Date of Conferral

8-12-2025

Degree

Ph.D.

School

Public Health

Advisor

Adebowale Awosika-Olumo

Abstract

Guinea worm disease (GWD) has persisted in a small number of endemic countries despite decades of eradication efforts. Ongoing GWD transmission in these countries underscores the need to examine behavioral, environmental, and surveillance-related drivers. The purpose of this quantitative study was to assess associations among risk factors, including dog tethering, pond treatment with Abate, and community awareness, and GWD incidence. The study also examined the relationship between climate-related environmental factors and GWD case distribution, as well as the influence of awareness levels on GWD rumor reports. Guided by the PRECEDE–PROCEED framework, this retrospective secondary analysis used data from national eradication programs (2012–2023), with a total sample size of N = 784. Statistical methods included multiple linear regression, negative binomial regression, Pearson correlations, spatial analysis (bivariate Moran’s I, LISA), and time-series forecasting. Dog tethering was significantly associated with increased reported Guinea worm disease (GWD) cases. This is likely due to responsive interventions in areas where transmission is high. However, environmental variables were not significant predictors of GWD case counts, but spatial clustering revealed geographic heterogeneity. Higher awareness was associated with fewer GWD rumors (β = .459, p < .001), suggesting that effective communication may reduce misinformation. Forecasts indicated that without intensified interventions, transmission may persist beyond 2030 in some countries. This study may promote positive social change by informing targeted interventions and improving surveillance.

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