Misidentification of Onchocerca volvulus as guinea worm

Over the past 10 years, the status of human infection with guinea worm (Dra cunculus medinensis) in the Central African Republic (CAR) has been difficu lt to ascertain. It is unclear if indigenous cases are occurring and whethe r cases are migrating into the CAR from surrounding countries. A team of in vestigators visited the CAR in July-August 2000, to attempt to ascertain th e presence of indigenous transmission. No cases of true guinea-worm infecti on (i.e. dracunculiasis) were detected, but three cases of human infection with Onchocerca volvulus, each of which had been misidentified as dracuncul iasis, were detected. The unusual presentation of skin blisters and extract ion of an intact female O. volvulus are described. As a result of this inve stigation, and the confusion of onchocerciasis being misidentified as dracu nculiasis, the presence of endemic transmission of guinea worm in the CAR r emains in question.