The role of case containment centers in the eradication of dracunculiasis in Togo and Ghana.

As part of the global effort to eradicate dracunculiasis (Guinea worm disease), several endemic countries established case containment centers to provide treatment and support to patients with emerging Guinea worms to keep them from contaminating water sources. To assess the functioning, effectiveness, and public perception of this intervention, we visited eight centers and conducted surveys in 32 villages in Togo and Ghana. In the areas served by these centers, incidence dropped by 71% in Togo and 42% in Ghana from 2003 to 2004. Among persons with emerging worms, admission to the centers was associated with younger age (P value = 0.04) after controlling for occupation and gender. Overall, the centers functioned well and were regarded favorably: 99% of the 152 center-attendees expressed satisfaction with their stay. Strategically-located case containment centers in conjunction with other interventions appear to play an important role in the final effort to eradicate dracunculiasis.