What it Means to be Guinea Worm Free in Ghana: An Insiders Account from Northern Ghana Público

Abstract

Despite several periods of stagnating Guinea worm incidence in Ghana through the 1990s and early 2000s, the last reported case of Guinea worm disease (GWD) was in May 2010. In July 2011 Ghana celebrated the interruption of Guinea worm transmission. While it has been established that Guinea worm (GW) causes disability, pain and socio-economic hardship, there is a dearth of population-based evidence collected in post GW endemic countries to document the value attributed to GWD eradication by residents in formerly endemic communities. Given Ghana's recent history of GWD and a concentrated burden of disease in the Northern Region, a phenomenon which remained true through to the final cases of the campaign, seven villages in the Northern Region were targeted for a retrospective, cross-sectional, descriptive and historical study to detail the perceptions, attitudes and beliefs about the impact of eradication of GWD in Northern Ghana. The study revealed that respondents from the sampled communities felt GW eradication served as an impetus for improved socio-economic conditions as the impact of infection prohibited the pursuit of individual and social advancement. Of the 143 respondents, 133 had experienced GWD, with incapacitation averaging six-weeks per GW event. Each respondent was infected nearly four separate times in their lifetime.

Table of Contents

Abstract. iii

Acknowledgements. v

List of Figures. vii

List of Tables. vii

List of Abbreviations. viii

Chapter 1: Introduction. 1

Disease eradication. 3

Criteria for disease eradication. 3

Eradicating Guinea worm. 4

Certification of eradication. 5

Guinea worm disease eradication in Ghana. 5

Significance, Rationale and Aims. 8

Journal Selection. 9

Chapter 2: Literature Review. 10

Chapter 3: Data Collection, Analysis and Results. 12

Materials and Methods. 12

Village Selection. 12

Household and Participant Selection. 13

Focus Group Selection. 15

Results. 16

Limitations. 20

Chapter 4: Discussion. 21

Chapter 5: Journal Article. 24

References. 37

Appendices. 40

Appendix I: Survey Verbal Consent Script. 40

Appendix II: Household Interview Tool. 41

Appendix III: Focus Group Interview Tool. 42

Appendix IV: IRB Letter. 43

Appendix V: Letter of Invitation. 44

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Anthropology, Cultural Health Sciences, Public Health Sociology, Individual and Family Studies
Palavra-chave	Community survey Disease eradication Legacy and meaning
Committee Chair / Thesis Advisor	Smith, Iris E, Emory University
Committee Members	Asiedu-Bekoe, Franklin, Ghana Health Service, Ministry of Health Torben, Vestergaard Frandsen, Vestergaard, Inc.
Partnering Agencies	Industrial or Commercial (for-profit) organization Non-US governmental agency (e.g., Minister of Health in Haiti)

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