2021
DOI: 10.1136/bmjopen-2021-049732
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Quantifying conflict zones as a challenge to certification of Guinea worm eradication in Africa: a new analytical approach

Louise A Kelly-Hope,
David H Molyneux

Abstract: ObjectivesTo quantify conflict events and access across countries that remain to be certified free of transmission of Dracunculus medinensis (Guinea worm disease) or require postcertification surveillance as part of the Guinea Worm Eradication Programme (GWEP).Setting and participantsPopulations living in Guinea worm affected areas across seven precertification countries and 13 postcertification sub-Saharan African countries.Outcome measuresThe number of conflict events and rates per 100 000 population, the ma… Show more

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Cited by 4 publications
(5 citation statements)
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“…It focuses on one set of NTDs that are targeted with an integrated drug intervention, but the impact and implications may extend to all NTDs and other national programmes addressing endemic diseases. The development of a stratified assessment method, taking different levels of risk of conflict, IDPs and geographical access into account, builds on other recent approaches [13][14][15] and will help the NTD programme better address the specific challenges of each district within Cabo Delgado province.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…It focuses on one set of NTDs that are targeted with an integrated drug intervention, but the impact and implications may extend to all NTDs and other national programmes addressing endemic diseases. The development of a stratified assessment method, taking different levels of risk of conflict, IDPs and geographical access into account, builds on other recent approaches [13][14][15] and will help the NTD programme better address the specific challenges of each district within Cabo Delgado province.…”
Section: Discussionmentioning
confidence: 99%
“…The increasing threat of conflict and displacement on NTD programmes has started to be examined [13][14][15]. However, more still needs to be addressed as it is a neglected area that will hinder programme progress and success.…”
Section: Introductionmentioning
confidence: 99%
“…112 Similarly, in a 2021 paper examining violence and conflict as a challenge to the GWEP, Louise Kelly-Hope and David Molyneux also identified …the porosity of international borders, extensive migration generated by insecurity, intercountry range of many of the actors responsible for violence, and the need for these geographically vast countries to ensure that any Guinea worm case is recognised and reported… as key obstacles to eradication. 113 The biological nature of guinea worm, with its year-long asymptomatic incubation period, further meant that the issues of conflict and cross-border transmission were intertwined. Those infected in the conflict zones that the GWEP struggled to reach could unknowingly carry guinea worm inside their bodies as they fled.…”
Section: Locating Agencymentioning
confidence: 99%
“…In Africa, the number of conflict events has increased dramatically in recent years 10 11 and impeded the effectiveness of many NTD programmes. [12][13][14][15] In response, practical approaches have been developed to address key issues such as safe and effective disease mapping and intervention strategies, [16][17][18] however more support to implement these at scale, and better understand the intersect with climate and complex humanitarian emergencies leading to displacement and how it affects vulnerable populations is urgently needed. 19 External and internal displacement are driven by multiple causes and pose multiple risks for national programmes.…”
Section: Strengths and Limitations Of This Studymentioning
confidence: 99%