Guineaworm infection in the Wa district of north-western Ghana.

The Ghana-5 schistosomiasis project is situated in an exclusively rural area of north-western Ghana. Since the inhabitants rely for the most part on natural sources of drinking water the transmission of both urinary schistosomiasis and guineaworm infection must often occur at the same sites, and the epidemiology and the problems of control of these diseases might be expected to have features in common. An epidemiological survey of 8 300 people in 1967-68 showed that guineaworm had a scattered distribution, 35 of 43 villages having an annual incidence of less than 10%. Intensive study of 5 of the most seriously affected villages over a period of 3 years has shown that there is a delicate balance between the parasite and its human host in this area, largely as a result of the impermanent nature of the principal transmission sites, i.e., ponds and the smaller riverine pools. The timing, duration, and intensity of transmission have been shown to vary widely from one locality to another, as well as from year to year. These characteristics are determined by the type and extent of the local source of drinking water, the availability of alternative sources, and the monthly pattern of rainfall.