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The American Journal of Tropical... Feb 2021The Guinea Worm Eradication Program has been extraordinarily successful-in 2019, there were 53 human cases reported, down from the estimated 3.5 million in 1986. Yet the...
The Guinea Worm Eradication Program has been extraordinarily successful-in 2019, there were 53 human cases reported, down from the estimated 3.5 million in 1986. Yet the occurrence of Guinea worm in dogs is a challenge to eradication efforts, and underlying questions about transmission dynamics remain. We used routine surveillance data to run negative binomial regressions predicting worm burden among infected dogs in Chad. Of 3,371 infected dogs reported during 2015-2018, 38.5% had multiple worms. A multivariable model showed that the number of dogs in the household was negatively associated with worm burden (adjusted incidence rate ratio [AIRR] = 0.95, 95% CI: 0.93-0.97, P < 0.0001) after adjusting for dog age (AIRR = 0.99, 95% CI: 0.96-1.01, P > 0.1). This could relate to the amount of infective inocula (e.g., contaminated food or water) shared by multiple dogs in a household. Other significant univariable associations with worm burden included dog history of Guinea worm infection (IRR = 1.30, 95% CI: 1.18-1.45) and dog owners who were hunters (IRR = 0.78, 95% CI: 0.62-0.99, P < 0.05) or farmers (IRR = 0.83, 95% CI: 0.77-0.90, P < 0.0001). Further analysis showed that the number of dogs in the household was significantly and positively correlated with nearly all other independent variables (e.g., owner occupation: farmer, fisherman, or hunter; dog age, sex, and history of Guinea worm). The associations we identified between worm burden and dogs per household, and dogs per household and owner characteristics should be further investigated with more targeted studies.
Topics: Animals; Animals, Domestic; Chad; Dog Diseases; Dogs; Dracunculiasis; Dracunculus Nematode; Family Characteristics; Female; Male; Parasite Load; Regression Analysis; Risk Factors
PubMed: 33617473
DOI: 10.4269/ajtmh.19-0924 -
Medical History Apr 2023Guinea worm disease (dracunculiasis) is a debilitating waterborne disease. Once widespread, it is now on the brink of eradication. However, the Guinea Worm Eradication...
Guinea worm disease (dracunculiasis) is a debilitating waterborne disease. Once widespread, it is now on the brink of eradication. However, the Guinea Worm Eradication Programme (GWEP), like guinea worm itself, has been under-studied by historians. The GWEP demonstrates an unusual model of eradication, one focused on primary healthcare (PHC), community participation, health education and behavioural change (safe drinking). The PHC movement collided with a waterborne disease, which required rapid but straightforward treatment to prevent transmission, creating a historical space for the emergence of village-based volunteer health workers, as local actors realigned global health policy on a local level. These Village Volunteers placed eradication in the hands of residents of endemic areas, epitomising the participation-focused nature of the GWEP. This participatory mode of eradication highlights the agency of those in endemic areas, who, through volunteering, safe drinking and community self-help, have been the driving force behind dracunculiasis eradication. In the twenty-first century, guinea worm has become firstly a problem of human mobility, as global health has struggled to contain cases in refugees and nomads, and latterly a zoonotic disease, as guinea worm has shifted hosts to become primarily a parasite of dogs. This demonstrates both the potential of One Health approaches and the need for One Health to adopt from PHC and the GWEP a focus on the health of humans and animals in isolated and impoverished areas. Guinea worm demonstrates how the biological and the historical interact, with the GWEP and guinea worm shaping each other over the course of the eradication programme.
Topics: Humans; Animals; Dogs; Dracunculus Nematode; Dracunculiasis; Waterborne Diseases; Health Education; Health Policy; Disease Eradication
PubMed: 37525460
DOI: 10.1017/mdh.2023.18 -
MMWR. Morbidity and Mortality Weekly... Oct 2012Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after initial infection from contaminated drinking...
Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after initial infection from contaminated drinking water, the worm emerges through the skin of the infected person, usually on the lower limb. Pain and secondary bacterial wound infection can cause temporary or permanent disability that disrupts work and schooling for the entire family. In 1986, the World Health Assembly (WHA) called for dracunculiasis elimination and the Guinea Worm Eradication Program, supported by The Carter Center, World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and other partners, was coalesced to assist ministries of health of endemic countries in meeting this goal. At that time, an estimated 3.5 million cases occurred annually in 20 countries in Africa and Asia. This report updates published and previously unpublished surveillance data reported by ministries of health and describes progress toward global dracunculiasis eradication. In 2011, a total of 1,058 cases were reported. As of 2012, dracunculiasis remained endemic in only four countries. Through June 2012, worldwide reductions in reported cases continued, compared with the first 6 months of 2011. Failures in surveillance and containment, lack of clean drinking water, and insecurity in Mali and parts of South Sudan continue to challenge dracunculiasis eradication efforts.
Topics: Africa; Animals; Dracunculiasis; Dracunculus Nematode; Global Health; Humans; Incidence; Population Surveillance; Social Conditions; Water Supply; World Health Organization
PubMed: 23095954
DOI: No ID Found -
International Health Dec 2021
Topics: Disease Eradication; Global Health; Humans
PubMed: 34532741
DOI: 10.1093/inthealth/ihab055 -
Reviews of Infectious Diseases 1982Control and prevention of parasitic disease depends on an adequate knowledge of interactions among factors such as human behavior, the environment, and the life cycles... (Review)
Review
Control and prevention of parasitic disease depends on an adequate knowledge of interactions among factors such as human behavior, the environment, and the life cycles of parasites. Sociocultural factors in large part determine transmission and persistence of parasites. The main determinants are poverty, low educational level, deficiencies in home technologies, high demographic density, and ruralism. Selected interventions designed to improve any of these situations may fail if they are applied in an isolated manner. The holistic implementation of interventions has proved successful in the control and prevention of parasitic infections in several parts of the word. The implementation of several kinds of interventions simultaneously, that is, a holistic approach, combined with an awareness of a society's infrastructure, can produce favorable results. For such an awareness--when it provokes action--can improve the overall quality of life.
Topics: Adolescent; Ascariasis; Behavior; Chad; Chagas Disease; Child; Child Rearing; Child, Preschool; Developing Countries; Dracunculiasis; Female; Guatemala; Hookworm Infections; Humans; Malaria; Nematode Infections; Nutrition Disorders; Parasitic Diseases; Plasmodium; Poverty Areas; Schistosomiasis; Socioeconomic Factors
PubMed: 6214836
DOI: 10.1093/4.4.871 -
PLoS Pathogens Jan 2016
Topics: Animals; Communicable Diseases; Disease Eradication; Dracunculiasis; Humans; Schistosomiasis; Smallpox
PubMed: 26741130
DOI: 10.1371/journal.ppat.1005298 -
International Journal For Parasitology.... Aug 2021Parasitic nematodes in the genus have a complex life cycle that requires more than one host species in both aquatic and terrestrial habitats. The most well-studied...
Parasitic nematodes in the genus have a complex life cycle that requires more than one host species in both aquatic and terrestrial habitats. The most well-studied species, , is the causative agent of human Guinea worm disease (dracunculiasis). There are several other species that infect non-human animals, primarily wildlife (reptiles and mammals). The classic route of transmission to humans is through the ingestion of water containing the intermediate host, a cyclopoid copepod, infected with third-stage larvae (L3s). However, many animal hosts (e.g., terrestrial snakes, dogs) of other sp. appear unlikely to ingest a large number of copepods while drinking. Therefore, alternative routes of infection (e.g., paratenic or transport hosts) may facilitate transmission to these species. To better understand the role of paratenic and transport hosts in transmission to animal definitive hosts, we compared copepod ingestion rates for aquatic species (fish, frogs [tadpoles and adults], and newts) which may serve as paratenic or transport hosts. We hypothesized that fish would consume more copepods than amphibians. Our findings confirm that African clawed frogs () and fish consume copepods, but that fish ingest, on average, significantly higher numbers (68% [34/50]) than adult African clawed frogs (36% [18/50]) during a 24-h time period. Our results suggest that amphibians and fish may play a role in the transmission of to definitive hosts. Still, additional research is required to determine whether, in the wild, fish or frogs are serving as paratenic or transport hosts. If so, they may facilitate transmission. However, if these animals simply act as dead-end hosts or as means of copepod population control, they may decrease transmission.
PubMed: 34189031
DOI: 10.1016/j.ijppaw.2021.06.001 -
MMWR. Morbidity and Mortality Weekly... Oct 2009Dracunculiasis is a parasitic infection caused by Dracunculus medinensis. Persons become infected by drinking water from stagnant sources (e.g., ponds) contaminated by...
Dracunculiasis is a parasitic infection caused by Dracunculus medinensis. Persons become infected by drinking water from stagnant sources (e.g., ponds) contaminated by copepods (water fleas) that contain immature forms of the parasite. In 1986, the World Health Assembly (WHA) called for the eradication of dracunculiasis (Guinea worm disease) at a time when an estimated 3.5 million cases occurred annually in 20 countries in Africa and Asia and 120 million persons were at risk for the disease. Because of slow mobilization in countries with endemic disease, the global dracunculiasis eradication program did not meet the 1995 target date for eradicating dracunculiasis set by WHA in 1991. In 2004, WHA established a new target date of 2009 ; despite considerable progress toward global eradication, that target date also will not be met. This report updates continued progress toward global eradication of dracunculiasis since January 2008. At the end of December 2008, dracunculiasis was endemic in six countries (Ethiopia, Ghana, Mali, Niger, Nigeria, and Sudan). The number of indigenous cases of dracunculiasis had decreased 52%, from 9,585 in 2007 to 4,619 in 2008. Of the 1,446 cases that occurred during January-June 2009, 1,413 (98%) were reported from Sudan and Ghana. Currently, insecurity (e.g., sporadic violence or civil unrest) in areas of Sudan and Mali where dracunculiasis is endemic poses the greatest threat to the success of the global dracunculiasis eradication program.
Topics: Africa; Animals; Dracunculiasis; Dracunculus Nematode; Humans; Water Supply; World Health Organization
PubMed: 19834453
DOI: No ID Found -
MMWR. Morbidity and Mortality Weekly... Nov 2014Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated...
Dracunculiasis (Guinea worm disease) is caused by Dracunculus medinensis, a parasitic worm. Approximately 1 year after a person acquires infection from contaminated drinking water, the worm will emerge through the skin, usually on the lower limb. Pain and secondary bacterial infection can cause temporary or permanent disability that disrupts work and schooling. In 1986, the World Health Assembly called for dracunculiasis elimination. The global Guinea Worm Eradication Program, supported by The Carter Center, World Health Organization (WHO), UNICEF, CDC, and other partners, began assisting ministries of health of countries in which dracunculiasis is endemic in meeting this goal. At that time, an estimated 3.5 million cases occurred each year in 20 countries in Africa and Asia. This report updates published (3-5) and unpublished surveillance data reported by ministries of health and describes progress toward dracunculiasis eradication. A total of 148 cases were reported in 2013 from five countries (in order of prevalence: South Sudan, Chad, Mali, Ethiopia, and Sudan) compared with 542 cases in 2012 from four countries (South Sudan, Chad, Mali, and Ethiopia). The disease remains endemic in four countries in 2014 (South Sudan, Chad, Mali, and Ethiopia), but the overall incidence is falling faster in 2013 compared with 2012 (by 73%) and continues to fall faster in the first 6 months of 2014 (by 71%) compared with the same period in 2013. Failures in surveillance and containment, lack of clean drinking water, insecurity in Mali and parts of South Sudan, and an unusual epidemiologic pattern in Chad are the main remaining challenges to dracunculiasis eradication.
Topics: Africa; Disease Eradication; Dracunculiasis; Global Health; Humans; Incidence; Population Surveillance; Social Conditions; Water Supply
PubMed: 25412061
DOI: No ID Found -
PLoS Neglected Tropical Diseases Mar 2021Guinea worm is a debilitating parasitic infection targeted for eradication. Annual human cases have dropped from approximately 3,500,000 in 1986 to 54 in 2019. Recent...
BACKGROUND
Guinea worm is a debilitating parasitic infection targeted for eradication. Annual human cases have dropped from approximately 3,500,000 in 1986 to 54 in 2019. Recent identification of canine cases in Chad threatens progress, and therefore detection, prevention, and containment of canine cases is a priority. We investigated associations between disease knowledge, community engagement, and canine cases in Chad to identify opportunities to improve active surveillance.
METHODS
We surveyed 627 respondents (villagers, local leaders, community volunteers, and supervisors) across 45 villages under active surveillance. Descriptive statistics were analyzed by respondent category. Logistic regression models were fitted to assess the effects of volunteer visit frequency on villager knowledge.
RESULTS
Knowledge increased with respondents' associations with the Guinea worm program. Household visit frequency by community volunteers was uneven: 53.0% of villagers reported visits at least twice weekly and 21.4% of villagers reported never being visited. Villagers visited by a volunteer at least twice weekly had better knowledge of Guinea worm symptoms (OR: 1.71; 95% CI: 1.04-2.79) and could name more prevention strategies (OR: 2.04; 95% CI: 1.32-3.15) than villagers visited less frequently. The primary motivation to report was to facilitate care-seeking for people with Guinea worm. Knowledge of animal "containment" to prevent contamination of water, knowledge of rewards for reporting animal cases, and ability to name any reasons to report Guinea worm were each positively correlated with village canine case counts.
CONCLUSIONS
Community volunteers play crucial roles in educating their neighbors about Guinea worm and facilitating surveillance. Additional training and more attentive management of volunteers and supervisors could increase visit frequency and further amplify their impact. Emphasizing links between animal and human cases, the importance of animal containment, and animal rewards might improve surveillance and canine case detection. The surveillance system should be evaluated routinely to expand generalizability of data and monitor changes over time.
Topics: Adult; Animals; Chad; Dog Diseases; Dogs; Dracunculiasis; Dracunculus Nematode; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Patient Education as Topic; Primary Prevention; Surveys and Questionnaires
PubMed: 33735242
DOI: 10.1371/journal.pntd.0009285