[Endemic dracunculiasis in new villages: re-emergence of the disease or failure of the surveillance system].

According to data sent to Bamako in March 1998 for the annual review of National Programs for the Eradication of the Guinea Worm (NPEGV), dracunculiasis was observed in 211 villages in Burkina Faso in 1997. Of this total, 110 (52 p. 100) were new villages not previously reporting dracunculiasis. A study focusing on these new villages was carried out in June 1998. The aim of the study was to evaluate the quality of the disease monitoring system and determine if endemicity was spreading to new villages. A twofold method was used first to analyze the data used in the geographic information section of the disease monitoring system and second to test the validity of this data in field surveys. Findings showed the actual number of new villages showing endemicity could be reduced from 46 p. 100 to 12 p. 100 since 67 p. 100 of the new villages had in fact previously reported endemicity but had been wrongly eliminated from monitoring records. This probably long-standing problem has been uncovered with a decrease in the number of villages showing endemicity and an increase in prevention activities. In addition this study identified several confounding factors and defects in disease monitoring and data reporting techniques. Based on this study, several recommendations were made to improve the quality of the disease monitoring system.