| Opportunities for Control of Dracunculiasis (1982) |
Workshop participants discussed various methods for assessing the problem, possible intervention strategies, several options for monitoring and evaluation of programs, and suggested priority areas for research related to dracunculiasis. The results of these discussions are included in this report to help authorities in countries where dracunculiasis is endemic to determine which control measures may be most appropriate.
Many other water-related diseases affect large numbers of people in countries where dracunculiasis is endemic, and program efforts targeted solely on this one problem may appear difficult to justify. However, taking humane and practical considerations into account, dracunculiasis is exceedingly painful, is easily diagnosed, and effective methods for controlling it are already known. Moreover, the International Drinking Water Supply and Sanitation Decade (1981-1990) presents an unprecedented, transient opportunity to reduce the incidence of this disease everywhere it occurs. The obvious next step is for endemic countries to start implementing control activities suited to their needs and resources immediately, and for international and bilateral agencies to assist them, if requested.
Many of the recommendations that follow are intended to apply to those situations in which water supply improvements are not imminent, thereby warranting initiation of control efforts targeted solely on dracunculiasis. The additional costs of such efforts are easily justified in these special circumstances, given the high likelihood of eliminating the infection from a given area within 2-4 years, and the possibility of assigning control activities to existing national and state programs. By comparison, maternal and child health care services, water supply and sanitation systems, and many communicable disease control programs will have recurring costs for many years to come.
Workshop participants were reluctant to make estimates of costs for each type of control activity because there is so little experience from which to generalize. They agreed that it would be important for national authorities and assistance organizations to design and carry out pilot projects so that costs can be carefully monitored. Control activities should be integrated into existing programs (e.g., immunization, agricultural extension services) whenever possible to reduce fuel, salary, and transportation costs.