ATLANTA (AP) — Guinea worm disease remains on the cusp of being eradicated, with the global number of cases in 2023 holding steady at 13, according to a provisional account released by The Carter Center.

A final count will be confirmed in the coming months. But the initial count matches the confirmed number of human cases in 2022, after 15 were recorded in 2021.

Global cases numbered about 3.5 million in 1986, when former President Jimmy Carter announced that his post-White House Carter Center would prioritize eradication of the parasitic disease that affected developing nations in Africa and Asia.

“Eradicating Guinea worm disease and the suffering it causes has long been a dream of my grandparents, and they have worked incredibly hard to make it a reality,” said Jason Carter, Carter Center board chair and eldest grandson of Jimmy Carter and his late wife, Rosalynn Carter.

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The former president is now 99 and remains under home hospice care in Plains, Georgia. The former first lady died in November at the age of 96. The Carter Center said animal cases increased slightly from 685 in 2022 to 713 in 2023, though authorities attributed that uptick to increased monitoring in Angola and Cameroon. The same species of worm is involved in both human and animal cases.

Nine of the 13 provisional human cases in 2023 occurred in Chad, two in South Sudan and one each in Cameroon and Mali. The provisional count includes no Guinea worm cases in Ethiopia, down from one case in 2022. South Sudan had five cases in 2022.

Jimmy Carter has said he hopes to outlive Guinea worm.

Humans typically contract Guinea worm disease through contaminated water sources that contain organisms that eat Guinea worm larvae. The larvae develop into adult worms and mate within the human host. Pregnant female worms often emerge from painful blisters on a host’s skin.

Guinea worm would become the second human disease, after smallpox, to be eradicated. It would become the first parasitic disease to be eradicated and the first to be eradicated without a vaccine. The Carter Center’s eradication programs have focused on locally based education and awareness programs about the disease and its source.

Donald Hopkins, the Carter Center’s senior advisor for Guinea worm eradication and architect of the eradication campaign, credited residents in the affected areas.

“Without any vaccine or medicine, Guinea worm disease is disappearing because everyday people are careful to filter their water, tether their animals, properly dispose of fish entrails, and keep their water sources safe,” Hopkins said in a statement, “because they care about their communities, families, and the people they love.”