Guinea worm disease in Northern Uganda: a major public health problem controllable through an effective water programme.

A modified cluster survey was conducted in northwestern Uganda in 1984 to provide descriptive epidemiological data on dracunculiasis in a water programme target area. A total of 2014 people participated from 58 randomly selected clusters. Interviewers elicited information on age and sex of household members, number, date of emergence and location of Guinea worms, and type of and distance from water source in an endemic area. The survey yielded an incidence rate of 193 cases/1000 people per year, and a prevalence rate of 43 active cases/1000. Respondents who reported using ponds, reservoirs, valley tanks or rivers as their primary water source had the highest attack rates; those using boreholes, the lowest. Adolescents and adults differed little in risk, but the disease was less common among young children. Guinea worm disease displayed a bimodal seasonal pattern. We concluded that the survey method used for determining dracunculiasis incidence was appropriate in this setting. The incidence of this disease may be significantly reduced in Uganda through the country's commitment to the International Drinking Water Supply and Sanitation Decade.