Dracunculiasis

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Dracunculiasis

 

MeSH scope note: Infection with nematodes of the genus DRACUNCULUS. One or

more worms may be seen at a time, with the legs and feet being the most commonly

infected areas. Symptoms include pruritus, nausea, vomiting, diarrhea, or

asthmatic attacks.

http://www.who.int/topics/dracunculiasis/en/

 

Nine out of ten people living in the depressed areas of Africa south of the

Sahara still have nothing else to drink but meagre quantities of impure water,

thus exposing themselves to serious diseases such as the appalling

dracunculiasis.

This parasitic disease causes dreadful suffering and disability among the

world's most deprived people. The disease reappears each year during the

agricultural season, handicapping farmers, mothers and schoolchildren already

weighed down by harsh living conditions and often existing just above survival

level. Families affected by the disease experience great loss: their food stocks

and savings gradually dwindle away, they are no longer able to participate in

vaccination campaigns and the children's schooling increasingly suffers.

Gradually worn down by penury, these underprivileged people find themselves

trapped in a vicious circle of poverty and disease.

Dracunculiasis is a disease caused by the parasitic worm Dracunculus

medinensis or " Guinea worm " . This worm is the largest of the tissue parasite

affecting human. The adult female, which carries about 3 million embryos, can

measure 600 to 800 mm in length and 2 mm in diameter. The parasite migrates

through the victim's subcutaneous tissues causing severe pain especially when it

occurs in the joints. The worm eventually emerges (from the feet in 90% of the

cases), causing an intensely painful oedema, a blister and the an ulcer

accompanied by fever, nausea and vomiting.

 

Infected persons try to relieve the burning sensation by immersing the

infected part of their body in local water sources, usually ponds water. This

also induce a contraction of the female worm at the base of the ulcer causing

the sudden expulsion of hundreds of thousands of first stage larvae into the

water. They move actively in the water and can live for a few days in water.

For further development, they need to be ingested by suitable species of

voracious predatory crustacean, Cyclops or water fleas which measure 1 – 2 mm

and widely abundant worldwide. In the cyclops, larvae develop to infective

third-stage in 14 days at 26°C.

When a person drink contaminated water from ponds or shallow open wells, the

cyclops is dissolved by the gastric acid of the stomach and the larvae are

released and migrate through the intestinal wall. After 100 days, the male and

female meet and mate. The male become encapsulated and die in the tissues while

the female move down the muscle planes. After about one year of the infection,

the female worm with the uterus filled with larvae, emerges usually from the

feet repeating the life cycle.

No drugs are currently available to prevent or heal this parasitic disease –

the only disease exclusively associated with unsafe drinking water.

Dracunculiasis is, however, extremely easy to combat and should no longer be

prevalent.

Dracunculiasis is rarely fatal. Frequently, however, the patient remain sick

for several months, mainly because:

Several worms are expelled successfully,

The migration and emergence of the worms occur in sensitive parts of the

body, e.g. the sole of the feet,

Serious secondary bacterial infection frequently sets in subsequent to the

accidental rupture of the worm.

Temporary disability can leave 58% unable to leave their beds for a month

during and after the emergence of the worm, as found by a longitudinal study in

Nigeria. This usually occurs during the peak agricultural activities and labour

is in a great demand, this can effect the nutritional status of their children.

In Sudan, households where more than half the adult members had suffered from

Guinea worm in one year, their under 6 year children were three times as likely

to be malnourished, as indicated by wasting. For that reason, considering only

the benefit of reducing incidence, the WB estimated 29% economic rate of return

for the global Guinea worm campaign which has cost US$ 90 millions todate.

However, this is only part of the cost as Guinea worm cause other negative

social and educational impact such as preventing infected people from engaging

into social activities and prohibit children from attending schools.

The epidemiology of the diseases is determined largely by the use of open

water sources such as ponds and sometimes shallow or step wells. Man-made ponds

such as hafirs in Sudan and small scale dams in West Africa are the main source

of transmission. The disease is seasonal occurring with two broad patterns found

in endemic areas of Africa depending upon climatic factors. In the Sahelian

zone, transmission generally occurs in the rainy season (May to August). In the

humid savanna and forst zone, the peak occurs in the dry season (September to

January). However, there are local variations in these patterns. Other risk

factors are mobility and infection the previous year.

Dracunculiasis is a vulnerable disease: man alone is responsible for

maintaining its fragile transmission cycle. It is therefore possible to

permanently curtail transmission by applying simple measures. Some elementary

steps include:

systematic filtering of drinking water derived from ponds and shallow

unprotected wells or from surface water. Finely-meshed cloth or, better still, a

filter made from a 0.15 mm nylon mesh, is all that is needed to filter out the

cyclops from the drinking water.

the construction of copings around well heads or the installation of

boreholes with handpumps. This would prevent not only dracunculiasis but also

diarrhoeal diseases.

If these measures are accepted and then administrated by village communities,

the ultimate goal will be achieved: the eradication of dracunculiasis .

http://www.who.int/ctd/dracun/disease.htm

 

 

" Respect means listening until everyone has been heard and understood, only

then is there a possibility of " Balance and Harmony " the goal of Indian

Spirituality. " Dave Chief, Grandfather of Red Dog

 

 

 

 

 

 

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