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Interrupting transmission of dracunculiasis in Angola [1]

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Date: 2024-01

During a 2-day visit to the southern province of Cunene in October 2023, staff from the World Health Organization (WHO) and the Ministry of Health (MoH) of Angola assessed efforts to eradicate Guinea worm disease (also called dracunculiasis).

The mission was led by WHO's Dr. Humphrey Karamagi and Dr. Maria Cecília de Almeida, who leads NTD control programmes within the national public health directorate in Luanda.

In addition to visiting local civil and health authorities, the team made a couple of field visits. Notably, a trip to Namacunde emphasized collaborative efforts with neighbouring Namibia to sustain community-based, cross-border surveillance, while a visit to Onanime showcased efforts to treat water surfaces with molluscicides with the aim of preventing people from getting the infection.

Angola never reported cases of dracunculiasis until recently. In 2018, a suspect case was detected through a nationwide case search held in conjunction with the national immunization campaign against measles and rubella. The specimen was sent to the WHO Collaborating Center for Dracunculiasis Eradication at the United States Centres for Disease Control and Prevention, where a polymerase chain reaction (PCR) test confirmed the worm as Dracunculus medinensis. Angola’s first case was an 8 year old girl from Cunene province.

Since then, one additional case has been reported in 2019 and another one in 2020, while no more cases have been reported thereafter. However, risk of transmission remains; this is further complicated by the fact that endemic areas are located along the border with Namibia, with a risk of introduction of transmission from Angola to the neighbouring country, which was certified by WHO as transmission-free in 1999.

It is therefore crucial that disease control activities including surveillance, awareness and vector control are sustained until when robust evidence of absence of guinea-worm disease in Angola is gathered and WHO can proceed with certification, as a key step towards global interruption of transmission.









Communities where dracunculiasis cases were detected in 2018-2020 are located along the border with Namibia. As people move across the border, the risk of introduction of transmission from Angola to Namibia is substantial, and cross-border surveillance is key to minimize such risk.





Community sensitization and health education are key activities aimed at raising awareness of the disease. People living in areas of persisting transmission should know what to do in case they see a person with suspected infection, and take immediate action to prevent any further spread.

The team interviewed local health staff with the aim of ascertaining capacities to detect and notify suspect cases, checking the level of community engagement in surveillance activities, and identifying any outstanding needs in terms of resources and equipment.





Copepods are small aquatic crustaceans that live in stagnant freshwater. Also called “water fleas”, they can swallow the larvae of the Guinea worm and serve as vectors of infection when in turn they are swallowed by humans. They may be seen at naked eye but a magnifying glass can certainly help.

Temephos (Abate®) is an organophosphate molluscicide used to treat water. This is usually done by specialized staff requiring dedicated equipment. It kills the copepods, thus minimizing the risk of transmission of Dracunculus medinensis to humans. Fine-mesh cloth filters can also be used to filter out the tiny crustaceans from water before drinking.

Photo credits: WHO/Omotola Akindipe

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[1] Url: https://www.who.int/news-room/feature-stories/detail/interrupting-transmission-of-dracunculiasis-in-angola

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