{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:57:18Z","timestamp":1790402238117,"version":"4.1.0"},"reference-count":44,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T00:00:00Z","timestamp":1529280000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1132415"],"award-info":[{"award-number":["OPP1132415"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["gatesopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Gates Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    The objective of this study was to document the worldwide decline of dracunculiasis (Guinea worm disease, GWD) burden, expressed as disability-adjusted life years (DALYs), from 1990 to 2016, as estimated in the Global Burden of Disease study 2016 (GBD 2016). While the annual number of cases of GWD have been consistently reported by WHO since the 1990s, the burden of disability due to GWD has not previously been quantified in GBD.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    The incidence of GWD was modeled for each endemic country using annual national case reports. A literature search was conducted to characterize the presentation of GWD, translate the clinical symptoms into health sequelae, and then assign an average duration to the infection. Prevalence measures by sequelae were multiplied by disability weights to estimate DALYs.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    The total DALYs attributed to GWD across all endemic countries (n=21) in 1990 was 50,725 (95% UI: 35,265\u201369,197) and decreased to 0.9 (95% UI: 0.5\u20131.4) in 2016. A cumulative total of 12,900 DALYs were attributable to GWD from 1990 to 2016.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Using 1990 estimates of burden propagated forward, this analysis suggests that between 990,000 to 1.9 million DALYs have been averted as a result of the eradication program over the past 27 years.\n                  <\/ns4:p>","DOI":"10.12688\/gatesopenres.12827.1","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T11:20:06Z","timestamp":1529320806000},"page":"30","update-policy":"https:\/\/doi.org\/10.12688\/gatesopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Slaying little dragons: the impact of the Guinea Worm Eradication Program on dracunculiasis disability averted from 1990 to 2016"],"prefix":"10.12688","volume":"2","author":[{"given":"Elizabeth A.","family":"Cromwell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieudonne P.","family":"Sankara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Stanaway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Goldberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Pigott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Larson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein Emil","family":"Vollset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristopher","family":"Krohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Foreman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hotez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiqar","family":"Bhutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayu Begashaw","family":"Bekele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6558-5829","authenticated-orcid":false,"given":"Dumessa","family":"Edessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Kassembaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Mokdad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J. L.","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-7272","authenticated-orcid":false,"given":"Simon I.","family":"Hay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2018,6,18]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"54-63","DOI":"10.1056\/NEJMra1200391","article-title":"Disease eradication.","volume":"368","author":"D Hopkins","year":"2013","journal-title":"N Engl J Med."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"223-46","DOI":"10.1128\/CMR.15.2.223-246.2002","article-title":"Dracunculiasis (Guinea worm disease) and the eradication initiative.","volume":"15","author":"S Cairncross","year":"2002","journal-title":"Clin Microbiol 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,19]],"date-time":"2019-10-19T12:04:36Z","timestamp":1571486676000},"score":1,"resource":{"primary":{"URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,18]]},"references-count":44,"URL":"https:\/\/doi.org\/10.12688\/gatesopenres.12827.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26532","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26528","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26527","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26527","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26528","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/gatesopenres.13900.r26532","asserted-by":"object"}]},"ISSN":["2572-4754"],"issn-type":[{"value":"2572-4754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,18]]},"assertion":[{"value":"Indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/gatesopenres.13900.r26528, Teshome Gebre, International Trachoma Initiative, Addis Ababa, Ethiopia, 29 Jun 2018, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-response-26528","order":0,"name":"referee-response-26528","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Simon Hay<\/b>; <i>Posted: 24 Jul 2018<\/i>; Thank you for the comments. We agree with the reviewer that reductions in cases post from 1990 to 1995 may reflect changes in reporting procedures.&nbsp; The results do include larger uncertainty intervals for the 1990 estimates compared to later time points, largely driven by the model attempting to correct for under-reporting or missing data from the early 1990s.","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-comment-3110","order":1,"name":"referee-comment-3110","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.13900.r26532, Guillaume Chabot-Couture, Institute for Disease Modeling, Bellevue, WA, USA, 05 Jul 2018, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-response-26532","order":2,"name":"referee-response-26532","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Simon Hay<\/b>; <i>Posted: 24 Jul 2018<\/i>; We thank the reviewer for the comment. As we mention above, we will review data sources to determine if worm burden can be included in future iterations of the model. While the point about DRC is noted, we would need additional data sources from the Ministry of Health to re-consider the geographic exclusions used in the analysis.&nbsp; The suggestion regarding Chad can be tested in a subsequent iteration of the GBD.","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-comment-3109","order":3,"name":"referee-comment-3109","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.13900.r26527, Philip Downs, Sightsavers, Durham, NC, USA, 13 Jul 2018, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-response-26527","order":4,"name":"referee-response-26527","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Simon Hay<\/b>; <i>Posted: 24 Jul 2018<\/i>; Thank you for the comment. We agree there is likely additional morbidity associated with the number of worms per individual infected. Depending on the availability of data, it may be possible to update the model in the GBD with an estimate of worm burden as it relates to either degree of pain and limited mobility or duration of disease. Mental health outcomes are difficult to estimate in this framework as data on morbidity due to Guinea worm disease likely come from cross-sectional studies. In addition to attributing disability weights to mental health states, there is not enough evidence to assign a duration to mental health outcomes associated with Guinea worm disease to include in the calculation of a DALY.","URL":"https:\/\/gatesopenresearch.org\/articles\/2-30\/v1#referee-comment-3108","order":5,"name":"referee-comment-3108","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Bill & Melinda Gates Foundation [OPP1132415]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":6,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}