Guineaworm, maternal morbidity, and child health.

Studies have documented the effect of guineaworm concerning days lost to agricultural work and drops in school attendance, but little is known about how the disease disables mothers and impairs their ability to care for their children and families. A pilot case study of 42 women in two rural Nigerian communities has been conducted to fill that gap. Guineaworm was responsible for half of child immunization defaulting and deterred women from using maternity services. Guineaworm kept women from their jobs and trades, costing an average of approximately $50 in lost income, a sizable chunk of a family's support considering the annual per capita income for the area is just over $100. Other problems experienced included loss of appetite and reduced food intake, unattended child illnesses, and disabling secondary infections resulting from unhygienic self-treatment. The ill women and her dependent children put great strain on the support network of family friends, a network already weakened in many cases when several other members were also afflicted with guineaworm. While further research is needed to learn more about this disabling disease, there is no excuse not to implement known guineaworm control interventions. The experience with mothers and children in Nigeria has shown that guineaworm control through water supply improvement should be a major child survival and development initiative.