Persistence of dracunculiasis in northern Mali: the case of the Gao region.

Summary Dracunculiasis is a dermo-epidermal filariasis that seems to persist in areas of Mali where potable water is scarce. From January to December of 2004 we carried out a study in the Gao region in an effort to determine the frequency of dracunculiasis and describe control efforts and their impact to date. To meet this objective we collected all documented cases of dracunculiasis during the study period and analyzed their reported activity and outcomes in the same year. In total, 294 patients suffering from dracunculiasis were reported in the Gao region during 2004, corresponding to a frequency of 82 cases per 100,000 inhabitants. The male to female ratio favored women by a factor of 1.05, or 151 women per 143 men. All age groups were affected with 34.69% of cases falling into the 5 to 14 year old age group and 62.93% in the group of 15 year old and above. Children represented 15.30% of detected cases. School childrean lead with a proportion of 31.97%, followed by homemakers' 31.63%. The needs for trained personnel in the context of dracunculiasis control were met at 90%(48/53); supervision rates of various regional circles were satisfied 100%. This rate varied from 50 to 66% at the outskirts. The need for filters was met, but 39% of these supplies were not distributed to the population. These activities resulted in an augmentation of isolated cases from 52% in 2003 to 62.26% in 2004. Dracunculiasis remains a public health problem in northern Mali. To eradicate this ailment efforts must be made at every level: by medical personnel in the field, sanitation authorities, and the general population. These actions must be accompanied by the provision of additional clean drinking water.