{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:19:43Z","timestamp":1783052383881,"version":"3.54.6"},"reference-count":23,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:p>A decade after reporting its last case of Guinea worm disease (GWD), a waterborne parasitic disease targeted for eradication, Chad reported 20 confirmed human cases from 17 villages\u201410 cases in 2010 and 10 cases in 2011. In 2012, the first GWD dog infections were diagnosed. We conducted a case-control study during April\u2013May 2012 to identify human transmission risk factors and epidemiologic links. We recruited 19 cases and 45 controls matched by age, sex, time, and location of exposure based on the case patients\u2019 periods of infection 10\u201314 months earlier. Data were analyzed with simple conditional logistic regression models using Firth penalized likelihood methods. Unusually, GWD did not appear to be associated with household primary water sources. Instead, secondary water sources, used outside the village or other nonprimary sources used at home, were risk factors (matched odds ratio = 38.1, 95% confidence interval = 1.6\u2013728.2). This study highlights the changing epidemiology of GWD in Chad\u2014household primary water sources were not identified as risk factors and few epidemiologic links were identified between the handfuls of sporadic cases per year, a trend that continues. Since this investigation, annual dog infections have increased, far surpassing human cases. An aquatic paratenic host is a postulated mode of transmission for both dogs and humans, although fish could not be assessed in this case-control study due to their near-universal consumption. GWD\u2019s evolving nature in Chad underscores the continued need for interventions to prevent both waterborne and potential foodborne transmission until the true mechanism is established.<\/jats:p>","DOI":"10.4269\/ajtmh.16-1026","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T07:00:41Z","timestamp":1497337241000},"page":"575-582","source":"Crossref","is-referenced-by-count":11,"title":["Recurrence of Guinea Worm Disease in Chad after a 10-Year Absence: Risk Factors for Human Cases Identified in 2010\u20132011"],"prefix":"10.4269","volume":"97","author":[{"given":"Nandini","family":"Sreenivasan","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Weiss","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Djiatsa","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernand","family":"Toe","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngarodjel","family":"Djimadoumaji","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 Publique, N\u2019Djamena, Chad"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Ayers","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Eberhard","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Ruiz-Tiben","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Roy","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Adv Parasitol","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0065-308X(05)61007-X","article-title":"Dracunculiasis (Guinea worm disease) eradication","volume":"61","author":"Ruiz-Tiben","year":"2006"},{"key":"b2","year":"1986"},{"key":"b3","series-title":"Wkly Epidemiol Rec","first-page":"166","article-title":"Dracunculiasis eradication: global surveillance summary, 2009","volume":"85","year":"2010"},{"key":"b4","series-title":"Wkly Epidemiol 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