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Dracunculiasis: The Endgame, Proximity, and Risk

Royal, Nathaniel Paul
Degree Grantor:
University of California, Santa Barbara.Geography
Degree Supervisor:
Goodchild Michael F
Place of Publication:
[Santa Barbara, Calif.]
University of California, Santa Barbara
Creation Date:
Issued Date:
Geography, Epidemiology, and Geographic information science and geodesy
Guinea Worm

Abstract Dracunculiasis: The Endgame, Proximity, and Risk By Nathaniel Royal Guinea worm (Dracunculiasis) is a two-host, nematode parasite that is currently the focus of an international eradication effort. The remaining few of these parasites live in sub-Saharan and Sahelian Africa in the countries of Chad, Ethiopia, Mali, and South Sudan. By the end of 2010 there were fewer than 1,800 cases of Guinea worm reported worldwide, an astonishing decrease from the estimated 3.5 million reported cases in 1980 when the international eradication effort began. There is no vaccine or preventative medicine to inoculate against the parasite and the eradication effort has focused on an educational program, teaching those at risk how to prevent infection. Through education and community programs to improve access to clean and safe drinking water, it is hoped that the parasite will have been eliminated from the waters worldwide in the near future. The goal of this research is to understand how Guinea worm has reemerged in regions where it had once been eliminated. A current hurdle to the eradication effort is to supervise the regions where Guinea worm once existed to ensure there is no reemergence. There have been several incidents of reemergence in the past and the work for this dissertation examines historical data on Guinea worm reemergence to better understand the process and identify the most suitable methods for locating regions at risk for reemergence. Results of this analysis show that specific transportation networks and medical facilities may play a role in determining the spread of Guinea worm as it reestablishes itself in a region. This work reiterates that both disease transmission and species abundance are fundamentally spatial processes and that the incorporation of spatial approaches provides new insights into the nature of Guinea worm reemergence. The techniques presented in this dissertation have many potential applications in health geography, spatial epidemiology, and spatial analysis.

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