Where We Work


Fighting Disease

Chad has waged a seesaw battle with Guinea worm disease since the 1990s. Transmission of the ancient disease was believed to have been stopped in 1999, but new cases were discovered and the country was reclassified as endemic in 2012. The Carter Center continues to work with village volunteers and Ministry of Health officials to eliminate the disease.

Eliminating Guinea Worm Disease

Current status: Endemic
Indigenous cases reported in 2020: 12*

Previous status: Transmission stopped, 1999. Prior to 2012, Chad was in precertification status. Reclassified as endemic in 2012.

View current case totals >


During 2020, 12* human cases of the disease were reported in Chad.

In recent years, Chad has had the most human cases and animal infections of any country. Most animal infections apparently are transmitted by eating raw or poorly cooked fish, but Chad’s Guinea Worm Eradication Program reported a common-source water-borne outbreak of human cases in 2019. The main endemic area is spread over 400 miles along the Chari River, with year-round transmission peaking in March-September. Two human cases and two to four dogs reported among shared populations in border villages across the river in Cameroon in 2019 and 2020 appear to have been infected in Chad.

Chad improved containment rates and coverage with the larvicide Abate® (donated by BASF) in 2019-2020 and reduced animal infections by 22% and human cases by 75% in 2020 compared to 2019. Chad began a new strategy of proactive containment of dogs in March 2020. In 2020 it had 2,329 villages under active surveillance, investigated over 134,000 rumors of Guinea worm infection, and found 85% of persons surveyed knew of its US$100 equivalent reward for reporting a suspected case.

Elimination Activities, 1993-2000

When its Guinea worm elimination efforts began in 1993, Chad had 1,231 cases in 106 villages in six of the nine national provinces. The strategy for interrupting transmission focused primarily on educating residents about the origin of the disease and how to prevent it. The Carter Center provided technical and financial assistance.

Through these efforts, in 1999 the country had its last indigenous case and met the criteria for breaking transmission of Guinea worm disease (having reported no indigenous cases for 12 consecutive months). Chad was honored at a special ceremony at The Carter Center in Atlanta in 2000 for having stopped Guinea worm disease transmission.


After more than a decade with no indigenous cases reported, 10 cases of Guinea worm disease were found in eight villages during a World Health Organization precertification mission to Chad in July 2010. In 2011, when 10 additional cases were reported from nine different villages, Chad's Ministry of Public Health formally asked The Carter Center to assist with a revived Guinea Worm Eradication Program.

Having reported indigenous cases for the third consecutive year in 2012, Chad officially returned to endemic status.

Around the same time, Guinea worm infections in animals (mainly domestic dogs) started being detected in increasing numbers. The worm’s life cycle in animals is not yet well understood, but intensive research continues. Cash rewards are being paid for reporting infected dogs and for keeping them away from water sources where the worms could reproduce.

Since 2011, program staff members have enhanced surveillance by training more than 2,500 village volunteers in more than 880 villages.

The village volunteers teach techniques to prevent contamination of drinking water, provide free first aid, and immediately report cases to public health authorities. Monetary rewards for information leading to confirmation of Guinea worm cases are publicized through local radio stations, posters, and person-to-person networks.

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Size: 1,284,000 square kilometers

Population: 16,877,357

Population below poverty line: 46.7%

Life expectancy: 58.3 years

Ethnic groups: Sara, Kanembu/Bornu/Buduma, Arab, Wadai/Maba/Masalit/Mimi, Gorane, Masa/Musseye/Musgum, Bulala/Medogo/Kuka, Marba/Lele/Mesme, Mundang, Bidiyo/Migaama/Kenga/Dangleat, Dadjo/Kibet/Muro, Tupuri/Kera, Gabri/Kabalaye/Nanchere/Somrai, Fulani/Fulbe/Bodore, Karo/Zime/Peve, Baguirmi/Barma, Zaghawa/Bideyet/Kobe, Tama/Assongori/Mararit, Mesmedje/Massalat/Kadjakse, other Chadian ethnicities, Chadians of foreign ethnicities and foreign nationals

Religions: Muslim, Roman Catholic, Protestant, animist, and other Christians

Languages: French (official), Sangho (lingua franca and national language), tribal languages

Source: U.S. Central Intelligence Agency World Factbook 2020 


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