenda and summarizes the results of the gap analysis that was conducted to identify Guinea worm–related research needs and opportunities. We describe five work streams informed by the research gap analysis that underpin the GWEP Research Agenda and address eradication endgame challenges through the employment of a systems-informed One Health approach. We also discuss the infrastructure in place to disseminate new evidence and monitor research results as well as plans for the continual review of evidence and research priorities.

September 2024
Factors Influencing Community Engagement during Guinea Worm and Polio Eradication Endgames in Chad: Recommendations for “Last Mile” Programming
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Maryann G. Delea, Lalique Browne, Severin Kaji, Adam J. Weiss, and Ouakou Tchindebet
Description: Community engagement is a strategy commonly used in health and development programming. Many disease eradication programs engage with communities through different structures and mechanisms to detect, report, contain, and respond to the diseases they target. Qualitative operational research was conducted in a district of Chad co-endemic for both dracunculiasis (i.e., Guinea worm disease) and circulating vaccine-derived poliovirus to reveal factors influencing community engagement behavior in the context of eradication-related programming. Women and men from six communities and stakeholders from the local, district, and central levels were recruited to participate in focus group discussions and semi-structured in-depth interviews. A thematic analysis was performed to identify barriers and facilitators of community engagement. Barriers to community engagement included mistrust in exogenously established health program initiatives (i.e., initiatives designed by partners external to targeted program communities) resulting from negative past experiences with external entities and community groups and the lure of profit-motivating community engagement. Subgroup and intersectionality analyses revealed that gender and other identities influence whether and to what extent certain members of the community engage in a meaningful way. Facilitators of community engagement included leadership and the influence of authorities and leaders in community participation, perceived benefits of being engaged with community-based initiatives, and use of incentives to enhance community participation. Study findings may be used to inform the refinement of community engagement approaches in Chad and learning agendas for other “last mile” disease eradication programs.

September 2024
Predicting the Environmental Suitability and Identifying Climate and Sociodemographic Correlates of Guinea Worm (Dracunculus medinensis) in Chad
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Obiora A. Eneanya, Maryann G. Delea, Jorge Cano, Philip Ouakou Tchindebet, Robert L. Richards, Yujing Zhao, Abdalla Meftuh, Karmen Unterwegner, Sarah Anne J. Guagliardo, Donald R. Hopkins, and Adam Weiss
Description: A comprehensive understanding of the spatial distribution and correlates of infection are key for the planning of disease control programs and assessing the feasibility of elimination and/or eradication. In this work, we used species distribution modeling to predict the environmental suitability of the Guinea worm (Dracunculus medinensis) and identify important climatic and sociodemographic risk factors. Using Guinea worm surveillance data collected by the Chad Guinea Worm Eradication Program (CGWEP) from 2010 to 2022 in combination with remotely sensed climate and sociodemographic correlates of infection within an ensemble machine learning framework, we mapped the environmental suitability of Guinea worm infection in Chad. The same analytical framework was also used to ascertain the contribution and influence of the identified climatic risk factors. Spatial distribution maps showed predominant clustering around the southern regions and along the Chari River. We also identified areas predicted to be environmentally suitable for infection. Of note are districts near the western border with Cameroon and southeastern border with Central African Republic. Key environmental correlates of infection as identified by the model were proximity to permanent rivers and inland lakes, farmlands, land surface temperature, and precipitation. This work provides a comprehensive model of the spatial distribution of Guinea worm infections in Chad 2010–2022 and sheds light on potential environmental correlates of infection. As the CGWEP moves toward elimination, the methods and results in this study will inform surveillance activities and help optimize the allocation of intervention resources.

Feb. 22, 2024
Advancing Health Security and Disease Eradication through Peace and Health: A Mali Case Study
Published by Health Security. Volume 22, Number 2, 2024
Authors: Angelia M. Sanders, Madeline Warman, Frederic Deycard, John Goodman, April Klein, Karmen Unterwegner, Boukary Sangare, Sadi Moussa, Stacia George, Irene Pujol Chica, Cheick Oumar Coulibaly, Moussa Saye, Kimberly A. Jensen, Adam J. Weiss, and Kashef Ijaz.
Description: Conflict and violence constitute threats to public health. As levels of conflict increase within and between countries, it is important to explore how conflict resolution initiatives can be adapted to meet the health needs of communities, and how addressing the health needs of communities can assist in conflict resolution and contribute to health security. In conflict-affected central Mali, a Peace through Health Initiative, piloted between 2018 and 2022, used conflict resolution trainings, facilitated community meetings, and human and animal health interventions to negotiate ‘‘periods of tranquility’’ to achieve public health goals.

Nov. 10, 2023
Progress Toward Global Eradication of Dracunculiasis, January 2022–June 2023
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report / November 10, 2023 Weekly / November 10, 2023 / 72(45);1230–1236
Authors: Donald R. Hopkins, MD; Adam J. Weiss, MPH; Sarah Yerian, MPH; Sarah G.H. Sapp, PhD; Vitaliano A. Cama, DVM, PhD
Abstract: The effort to eradicate Dracunculus medinensis, the etiologic agent of dracunculiasis, or Guinea worm disease, commenced at CDC in 1980. In 1986, with an estimated 3.5 million cases worldwide in 20 African and Asian countries, the World Health Assembly called for dracunculiasis elimination. The Guinea Worm Eradication Program (GWEP) was established to help countries with endemic dracunculiasis reach this goal. GWEP is led by The Carter Center and supported by partners that include the World Health Organization, UNICEF, and CDC.

Oct. 4, 2023
A Tribute to the Global Health Legacy of Jimmy and Rosalynn Carter (PDF)
Published by The American Journal of Tropical Medicine and Hygiene; 109(4), 2023, pp. 713–714 doi:10.4269/ajtmh.23-0641.
Authors: Kashef Ijaz and Julie Jacobson.
Abstract: The global public health legacy of former U.S. President Jimmy Carter and First Lady Rosalynn Carter cannot be overstated. For more than 50 years, they have leveraged the power of their characters and connections to advance public health in the United States and around the world.

Aug. 17, 2022
Dracunculiasis Eradication: End Stage Challenges
Published by The American Journal of Tropical Medicine and Hygiene; 102(6): 1411–1416. doi: 10.4269/ajtmh.20-0064.
Authors: Donald R. Hopkins, Adam J. Weiss, Fernando J. Torres-Velez, Sarah G. H. Sapp, and Kashef Ijaz.
Abstract: This report summarizes the status of the global Dracunculiasis Eradication Program as of the end of 2021. Dracunculiasis (Guinea worm disease) has been eliminated from 17 of 21 countries where it was endemic in 1986, when an estimated 3.5 million cases occurred worldwide. Only Chad, Ethiopia, Mali, and South Sudan reported cases in humans in 2021.

May 16, 2022
This Is How We Finish off Guinea Worm
Op-ed by World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus and Carter Center Chair Board of Trustees Jason Carter in the Guardian/print edition special supplement
In the past 200 years, humankind has made incredible progress against many threats to health: vaccines, medicines and other innovations have saved millions of lives from feared killers, from malaria to cancer. But only one human disease – smallpox – has ever been eradicated. Less noticed by the rest of the world, we stand on the threshold of consigning another disease to the history books: Guinea worm.

Nov. 23, 2021
Epidemiological and Molecular Investigations of a Point-source Outbreak of Dracunculus Mdinensis Infecting Humans and Dogs in Chad: A Cross-sectional Study
Published by The Lancet Microbe Elsevier.
Authors: Sarah Anne J Guagliardo, PhD; Elizabeth Thiele, PhD; Karmen Unterwegner, MPH; Ndoyengar Narcisse Nanguita, MPH; Laurès Dossou , MPH; Philip Tchindebet Ouakou, MD; Hubert Zirimwabagabo, MD; Ernesto Ruiz-Tiben, PhD; Donald R Hopkins, MD; Sharon L Roy, MD; Vitaliano Cama, DVM; Henry Bishop, BS; Sarah Sapp, PhD; Sarah Yerian, MPH; Adam J Weiss, MPH
Summary: Dracunculiasis (also known as Guinea worm disease), caused by the Dracunculus medinensis nematode, is progressing towards eradication, with a reduction in cases from 3·5 million cases in the mid-1980s to only 54 human cases at the end of 2019. Most cases now occur in Chad. On April 19, 2019, a 19-year-old woman presented with D medinensis in an area within the Salamat region of Chad, where the disease had not been previously reported. We aimed to investigate the connection between this case and others detected locally and elsewhere in Chad using a combination of epidemiological and genetic approaches.

November 5, 2021
Progress Toward Global Eradication of Dracunculiasis, January 2020–June 2021
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report / November 5, 2021 Vol. 70, No. 44; 1527–1533.
Authors: Donald R. Hopkins, MD; Adam J. Weiss, MPH; Sharon L. Roy, MD; Sarah Yerian, MPH; Vitaliano A. Cama, PhD
Abstract: With 27 cases in humans reported in 2020, five during January–June 2021, and only six countries currently affected by dracunculiasis (Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon), achievement of eradication appears to be close. Existence of infected dogs, especially in Chad, and impeded access because of civil unrest and insecurity in Mali and South Sudan are now the greatest challenges to interrupting transmission.

Sept. 16, 2021
Reply to: Rethinking Disease Eradication: Putting Countries First
Published by International Health.
Authors: Donald R. Hopkins, Kashef Ijaz, Adam Weiss, Sharon L. Roy, David A. Ross
In a recent article, Gebre suggests that endemic countries should lead in deciding on disease eradication initiatives and asserts that ‘elimination as a public health problem’ is the preferred option because eradication occurs at the expense of other health programs and weakens fragile health systems. The author's primary example is dracunculiasis (Guinea worm) eradication, but he fails to take into account that vertical disease elimination and eradication programs also strengthen health systems overall. 
Related Resource:
Original Article
March 10, 2021
Rethinking Disease Eradication: Putting Countries First 
Published by International Health.

Feb. 22, 2021
Correlates of Variation in Guinea Worm Burden among Infected Domestic Dogs
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Sarah Anne J. Guagliardo, Ryan Wiegand, Sharon L. Roy, Christopher A. Cleveland, Hubert Zirimwabagabo, Elisabeth Chop, Philippe Tchindebet Ouakou, Ernesto Ruiz-Tiben, Donald Hopkins, Adam Weiss
The Guinea Worm Eradication Program has been extraordinarily successful-in 2019, there were 53 human cases reported, down from the estimated 3.5 million in 1986. Yet the occurrence of guinea worm in dogs is a challenge to eradication efforts, and underlying questions about transmission dynamics remain.

Dec. 7, 2020
Investigation of Dracunculiasis Transmission among Humans, Chad, 2013-2017
Published by National Library of Medicine.
Authors: Eugene W. Liu, Anita D. Sircar, Kolio Matchanga, Ada Mbang Mahamat, Neloumta Ngarhor, Philip Tchindebet Ouakou, Hubert Zirimwabagabo, Ernesto Ruiz-Tiben, Dieudonné Sankara, Ryan Wiegand, Sharon L. Roy
Dracunculiasis, slated for global eradication, typically is acquired by drinking stagnant water containing microscopic crustaceans (copepods) infected with Dracunculus medinensis larvae, causing clusters of case persons with worms emerging from the skin. Following a 10-year absence of reported cases, 9-17 sporadic human cases with few epidemiologic links have been reported annually in Chad since 2010; dog infections have also been reported since 2012.

Nov. 30, 2020
Population Genomic Evidence that Human and Animal Infections in Africa Come from the Same Populations of Dracunculus Medinensis
Published by PLOS Neglected Tropical Disease.
Authors: Caroline Durrant, Elizabeth A. Thiele, Nancy Holroyd, Stephen R. Doyle, Guillaume Sallé, Alan Tracey, Geetha Sankaranarayanan, Magda E. Lotkowska, Hayley M Bennett, Thomas Huckvale, Zahra Abdellah, Ouakou Tchindebet, Mesfin Wossen, Makoy Samuel Yibi Logora, Cheick Oumar Coulibaly, Adam Weiss, Albrecht I Schulte-Hostedde, Jeremy M Foster, Christopher A Cleveland, Michael J. Yabsley, Ernesto Ruiz-Tiben, Matthew Berriman, Mark L. Eberhard, James A. Cotton
Guinea worm-Dracunculus medinensis-was historically one of the major parasites of humans and has been known since antiquity. Now, Guinea worm is on the brink of eradication, as efforts to interrupt transmission have reduced the annual burden of disease from millions of infections per year in the 1980s to only 54 human cases reported globally in 2019.

Oct. 30, 2020
Progress Toward Global Eradication of Dracunculiasis, January 2019–June 2020
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report / October 30, 2020 Vol. 69, No. 43; 1563-1568.
Authors: Donald R. Hopkins MD, Adam J. Weiss MPH, Sharon L. Roy MD, Sarah Yerian MPH, Sarah G.H. Sapp PhD
Dracunculiasis (Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability. There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment to prevent water contamination.

Oct. 26, 2020
Development of a Multiplex Bead Assay for the Detection of Canine IgG 4 Antibody Responses to Guinea Worm
Published by the American Journal of Tropical Medicine and Hygiene.
Authors: Jeffrey W. Priest, Bongo Nare Richard Ngandolo, Monique Lechenne, Christopher A. Cleveland, Michael J. Yabsley, Adam J. Weiss, Sharon L. Roy, Vitaliano Cama
Increased levels of guinea worm (GW) disease transmission among dogs in villages along the Chari River in Chad threaten the gains made by the GW Eradication Program. Infected dogs with preemergent worm blisters are difficult to proactively identify.

Sept. 14, 2020
Identifying Correlates of Guinea Worm (Dracunculus Medinensis) Infection in Domestic Dog Populations
Published by PLOS Neglected Tropical Disease.
Authors: Robert L. Richards, Christopher A. Cleveland, Richard J. Hall, Philip Tchindebet Ouakou, Andrew W. Park, Ernesto Ruiz-Tiben, Adam Weiss, Michael J. Yabsley, Vanessa O. Ezenwa
Few human infectious diseases have been driven as close to eradication as dracunculiasis, caused by the Guinea worm parasite (Dracunculus medinensis). The number of human cases of Guinea worm decreased from an estimated 3.5 million in 1986 to mere hundreds by the 2010s.

July 2, 2020
Ecology of Domestic Dogs (Canis familiaris) as a Host for Guinea Worm (Dracunculus Medinensis) Infection in Ethiopia
Published by Transboundary and Diseases.
Authors: Jared K. Wilson-Aggarwal, Cecily E. D. Goodwin, George J. F. Swan, Helen Fielding, Zerihun Tadesse, Desalegn Getahun, Anyaro Odiel, Alamo Adam, Harry H. Marshall, Jessica Bryant, James A. Zingeser, Robbie A. McDonald
The global programme for the eradication of Guinea worm disease, caused by the parasitic nematode Dracunculus medinensis, has been successful in driving down human cases, but infections in non-human animals, particularly domestic dogs (Canis familiaris), now present a major obstacle to further progress.

May 28, 2020
Guinea Worm in Domestic Dogs in Chad: A Description and Analysis of Surveillance Data
Published by PLOS Neglected Tropical Diseases.
Authors: Sarah Anne J. Guagliardo, Sharon L. Roy, Ernesto Ruiz-Tiben, Hubert Zirimwabagabo, Mario Romero, Elisabeth Chop, Philippe Tchindebet Ouakou, Donald R. Hopkins, Adam J. Weiss
After a ten-year absence of reported Guinea worm disease in Chad, human cases were rediscovered in 2010, and canine cases were first recorded in 2012. In response, active surveillance for Guinea worm in both humans and animals was re-initiated in 2012. As of 2018, the Chad Guinea Worm Eradication Program (CGWEP) maintains an extensive surveillance system that operates in 1,895 villages, and collects information about worms, hosts (animals and humans), and animal owners.

April 20, 2020
Ecology of Domestic Dogs Canis Familiaris as an Emerging Reservoir of Guinea Worm Dracunculus Medinensis Infection
Published by PLOS Neglected Tropical Disease.
Authors: Robbie A. McDonald, Jared K. Wilson-Aggarwal, George J. F. Swan, Cecily E. D. Goodwin, Tchonfienet Moundai, Dieudonné Sankara, Gautam Biswas, James A. Zingeser
Global eradication of human Guinea worm disease (dracunculiasis) has been set back by the emergence of infections in animals, particularly domestic dogs Canis familiaris. The ecology and epidemiology of this reservoir is unknown.

Jan. 29, 2020
Dogs and the Classic Route of Guinea Worm Transmission: An Evaluation of Copepod Ingestion
Published by Scientific Reports.
Authors: Kayla B. Garrett, Erin K. Box, Christopher A. Cleveland, Ania A. Majewska, Michael J. Yabsley
Dracunculus medinensis, the causative agent of Guinea worm disease in humans, is being reported with increasing frequency in dogs. However, the route(s) of transmission to dogs is still poorly understood.

November 1, 2019
Progress Toward Global Eradication of Dracunculiasis — January 2018–June 2019 (PDF)
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report / November 1, 2019 Vol. 68, No. 43; 979-984.
Authors: Donald R. Hopkins, MD; Adam J. Weiss, MPH; Sharon L. Roy, MD; James Zingeser, DVM; Sarah Anne J. Guagliardo, PhD
Dracunculiasis (also known as Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1).

Jan. 23, 2019
A Search for Tiny Dragons (Dracunculus Medinensis Third-Stage Larvae) in Aquatic Animals in Chad, Africa
Published by Nature Scientific Reports.
Authors: Christopher A. Cleveland, Mark L. Eberhard, Alec T. Thompson, Kayla B. Garrett, Liandrie Swanepoel, Hubert Zirimwabagabo, Tchonfienet Moundai, Philippe T. Ouakou, Ernesto Ruiz-Tiben, Michael J. Yabsley
Since 2012, an increase in GW infections in domestic dogs, cats and baboons has been reported. Because these infections have not followed classical GW epidemiological patterns resulting from water-borne transmission, it has been hypothesized that transmission occurs via a paratenic host. Thus, we investigated the potential of aquatic animals to serve as paratenic hosts for D. medinensis in Chad.

Nov. 16, 2018
Progress Toward Global Eradication of Dracunculiasis — January 2017–June 2018
Published by U.S. Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report.
Authors: Donald R. Hopkins, MD; Ernesto Ruiz-Tiben, PhD; Adam J. Weiss, MPH
Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with dracunculiasis.

Aug. 1, 2018
Dracunculiasis Eradication: Are We There Yet?
Published by American Journal of Tropical Medicine and Hygiene.
This 15-page report summarizes the status of the global Dracunculiasis Eradication Program as of the end of 2017.

March 19, 2018
What It Means to be Guinea Worm-Free
Published by American Journal of Tropical Medicine and Hygiene.
Authors: Adam J. Weiss, Torben Vestergaard Frandsen, Ernesto Ruiz-Tiben, Donald R. Hopkins, Franklin Aseidu-Bekoe, David Agyemang
Residents of seven communities in northern Ghana feel GW eradication improved their socioeconomic conditions, as the impact of infection prohibited the pursuit of individual and social advancement.

Dec. 8, 2017
Progress Toward Global Eradication of Dracunculiasis, January 2016-June 2017
Published by U.S. Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report.
Authors: Donald R. Hopkins; Ernesto Ruiz-Tiben; Mark L. Eberhard; Sharon L. Roy; Adam J. Weiss. 
In 2016, a total of 25 cases were reported from three countries (Chad [16], South Sudan [six], Ethiopia [three]), compared with 22 cases reported from the same three countries and Mali in 2015. The 14% increase in cases from 2015 to 2016 was offset by the 25% reduction in number of countries with indigenous cases.

Oct. 5, 2017
The Cost-Effectiveness of an Eradication Programme in the End Game: Evidence from Guinea Worm Disease
Published by PLOS Neglected Tropical Diseases.
Authors: Christopher Fitzpatrick, Dieudonné P. Sankara, Junerlyn Farah Agua, Lakshmi Jonnalagedda, Filippo Rumi, Adam Weiss, Matthew Braden, Ernesto Ruiz-Tiben, Nicole Kruse, Kate Braband, Gautam Biswas
We analyze the cost-effectiveness of the GWEP to find that it remains highly cost-effective in spite of high costs in the end game.

Aug. 18, 2017
Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game
Published by Ethiopian Medical Journal.
Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as 'fiery serpent' from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods.

June 19, 2017
Recurrence of Guinea Worm Disease in Chad after a 10-Year Absence: Risk Factors for Human Cases Identified in 2010-2011
Published by American Journal of Tropical Medicine & Hygiene. 2017 Aug;97(2):575-582.
Authors: Sreenivasan N, Weiss A, Djiatsa JP, Toe F, Djimadoumaji N, Ayers T, Eberhard M, Ruiz-Tiben E, Roy S.  
A decade after reporting its last case of Guinea worm disease (GWD), a waterborne parasitic disease targeted for eradication, Chad reported 20 confirmed human cases from 17 villages-10 cases in 2010 and 10 cases in 2011. In 2012, the first GWD dog infections were diagnosed.

Nov. 22, 2016
Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad
Published by CDC Centers for Disease Control and Prevention. 2016 Nov; 22(11): 1961–1962.
Authors: Mark L. Eberhard, Christopher A. Cleveland, Hubert Zirimwabagabo, Michael J. Yabsley, Philippe Tchindebet Ouakou, and Ernesto Ruiz-Tiben. 
A third-stage (infective) larva of Dracunculus medinensis, the causative agent of Guinea worm disease, was recovered from a wild-caught Phrynobatrachus francisci frog in Chad. Although green frogs (Lithobates clamitans) have been experimentally infected with D. medinensis worms, our findings prove that frogs can serve as natural paratenic hosts.

Nov. 1, 2016
Dogs and Guinea Worm Eradication
Published by The Lancet, Vol.16.
Authors: Eberhard, M. L., Ruiz-Tiben, E., & Hopkins, D. R.
Teresa Galán-Puchades, in her Correspondence on dogs and Guinea worm eradication, noted several critical points about the Guinea Worm Eradication Program (GWEP) in Chad. We would like to clarify several of the issues.

Aug. 1, 2016
Possible Role of Fish and Frogs as Paratentic Hosts of Dracunculus medinensis, Chad
Published by Emerging Infectious Diseases. 2016 Aug; 22(8): 1428–1430.
Authors: Mark L. Eberhard, Michael J. Yabsley, Hubert Zirimwabagabo, Henry Bishop, Christopher A. Cleveland, John C. Maerz, Robert Bringolf, and Ernesto Ruiz-Tiben
Copepods infected with Dracunculus medinensis larvae collected from infected dogs in Chad were fed to 2 species of fish and tadpoles. Although they readily ingested copepods, neither species of fish, Nile tilapia (Oreochromis niloticus) nor fathead minnow (Pimephalis promelas), were found to harbor Dracunculus larvae when examined 2–3 weeks later.

Oct. 23, 2015
Progress Toward Global Eradication of Dracunculiasis, January 2014-June 2015
Published by CDC Centers for Disease Control and Prevention. 64(41);1161-5.
Authors: Donald R. Hopkins, M.D.; Ernesto Ruiz-Tiben, Ph.D.; Mark L. Eberhard, Ph.D.; Sharon L. Roy, M.D.
Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm emerges through the skin, usually on the lower limb. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. The campaign to eradicate dracunculiasis worldwide began in 1980 at CDC.

June 8, 2015
Case Report: Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.
The American Journal of Tropical Medicine and Hygiene, 93(2), 2015, pp. 350–355.
Authors: Mark L. Eberhard, Elizabeth A. Thiele, Gole E. Yembo, Makoy S. Yibi, Vitaliano A. Cama, and Ernesto Ruiz-Tiben.
Thirty-seven unusual specimens, three from Ethiopia and 34 from South Sudan, were submitted since 2012 for further identification by the Ethiopian Dracunculiasis Eradication Program (EDEP) and the South Sudan Guinea Worm Eradication Program (SSGWEP), respectively. Although the majority of specimens emerged from sores or breaks in the skin, there was concern that they did not represent bona fide cases of Dracunculus medinensis. All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp. The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite.

Nov. 21, 2014
Progress Toward Global Eradication of Dracunculiasis — January 2013–June 2014 (PDF)
Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Vol.63 / No. 42.
Authors: Donald R. Hopkins, MD, Ernesto Ruiz-Tiben, PhD, The Carter Center, Atlanta, Georgia; Mark L. Eberhard, PhD, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC; Sharon L. Roy, MD, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases and World Health Organization Collaborating Center for Research, Training, and Eradication of Dracunculiasis, CDC.
Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm will emerge through the skin, usually on the lower limb. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling.

April 11, 2014
¿Cómo erradicar una enfermedad sin vacunas ni fármacos?
Published by BBC Mundo.
Author: Ernesto Ruiz-Tiben
Cuando en 1986 iniciamos la campaña de erradicación del gusano de Guinea, este parásito afectaba a unas 3,5 millones de personas en 21 países de África y Asia. Hoy en día hemos reducido la enfermedad a 148 casos en cuatro países africanos. No ha sido fácil, pues para esta infección no hay medicamentos ni vacunas. La prevención es la única forma de evitar la transmisión.

Jan. 20, 2014
Logistics of Guinea Worm Disease Eradication in South Sudan (PDF)
Published by American Journal of Tropical Medicine and Hygiene, Volume 90, Issue 3, Mar 2014, p. 393 - 401.
Authors: Alexander H. Jones,* Steven Becknell, P. Craig Withers, Ernesto Ruiz-Tiben, Donald R. Hopkins, David Stobbelaar, and Samuel Yibi Makoy. 
From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Logistics have played a key role in program achievements to date. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical disease and other disease eradication programs.

Jan. 16, 2014
The World's Youngest Country and a Very Old Disease: South Sudan Proves Guinea Worm Can Be Defeated With Return To Peace
Published by The Huffington Post.
Author: Donald R. Hopkins
In the 1970s, a decade of peace opened up between civil wars in Sudan, allowing health workers to reach and immunize at-risk communities for smallpox. Without this window of peace, historians argue, smallpox might not have been conquered there. Recent outbreaks of violence (Dec. 15, 2013) in the new country of South Sudan have led some to speculate whether eradication efforts will succeed for another primeval plague — the Bible's "fiery serpent," known today as Guinea worm disease (dracunculiasis). Read the Carter Center Press Release. Watch President Carter's Huffington Post Live interview on Guinea worm.

Jan. 9, 2014
The Sudan Conflict and Disease
Published by The New York Times.
Author: Donald R. Hopkins
U.S. Is Facing Hard Choices in South Sudan" (front page, Jan. 4) reports that the conflict there "has left the Obama administration scrambling to prevent the unraveling of a major American achievement in Africa." The conflict also jeopardizes an important South Sudanese achievement, which aims to eliminate Guinea worm disease from the young country by the end of this year, with significant benefits to health, agricultural productivity and school attendance.

Dec. 30, 2013
Case Report: Cutaneous Emergence of Eustrongylides in Two Persons from South Sudan
Published by The American Journal of Tropical Medicine and Hygiene, 90(2), 2014, pp. 315–317.
Authors: Mark L. Eberhard and Ernesto Ruiz-Toben.
Two large, living worms were collected as they emerged from the lower limb of each of two persons in South Sudan. The worms were observed by staff of the South Sudan Guinea Worm Eradication Program during surveillance activities in communities at-risk for cases of Guinea worm disease. The worms measured seven and eight cm in length and were identified as fourth-stage larvae of Eustrongylides. This is the first report of such worms emerging from the skin; all five previous reports of human infection involved surgical removal of worms from the peritoneal cavity.

Nov. 25, 2013
The Peculiar Epidemiology of Dracunculiasis in Chad
Published by The American Journal of Tropical Medicine and Hygiene, 90(1), 2014, pp. 61–70.
Authors: Mark L. Eberhard, Ernesto Ruiz-Tiben, Donald R. Hopkins, Corey Farrell, Fernand Toe, Adam Weiss, P. Craig Withers Jr., M. Harley Jenks, Elizabeth A. Thiele, James A. Cotton, Zahra Hance, Nancy Holroyd, Vitaliano A. Cama, Mahamat Ali Tahir, and Tchonfienet Mounda.
Dracunculiasis was rediscovered in Chad in 2010 after an apparent absence of 10 years. In April 2012 active village-based surveillance was initiated to determine where, when, and how transmission of the disease was occurring, and to implement interventions to interrupt it.

Oct. 25, 2013
Progress Toward Global Eradication of Dracunculiasis, January 2012 – June 2013 (PDF)
Published by Morbidity and Mortality Weekly Report. Vol. 62, No. 42.
A total of 542 cases were reported in 2012, compared with 1,058 in 2011. The disease remains endemic in four countries in 2013, but the overall rate of reduction in cases has accelerated compared with the first 6 months of 2012. In the month of January 2013, no cases were reported worldwide for the first time since the eradication program began in 1986. Failures in surveillance and containment, lack of clean drinking water, insecurity in Mali and parts of South Sudan, and an unusual epidemiologic pattern in Chad are the main remaining challenges to dracunculiasis eradication.

Sept. 4, 2013
Jimmy Carter, New York Times' Nicholas Kristof, and Carter Center's Donald Hopkins Cover Global Health
Published by Challenges in New Conversations on Google+ Series.
Authors: Nicholas D. Kristof & Donald R. Hopkins
On Sept. 10, former U.S. President Jimmy Carter, New York Times Op-Ed Columnist Nicholas D. Kristof, and Carter Center disease eradication expert Dr. Donald R. Hopkins held a special video chat, "Global Health: How We Can Make a Difference," to kick off a new series called Conversations on Google+ launching later this fall.

July 1, 2013
Perspective Piece: Dracunculiasis Eradication: And Now, South Sudan (PDF)
Published by the American Journal of Tropical Medicine and Hygiene, 89(1), 2013, pp.5-10.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Adam Weiss, P. Craig Withers Jr., Mark L. Eberhard, and Sharon L. Roy. Abstract.
This report summarizes the status of the global Dracunculiasis Eradication Program as of the end of 2012. Dracunculiasis (Guinea worm disease) has been eliminated from 17 of 21 countries where it was endemic in 1986, when an estimated 3.5 million cases occurred worldwide. Only 542 cases were reported from four countries in 2012, and 103 villages still had indigenous transmission. Most remaining cases were reported from the new Republic of South Sudan, whereas Chad, Ethiopia, and Mali each reported 10 cases or less. Political instability and insecurity in Mali may become the main obstacles to interrupting dracunculiasis transmission forever.

May 30, 2013
Contributions of the Guinea Worm Disease Eradication Campaign Toward Achievement of the Millennium Development Goals (PDF)
Published by PLoS Neglected Tropical Diseases and is reprinted with permission. Volume 7, Issue 5, e2160.
Authors: Callahan K, Bolton B, Hopkins D, Ruiz-Tiben E, Withers PC, Meagley K.
Dracunculiasis (Guinea worm disease) was considered a mild affliction not warranting a widespread public health campaign. However, examination of the benefits of eradicating Guinea worm disease (GWD) reveals the effort is contributing to development, including contributions to certain Millennium Development Goals. The prevention of NTDs, and their cost-effective interventions, fuels long-term economic growth and development, and human advancement.

Jan. 3, 2013
Disease Eradication
Published by New England Journal of Medicine, 2013; 368:54-63.
Author: Donald R. Hopkins.
Since the last case of naturally-occurring smallpox in 1977, there have been three major international conferences devoted to the concept of disease eradication. Several other diseases have been considered as potential candidates for eradication, but the World Health Organization (WHO) has targeted only two other diseases for global eradication after smallpox.  In 1986, WHO's policy-making body, the World Health Assembly, adopted the elimination of dracunculiasis (Guinea worm disease) as a global goal, and it declared eradication of poliomyelitis a global goal in 1988. Although both diseases now appear to be close to eradication, the fact that neither goal has been achieved after more than two decades, and several years beyond the initial target dates for their eradication, underscores the daunting challenge of such efforts, as does the failure of previous attempts to eradicate malaria, hookworm, yaws and other diseases. "Disease Eradication" was published as part one of "A Global View of Health – An Unfolding Series." Read the overview of the series >

Oct. 26, 2012
Progress Toward Global Eradication of Dracunculiasis, January 2011 – June 2012
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Vol.61 No. 42.
This article was reprinted on Jan. 9, 2013, by the Journal of the American Medical Association.
Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after initial infection from contaminated drinking water, the worm emerges through the skin of the infected person, usually on the lower limb. Pain and secondary bacterial wound infection can cause temporary or permanent disability that disrupts work and schooling for the entire family.

Dec. 18, 2011
Dracunculiasis Eradication and the Legacy of the Smallpox Campaign: What's New and Innovative? What's Old and Principled? [Presented at the Symposium on Smallpox Eradication: Lessons, Legacies & Innovations]
Published by Vaccine. Volume 29, Supplement 4, Pages D86-D90. Online signup is required to read the full article.
Authors: Frank O.Richards, ErnestoRuiz-Tiben, Donald R.Hopkins
Coming on the heels the declaration of smallpox eradication in 1980 was the launch of the dracunculiasis (Guinea worm) eradication program, as a key outcome indicator of the success of the United Nations 1981-1990 International Drinking Water Supply and Sanitation Decade (IDWSSD). The dracunculiasis eradication campaign has carried on well beyond the close of the IDWSSD largely due to the efforts of President Jimmy Carter and The Carter Center, to assist the national Guinea Worm Eradication Programs in collaboration with partner organizations, including the Centers for Disease Control and Prevention (CDC), UNICEF, and the World Health Organization.

Oct. 28, 2011
Progress Toward Global Eradication of Dracunculiasis, January 2010 - June 2011
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Vol. 60 / No. 42.
Authors: Donald R. Hopkins, MD, Ernesto Ruiz-Tiben, PhD, The Carter Center, Atlanta, Georgia.
World Health Organization Collaborating Center for Research, Training, and Eradication of Dracunculiasis. Mark L. Eberhard, Div of Parasitic Diseases and Malaria, Center for Global Health; Sharon L. Roy, Div of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
In 1986, the World Health Assembly (WHA) called for the elimination of dracunculiasis (Guinea worm disease), a parasitic infection in humans caused by Dracunculus medinensis (1). At the time, an estimated 3.5 million cases were occurring annually in 20 countries in Africa and Asia, and 120 million persons were at risk for the disease (1,2).

March 7, 2011
End Game for Guinea Worm Disease is Near
Published by the Emory Report.
Author: Paige Rohe
Former U.S. President and Carter Center founder Jimmy Carter announced on Feb. 17 that only three endemic countries remain in the fight against Guinea worm disease, poised to be only the second disease in history-after smallpox-to be eradicated.

Jan. 15, 2011
Looking to the Future in Sudan: Dr. Donald R. Hopkins' Letter to the Editor, The New York Times
Published by The New York Times.
Author: Donald R. Hopkins
This letter by Carter Center Health Programs Vice President Donald R. Hopkins, M.D., M.P.H., is in response to an editorial published Jan. 8, 2011, "Southern Sudan Votes" (editorial, Jan. 8) rightly notes that the government of southern Sudan has "set up more than two dozen ministries and built schools and roads" since the signing of the comprehensive peace agreement in 2005.

Dec. 21, 2010
Jimmy Carter's Dream of Eradication: CNN Impact Your World
Former U.S. President Jimmy Carter discusses the Carter Center's efforts to eradicate Guinea worm disease.

Nov. 1, 2010
Emergence of Onchocerca Volvulus From Skin Mimicking Dracunculiasis Medinensis (PDF)
Published by American Journal of Tropical Medicine and Hygiene, 83(6), 2010, pp. 1348-1351.
Authors: Mark L. Eberhard, Ernesto Ruiz-Tiben, Andrew S. Korkor, Sharon L. Roy, and Philip Downs. We describe 11 cases of suspected Dracunculus medinensis infection in which the worm recovered was identified as Onchocerca volvulus. Identification was based on morphology of the examined specimen.

Oct. 1, 2010
Progress Toward Global Eradication of Dracunculiasis, January 2009–June 2010
Published by Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Vol. 59 / No. 38.
Authors: Dr. Hopkins, M.D., E. Ruiz-Tiben, Ph.D., The Carter Center, Atlanta, Ga. ML Eberhard, Div. of Parasitic Diseases and Malaria, Center for Global Health; SL Roy, Div. of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
In 1986, the World Health Assembly (WHA) called for the elimination of dracunculiasis (Guinea worm disease), a parasitic infection in humans caused by Dracunculus medinensis (1). At the time, an estimated 3.5 million cases were occurring annually in 20 countries in Africa and Asia, and 120 million persons were at risk for the disease (1,2). Because of slow mobilization in countries with endemic disease, the 1991 WHA goal to eradicate dracunculiasis globally by 1995 was not achieved (3).

Aug. 4, 2010
Nigeria's Triumph: Dracunculiasis Eradicated (PDF)
Published by The American Journal of Tropical Medicine and Hygiene. 83(2), 2010, pp. 215-225. doi:10.4269/ajtmh.2010.10-0140.
Authors: Emmanuel S. Miri, Donald R. Hopkins*, Ernesto Ruiz-Tiben, Adamu S. Keana, P. Craig Withers, Jr., Ifeoma N. Anagbogu, Lola K. Sadiq,Oladele O. Kale, Luke D. Edungbola, Eka I. Braide, Joshua O. Ologe, and Cephas Ityonzughul. Read the media advisory "Carter Center Experts and Partners Chronicle "Nigeria's Triumph" Over Ancient Guinea Worm Disease in American Journal of Tropical Medicine and Hygiene Article."
This report describes how Nigeria, a country that at one time had the highest number of cases of dracunculiasis (Guinea worm disease) in the world, reduced the number of cases from more than 653,000 in 1988 to zero in 2009, despite numerous challenges. Village-based volunteers formed the foundation of the program, which used health education, cloth filters, vector control, advocacy for safe water, voluntary isolation of patients, and monitored program interventions and cases reported monthly.

Aug. 4, 2010
Carter Center Experts and Partners Chronicle "Nigeria's Triumph" Over Ancient Guinea Worm Disease in American Journal of Tropical Medicine and Hygiene Article
Published by The Carter Center
Authors: Emily Staub & Paige Rohe
In the August 2010 issue of the American Journal of Tropical Medicine and Hygiene, a new paper co-authored by experts from the Nigeria Ministry of Health, The Carter Center, and the World Health Organization, details Nigeria's historic triumph over many challenges to successfully eliminate the ancient waterborne plague Guinea worm disease (also known as dracunculiasis).

Oct. 30, 2009
Monthly Report on Dracunculiasis Cases, January–August 2009 (PDF)
Published by Weekly Epidemiological Record, No. 44, 2009, 84, 453–468.
Authors: World Health Organization.
Number of dracunculiasis cases reported worldwide. In 2004, during the 57th World Health Assembly, the ministers of health of countries where dracunculiasis (guinea-worm disease) is endemic pledged to interrupt transmission of the disease by the end of 2009.

Oct. 16, 2009
Progress Toward Global Eradication of Dracunculiasis, January 2008-June 2009
Published by Centers for Disease Control and Prevention. MMWR 2009; 58(40);1123-1125.
Authors: DR Hopkins, MD, E Ruiz-Tiben, PhD, the Carter Center, Atlanta, Georgia. ML Eberhard, S Roy, Div of Parasitic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, CDC.
Dracunculiasis is a parasitic infection caused by Dracunculus medinensis. Persons become infected by drinking water from stagnant sources (e.g., ponds) contaminated by copepods (water fleas) that contain immature forms of the parasite. In 1986, the World Health Assembly (WHA) called for the eradication of dracunculiasis (Guinea worm disease) at a time when an estimated 3.5 million cases occurred annually in 20 countries in Africa and Asia and 120 million persons were at risk for the disease (1,2).

July 1, 2009
Atlas of Pediatrics in the Tropics: Dracunculiasis Chapter (PDF)
Published by the "American Academy of Pediatrics' Atlas of Pediatrics in the Tropics and Resource-limited Settings." June 2009 edition. 
Authors: Jonathan M. Spector, MD, MPH, FAAP and Timothy E. Gibson, MD, FAAP.  Donald R. Hopkins, M.D., M.P.H, vice president of the Carter Center's Health Programs, contributor. 
Dracunculiasis follows ingestion of freshwater contaminated with copepods (water fleas) that contain the parasitic nematode Dracunculiasis medinensis. The affliction is ancient. It has been identified in a 3,000- year-old mummy and is believed to be described in the Old Testament as the “fiery serpent” responsible for torturing the Hebrews during their exodus from Egypt. The dracunculiasis chapter is part of the AAP's take-along guide to more than 80 pediatric tropical diseases and conditions. © AAP. Reprinted with permission. ISBN 13: 978-1-58110-303-8. American Academy of Pediatrics.

May 1, 2009
Nigeria's War on Terror: Fighting Dracunculiasis, Onchocerciasis, Lymphatic Filariasis, and Schistosomiasis at the Grassroots (PDF)
Published by American Journal of Tropical Medicine and Hygiene and is reprinted with permission. May 2009 issue. 80(5), 2009, pp. 691–698.
Authors: Ngozi A. Njepuome, Donald R. Hopkins,* Frank O. Richards Jr, Ifeoma N. Anagbogu, Patricia Ogbu Pearce, Mustapha Muhammed Jibril, Chukwu Okoronkwo, Olayemi T. Sofola, P. Craig Withers Jr, Ernesto Ruiz-Tiben, Emmanuel S. Miri, Abel Eigege, Emmanuel C. Emukah, Ben C. Nwobi, and Jonathan Y. Jiya.
Africa's populous country, Nigeria, contains or contained more cases of dracunculiasis, onchocerciasis, lymphatic filariasis, and schistosomiasis than any other African nation and ranks or ranked first (dracunculiasis, onchocerciasis, schistosomiasis) or third (lymphatic filariasis) in the world for the same diseases.

Feb. 24, 2009
Teaching Module:  Eradication & Control Programs – Guinea Worm
Published by Global Health Education.
Guinea worm eradication teaching module #109 by Sharon Roy, M.D., M.P.H., Centers for Disease Control and Prevention, and Ernesto Ruiz-Tiben, Ph.D., The Carter Center.  Prepared as part of an educational project of the Global Health Education Consortium, University of California (San Francisco) School of Medicine and collaborating partners.

Oct. 31, 2008
Update: Progress Toward Global Eradication of Dracunculiasis, January 2007-June 2008
Published by Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention.
Authors: DR Hopkins, MD, E Ruiz-Tiben, PhD, The Carter Center, Atlanta, Georgia. ML Eberhard, S Roy, Div of Parasitic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, CDC.
The World Health Assembly (WHA) first adopted a resolution calling for the eradication of dracunculiasis (Guinea worm disease) in 1986, when an estimated 3.5 million cases occurred annually in 20 countries (17 in Africa and three in Asia) and 120 million persons were at risk for the disease (1,2). Because of slow mobilization in countries with endemic disease, the global dracunculiasis eradication program did not meet the 1995 target date for eradicating dracunculiasis that was set by African ministers of health in 1988 and confirmed by WHA in 1991 (3).

Oct. 1,  2008
Dracunculiasis Eradication: Neglected No Longer (PDF)
Published by Am. J. Trop. Med. Hyg., 79(4), 2008, pp. 474–479. Copyright © 2008 by The American Journal of Tropical Medicine and Hygiene. 
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Philip Downs, P. Craig Withers, Jr., and Sharon Roy.
This report summarizes the status of the global Dracunculiasis Eradication Program as of early 2008. By the end of 2007, dracunculiasis (Guinea worm disease) transmission had been eliminated from 15 of the 20 countries where the disease was endemic in 1986, only 9,585 cases were reported worldwide, and 2,016 villages still had indigenous cases of the disease. Two of the remaining affected countries (Nigeria and Niger) reported < 100 cases in 2007 and are on the verge of eliminating dracunculiasis if they have not stopped transmission already. Sudan, Ghana, and Mali are addressing their final challenges to interrupting all remaining transmission by the end of 2009.

June 1, 2008
Dracunculiasis, Onchocerciasis, Schistosomiasis, and Trachoma (PDF)
Published by Annals of the New York Academy of Sciences, 1136: 45-52 (2008), Issue - Reducing the Impact of Poverty on Health and Human Development: Scientific Approaches, The definitive version is available at wiley.com. Published Online: 25 Jul 2008.
Authors: Donald R. Hopkins, Frank O. Richards, Jr, Ernesto Ruiz-Tiben, Paul Emerson, P. Craig Withers, Jr. 
The four diseases discussed in this chapter (dracunculiasis, onchocerciasis, schistosomiasis, and trachoma) are among the officially designated "Neglected Tropical Diseases," and each is also both the result of and a contributor to the poverty of many rural populations. To various degrees, they all have adverse effects on health, agricultural productivity, and education. The Carter Center decided to work on these health problems because of their adverse effect on the lives of poor people and the opportunity to help implement effective interventions.

March 1, 2008
Within Reach: Guinea Worm Eradication in Ghana (PDF)
Published by The Carter Center.
A painful and debilitating condition, Guinea worm disease has plagued Ghana since ancient times. In 1988, Ghana joined an international effort to eradicate the disease and has made remarkable progress over the past 20 years. Guinea worm has been found in the most forgotten communities, where there is little or no access to safe water.

Nov. 28, 2007
Carter Center Expert Donald Hopkins Receives Prestigious Fries Prize for Guinea Worm Eradication Leadership
Published by The Carter Center
Author: Emily Staub
Poised to be the first parasitic disease eradicated in human history, Guinea worm disease now teeters on the verge of extinction. The 2007 Fries Prize for Improving Health was bestowed on Donald R. Hopkins, M.D., M.P.H., Carter Center vice president for health programs, for his sustained leadership in the global campaign to eradicate Guinea worm disease (dracunculiasis), a debilitating parasitic infection contracted from drinking contaminated water.

Aug. 17, 2007
Progress Toward Global Eradication of Dracunculiasis, January 2005--May 2007
Published by Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, 56(32); 813-817.
Authors: DR Hopkins, MD, E Ruiz-Tiben, PhD, The Carter Center, Atlanta, Georgia. ML Eberhard, S Roy, Div of Parasitic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, CDC.
The World Health Assembly first adopted a resolution calling for the eradication of dracunculiasis (Guinea worm disease) in 1986, when an estimated 3.5 million cases were reported in 20 countries, and 120 million persons were at risk for the disease (1,2). This report describes the continued progress of the dracunculiasis eradication program worldwide during July 2005--May 2007.

July 1, 2006
Uganda's Successful Guinea Worm Eradication Program (PDF) 
Published by Am. J. Trop. Med. Hyg., 75(1), 2006, pp. 3-8. Copyright © 2006 by The American Journal of Tropical Medicine and Hygiene, 75(1), 2006, pp. 3–8.
Authors: John B. Rawkimari, Donald R. Hopkins, and Ernesto Ruiz-Tiben, Ministry of Health, Entebbe, Uganda; The Carter Center, Atlanta, Georgia.
Having begun its national Guinea Worm Eradication Program (UGWEP) in 1991 (1991 population, 16.6 million) with the third-highest number of cases reported by any endemic country, and ranked as the second-highest endemic country in the world in 1993, by 2004, Uganda celebrated it first full calendar year with no indigenous cases of the disease. Systematic interventions began in 1992 and were gradually intensified until the final indigenous case occurred in July 2003.

Oct. 28, 2005
Progress Toward Global Eradication of Dracunculiasis, January 2004 - July 1005
Published by Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Philip Downs, P. Craig Withers, Jr., and James H. Maguire; The Carter Center, Atlanta, Georgia; World Health Organization Collaborating Center for Research, Training, and Eradication of Dracunculiasis; Div of Parasitic Diseases, National Center for Infectious Diseases, CDC.
In 1986, an estimated 3.5 million cases of dracunculiasis occurred in 20 countries, and 120 million persons were at risk for the disease. That year, the World Health Assembly adopted a resolution calling for the eradication of dracunculiasis, also known as Guinea worm disease.   

Oct. 1, 2005
Dracunculiasis Eradication: The Final Inch (PDF)
Published by Am. J. Trop. Med. Hyg., 73(4), 2005, pp. 669–675 Copyright © 2005 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Philip Downs, P. Craig Withers, Jr., and James H. Maguire; The Carter Center, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
This report summarizes the status of the Dracunculiasis Eradication Program as of early 2005. Nine of the 20 countries that were endemic for this disease when the program began have already interrupted transmission, Asia is free of Guinea worm, and five of the remaining disease-endemic countries reported less than 50 cases each in 2004. Ghana and Sudan each reported 45% of the 16,026 cases in 2004.

May 10, 2005
Differentiating Dracunculus medinesis from D. insignis, by the sequence analysis of the 18S rRNA gene (PDF)
Published in the Annals of Tropical Medicine & Parasitology, Vol. 99, No. 5, 511-517 (2005).
Authors: L. Bimi, A.R. Freeman, M.L. Eberhard, E. Ruiz-Tiben (The Carter Center), and N.J. Pieniazek* (all others, Parasitic Diseases Branch, Division of Parasitic Diseases, Centers for Disease Control and Prevention), Received 15 February 2005, Revised 9 May 2005, Accepted 10 May 2005.
This study, undertaken as a component of the global Dracunculiasis Eradication Program (DEP), was designed to provide molecular tools to distinguish Dracunculus medinensis, the nematode causing human dracunculiasis, from other tissue-dwelling nematodes, including other Dracunculus species that infect humans and other animals. DNA was extracted from D. medinensis and from a closely related species that infects North American carnivores, D.insignis, so that the genes coding for the small-subunit ribosomal RNA (18S rRNA) of the parasites could be amplified, sequenced and compared. Sequences were obtained for 20 specimens of D. medinensis (from humans in Pakistan, Yemen and six African countries endemic for dracunculiasis) and three of D. insignis (from raccoons trapped in the state of Georgia in the southern U.S.A.).  

Feb. 9, 2004
Final Reflections From Africa: Web Log (Blog) Update
Published by The Carter Center.
Former U.S. President Jimmy Carter and his wife, Rosalynn, are traveling in West Africa Feb. 2-7, 2004, on behalf of The Carter Center. The purpose of their trip is two-fold: to call international attention to the need to eliminate the last 1 percent of Guinea worm disease remaining in the world and to launch the Development and Cooperation Initiative, a multiyear effort to help reduce poverty in Mali.

March 17, 2003
Sudan's War and Eradication of Dracunculiasis
Published by The Lancet.
Authors: Donald R. Hopkins and P. Craig Withers, Jr. "You can bring whatever you like here. If this war continues, it will mean nothing." The quote from the exasperated village elder in the Nuba Mountains area of Sudan says it all. Although the incidence of dracunculiasis (Guinea worm disease) has been reduced by 98% from an estimated 3.5 million cases less than two decades ago, and seven of the twenty formerly endemic countries have already eliminated the infection, most of the remaining patients are in southern Sudan, and the global eradication campaign cannot be completed until that country's civil war ends.

Dec. 1, 2002
Guinea Worm and Sudan: Center Experts Featured in The Lancet
Published by The Lancet.
Authors: Donald R. Hopkins and P. Craig Withers, Jr.
"You can bring whatever you like here. If this war continues, it will mean nothing." The quote from the exasperated village elder in the Nuba Mountains area of Sudan says it all. Although the incidence of dracunculiasis (Guinea worm disease) has been reduced by 98% from an estimated 3.5 million cases less than two decades ago, and seven of the twenty formerly endemic countries have already eliminated the infection, most of the remaining patients are in southern Sudan, and the global eradication campaign cannot be completed until that country's civil war ends.

Oct. 1, 2002 
Dracunculiasis Eradication: And Now, Sudan
Published in Am. J. Trop. Med. Hyg., 67(4), 2002, pp. 415-422. Copyright © 2002 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Nwando Diallo, P. Craig Withers, Jr. and James H. Magguire; Global 2000 Program of The Carter Center, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
This paper summarizes the status of the global dracunculiasis eradication campaign as of early 2002. Of the 20 countries that were endemic when the campaign began, seven have already interrupted transmission, four countries reported less than 100 cases each, and only five countries reported more than 1,000 cases each in 2001. Only 14,000 cases remained outside Sudan in 2001. Sudan reported 78% of all cases of dracunculiasis in 2001, and virtually all of Sudan's cases were in the southern states, where the long-standing civil war limits accessibility to endemic areas. A political settlement of the waris now urgently needed, since it will be impossible to complete the eradication of dracunculiasis without peace in Sudan.

Feb. 1, 2000
Dracunculiasis Eradication: Delayed, Not Denied (PDF)
Published in Am. J. Trop. Med. Hyg., 62(2), pp. 163-168. Copyright © 2000 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben,Trenton K. Ruebush, Nwando Diallo, Andrew Agle, and P. Craig Withers Jr.; Global 2000 Program of The Carter Center, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
By the end of 1998, Asia was free of dracunculiasis (Guinea worm disease), with Pakistan, India, and Yemen having interrupted transmission in 1993, 1996, and 1997, respectively. Transmission of the disease was also interrupted in Cameroon and Senegal during 1997.

Sept. 1, 1997
Dracunculiasis Eradication: Almost a Reality (PDF)
Published in Am. J. Trop. Med. Hyg., 57(3), pp. 252-259. Copyright © 1997 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben,Trenton K. Ruebush; Global 2000 Program, The Carter Center, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
The idea of a global campaign to eradicate dracunculiasis was first proposed by the Centers for Disease Control and Prevention in 1980, during the advent of the International Drinking Water Supply and Sanitation Decade (IDWSSD) (1981-1990). In 1981, the Steering Committee of the IDWSSD adopted eradication of dracunculiasis as a subgoal of their efforts to provide safe drinking water to unserved populations.

July 1, 1997
Cost-Benefit Analysis of the Global Dracunculiasis Eradication Campaign (PDF)
Published by The World Bank and The Carter Center.
Authors: Aehyung Kim, Ajay Tandon (The World Bank), and Ernesto Ruiz-Tiben (The Carter Center)
An analysis prepared by the Africa Human Development Department at the World Bank. By Aehyung Kim and Ajay Tandon, The World Bank, and Ernesto Ruiz-Tiben, The Carter Center. July 1997. ABSTRACT This paper is a cost-benefit analysis of the Global Dracunculiasis Eradication Campaign (GDEC). Dracunculiasis (or Guinea worm disease) has been endemic in several African countries as well as in Yemen, Pakistan, and India. In the past decade, the incidence of dracunculiasis has seen a remarkable decline as a result of GDEC. This paper compares expenditure on GDEC activities with estimates of increased agricultural production due to reductions in infection-related morbidity resulting from the eradication program. Using a project horizon of 1987-1998, the Economic Rate of Return (ERR) is 29%, under conservative assumptions regarding the average degree of incapacitation caused by Guinea worm infection (5 weeks). In addition, our results indicate that eradication must be achieved in Sudan -- which is projected to be the sole endemic country after 1998 -- at the very latest by the year 2001 in order for economic returns there to be consistent with those obtained in other endemic countries.

Sept. 2, 1995
Eradication of dracunculiasis from Pakistan (PDF)
Published in Lancet Sept 1995 issue 346 vol 8975 pp. 621-624.
Authors: Hopkins, D.R.; Azam, M; Ruiz-tiben, E; Kappus, KD.
In 1986 the World Health Organization targeted dracunculiasis (Guinea-worm disease), which seriously impairs socioeconomic development in 16 African countries, India, Pakistan, and Yemen, to be eradicated globally. The target date for eradication by the end of 1995 was established in 1991. Pakistan eradicated dracunculiasis from the country in October, 1993, after a national campaign which began in 1987 with a nationwide village-by-village search for cases. The infection, which is transmitted by drinking water from ponds containing infected water fleas, was eradicated by using health education, cloth filters, and the cyclopsicide, temephos; and in the later stages, by case containment. Methods pioneered in Pakistan's National Guinea Worm Eradication Program are now being applied in remaining endemic countries.

March 1, 1994
Dracunculiasis Eradication: March 1994 Update (PDF)
Published in Am. J. Trop. Med. Hyg., 52(1), pp. 14-20. Copyright © 1995 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Trenton Ruebuch II, Andrew N. Agle, and P. Craig Withers, Jr.; Global 2000, Inc., The Carter Center, Atlanta, Georgia; World Health Organization Collaborating Center for Research, Training and Eradication of Dracunculiasis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Substantial progress has been realized in the global campaign to eradicate dracunculiasis by the end of 1995 since a previous review of the subject was published in this journal a year ago. All known endemic countries are now engaged in the eradication effort, and one or more control measures are now in place in 93% of endemic villages.

Sept. 1, 1993
Dracunculiasis Eradication: Beginning of the End (PDF)
Published in Am. J. Trop. Med. Hyg., 49(3), pp. 281-289. Copyright © 1993 by The American Journal of Tropical Medicine and Hygiene.
Authors: Donald R. Hopkins, Ernesto Ruiz-Tiben, Robert L. Kaiser, Andrew N. Agle, and P. Craig Withers, Jr.; Global 2000, Inc., The Carter Center, Atlanta, Georgia; World Health Organization Collaborating Center for Research, Training and Eradication of Dracunculiasis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Beginning with the International Drinking Water Supply and Sanitation Decade (1981-1990), an increasingly broad coalition of international and bilateral agencies, organizations, private companies, and other institutions have joined forces to eradicate draculiasis (Guinea worm disease).

June 1, 1992
Homing In On Helminths (PDF)
Published in Am. J. Trop. Med. Hyg., 46(6), pp. 626-634. Copyright © 1992 by The American Journal of Tropical Medicine and Hygiene.
Author: Donald R. Hopkins; Global 2000, Inc., The Carter Center, Atlanta, Georgia
"I am honored to give this lecture dedicated to the memory of Dr. Fred Soper, whose pioneering efforts against the insect vectors of malaria and yellow fever are legendary. Soper and his colleagues also played key roles in restoring the concept of eradication to respectability after the collapse of earlier campaigns to eradicate hookworm and yellow fever."

Jan. 1, 1992
Guinea Worm No One Should Suffer (PDF)
Published in Encyclopaedia Britannica Inc., 46(6), 1992, pp 626-634, Copyright  © 1991.  
Author: Donald R. Hopkins
In this article Dr. Donald Hopkins and Dr. Ernestine Hopkins present a history of Guinea worm disease.  The article highlights both early and more recent eradication efforts, focusing on the successful approaches of the early 1980s through 1991, which resulted in dramatic declines in the incidence of Guinea worm disease.  The piece also recognizes many of the initial donors who supported the campaign in its earliest days.  The article includes a forward by former U.S. President Jimmy Carter.

June 1992
Introduction of the Soper Lecture
Published in The American Journal of Tropical Medicine and Hygiene 1992, 46(6), 1992, p. 625
Author: Robert L. Kaiser.
Dr. Fred Soper dedicated his life to disease eradication. Shortly after his death in 1977, the Gorgas Memorial Institute established the Soper Lectureship in his honor. As a leader in the fight for Guinea Worm eradication, Dr. Don Hopkins exemplifies Soper's many qualities.

Dec. 12, 1991
Strategies for Dracunculiasis Eradication (PDF)
Published in Bulletin of the World Health Organization, Vol 69 No. 5.
Authors: D.R. Hopkins and E. Ruiz-Tiben
In 1991 the Forty-fourth World Health Assembly declared the goal of eradicating dracunculiasis (Guinea worm disease) by the end of 1995. This article summarizes the recommended strategies for surveillance and interventions in national dracunculiasis eradication programmes. It is based on personal experience with dracunculiasis programmes in Ghana, Nigeria and Pakistan. Three phases are described: establishment of a national programme office and conduct of a baseline survey; implementation of interventions; and case containment. The relevance of dracunculiasis eradication activities to strengthening of primary health care in the three countries is discussed briefly. Similar strategies would help eradicate this disease in the remaining endemic countries.

Dec. 5, 1991
Homing in on Helminths
Published in The American Journal of Tropical Medicine and Hygiene 1992, 46(6), 1992, pp. 626-634.
Author: Donald R. Hopkins.
Dr. Donald Hopkins presented the 13th annual Soper Lecture at the 40th Meeting of the American Society of Tropical Medicine and Hygiene.