Dracunculiasis , also called Guinea worm disease ( GWD ), is an infection by the Guinea worm. A person becomes infected when they drink water containing infected water fleas with the worm's guinea larvae. Initially there were no symptoms. About a year later, female worms form painful blisters on the skin, usually on the lower extremities. Other current symptoms may include vomiting and dizziness. The worm then emerged from the skin for several weeks. During this time, it may be difficult to walk or work. Very rarely this disease causes death.
In humans, the only known cause is Dracunculus medinensis . This worm has a width of one to two millimeters, and adult females are 60 to 100 centimeters (the male is much shorter at 12-29 mm or 0.47 to 1.14 inches). Outside humans, young shapes can last up to three weeks, where they should be eaten by water fleas to keep growing. Larvae in water fleas can survive for up to four months. Thus, in order for the disease to remain in an area, it must occur every year in humans. Diagnosis of the disease can usually be made based on signs and symptoms.
Prevention is by early diagnosis of disease followed by keeping people from putting wounds in drinking water to reduce the spread of parasites. Other efforts include increasing access to clean water and if not filtering water if it is not clean. Filtering through the fabric is often enough to remove water fleas. Contaminated drinking water can be treated with a chemical called temefos to kill the larvae. There is no cure or vaccine against this disease. The worm can be slowly removed for several weeks by rolling it on a stick. Ulcers formed by worms that appear can be infected by bacteria. Pain may continue for months after the worm has been removed.
By 2015 there are 22 cases of disease reported while in 2016 there are 25. This fell from an estimated 3.5 million cases in 1986. By 2016 the disease occurs in three countries, all in Africa, down from 20 countries in 1980 -an. This is likely to be the first parasite disease that is globally eradicated. Guinea worm disease has been known since ancient times. The method of removing worms is described in Egyptian medical papersrus Ebersrus, dating from 1550 BC. The name dracunculiasis comes from the Latin "suffering with small dragons", while the name "guinea worm" came after Europeans saw the disease on the coast of Guinea West Africa in the 17th century. Other Dracunculus species are known to infect various mammals, but do not appear to be infecting humans. Dracunculiasis is classified as neglected tropical diseases. Because dogs can also be infected, eradication programs also monitor and care for dogs.
Video Dracunculiasis
Signs and symptoms
Dracunculiasis is diagnosed by looking at the worms that arise from lesions on the feet of the infected person and by microscopic examination of the larvae.
As the worm moves downward, usually to the lower leg, through the subcutaneous tissues, this causes severe pain to be localized to the pathway. The burning sensation experienced by an infected person has caused a disease called "fiery fiery". Other symptoms include fever, nausea, and vomiting. Female worms cause an allergic reaction during blister formation as they migrate to the skin, causing pain to burn. The allergic reaction produces rash, nausea, diarrhea, dizziness, and localized edema. When the blisters blister, the allergic reaction subsides, but a skin ulcer is formed, through which the worm can stand out. Only when the worm is removed the healing is complete. The death of adult worms in the joints can cause arthritis and paralysis in the spinal cord.
The pain caused by the appearance of worms - which usually occurs during the growing season and harvest - prevents many people from working or attending school for three months. In heavily overburdened agricultural villages fewer people are able to care for their fields or livestock, resulting in less food and lower income. A study in southeastern Nigeria, for example, found that small farmers in a small area lost US $ 20 million in just one year due to Guinea worm disease outbreaks.
Maps Dracunculiasis
Cause
Dracunculiasis is caused by drinking water contaminated by water fleas that host the larval D. medinensis . Dracunculiasis has a very common history in some of the poorest areas of the world, especially those with limited access or no clean water. In these areas, stagnant water sources may still host copepods, which may carry guinea worm larvae.
After swallowing, the copepod is dead and digested, releasing stage 3 larvae, which then penetrate the stomach or intestinal wall, and then into the abdominal cavity and retroperitoneal space. After maturation, which takes about three months, the marriage takes place; Male worms die after mating and are absorbed by the host's body.
About a year after mating, the fertilized females migrate in subcutaneous tissue adjacent to long bones or limb joints. They then move to the surface, producing abrasions on the skin, generally on the distal lower extremities (legs). Within 72 hours, a blister ruptures, showing one end of the worm that appears. The blisters cause a very painful burning sensation when the worms appear, and the sufferer will often immerse the affected limbs in the water to relieve the burning sensation. When blisters or open sores are submerged in water, adult women release hundreds of thousands of guinea larvae worm larva 1, thus polluting the water.
Over the next few days, the female worm can release more larvae every time it comes into contact with water, as it dilates its posterior end through a hole in the host's skin. The larvae are eaten by copepods, and after two weeks (and two moles), the 3rd stage larvae become infectious and, if not filtered from drinking water, will cause repetitive cycles. Infected copepods can live in water for up to four months.
Male guinea worms are usually much smaller (12-29 mm or 0.47-1.14 inches) than females, which, as adults, can grow up to 60-100 cm (2-3 feet) and thick spaghetti noodles.
Infection does not create immunity, so people can repeatedly experience Dracunculiasis throughout their lives. Some worms may appear simultaneously; average 1.8. Up to 14 worms have been reported on one individual.
In the drier areas south of the Sahara desert, cases of this disease often occur during the rainy season, which for many agricultural communities is also a growing or harvesting season. Elsewhere, worms that appear are more common during the dry season, when ponds and lakes are smaller and copepods are thus more concentrated in them. Guinea worm disease outbreaks can cause serious disruptions to local food supplies and school attendance.
Infection can be obtained by eating hosted parataotic fish, but this is rare. No reservoir host is known; that is, every generation of worms must pass through humans - or maybe a dog.
Host
Up to now humans and water lice ( Cyclops ) are considered the only animals infected with this parasite. It has been shown that baboons, cats, dogs, frogs and catfish ( Synodontis ) can also be naturally infected. Ferrets have been experimentally infected.
Prevention
Guinea worm disease can be spread only by drinking contaminated water, and can be completely prevented through two relatively simple steps:
- Prevents people from drinking contaminated water that contains copepods Cyclops (water fleas), which can be seen in clear water as white swim spots.
- Drink water taken from a source free from contamination.
- Filter all the drinking water, using a filter of fine cloth like nylon, to remove the shell containing guinea corm. Ordinary cotton fabrics folded several times is an effective filter. Portable plastic straws containing nylon filters have proven popular.
- Filter water through ceramic or sand filters.
- Boil water.
- Develop new sources of drinking water without parasites, or repair non-functioning water sources.
- Treat water sources with larvicides to kill water fleas.
- Prevent people with Guinea worms from emerging from water sources used for drinking.
- Case detection and community level case detention are the key. For this, staff should go door to door looking for cases, and residents should be willing to help and not hide their case.
- Insert the worms that appear in a bucket of water to reduce the number of larvae in the worm, then dispose of it on dry ground.
- Cancel all members of the community to set foot in the water source.
- Keep local water sources to prevent people with worms coming in.
Treatment
There is no vaccine or drug to treat or prevent Guinea worm disease. Untreated cases can lead to secondary infections, defects and amputations. Once Guinea worms begin to emerge, the first step is to conduct a controlled dipping of the affected area in a bucket of water. This causes the worm to release many larvae, making it less contagious. Water is then dumped in soil away from water sources. Immersion produces a subjective relief from the burning sensation and makes further extraction of the worms easier. To extract the worms, one must wrap live worms around a piece of gauze or a stick. This process can take several weeks. Massaging the area around the blisters gently can help loosen worms. This is a similar treatment recorded in the famous ancient Egyptian medical texts, Ebers papyrus of c. 1550 BC. Some say that extracting a Guinea worm feels like an area suffering from burning. However, if the infection is identified before the ulcer form, this worm can also be surgically removed by a trained doctor at a medical facility.
Although Guinea worm disease is usually not fatal, the wound in which the worms appear can develop secondary bacterial infections such as tetanus, which can be life-threatening - anxiety in endemic areas where there is usually limited or no access to health care. Analgesics can be used to help reduce swelling and pain and antibiotic ointment may help prevent secondary infections at wound sites. At least in the northern region of Ghana, the Guinea worm team found that antibiotic ointment on the wound site caused the wounds to heal too well and too quickly making it harder to extract the worms and more likely to attract would break the worms. Local teams prefer to use something called "Tamale oil" (after the regional capital) which lubricates the worms and helps the extraction.
It's important not to break the worm when pulling it out. Broken worms have a tendency to rot or petrify. Decay leads to skin peeling around the worms. The problem is the problem if the worm is in the joint or wrapping the vein or other important areas.
The use of metronidazole or thiabendazole can make extraction easier, but it can also cause migration to other parts of the body.
Epidemiology
In 1986, there were an estimated 3.5 million cases of Guinea worms in 20 endemic countries in Asia and Africa. The number of cases has decreased by more than 99.999% to 30 by 2017 in the four remaining countries in Africa: Southern Sudan, Chad, Mali and Ethiopia.
Endemic countries should document the absence of genuine Guinea worm cases for at least three consecutive years to be certified as Guinea-free worms. The results of this certification scheme are remarkable: by 2017, 15 countries previously endemic - Benin, Burkina Faso, Cameroon, Central African Republic, Cote d'Ivoire, Ghana, India, Mauritania, Niger, Nigeria, Pakistan, Senegal, Togo, Uganda and Yemen - has been certified to eradicate the disease.
Current situation
In 2017, 30 human cases were reported - 15 in Chad and 15 in Ethiopia; 13 of which are fully contained. For the first time, South Sudan reported no human infections during a calendar year: the latest reported cases occurred on November 20, 2016. No human cases were reported in Mali for the second year in a row. In addition to human cases, Chad reported 817 infected dogs and 13 domestic domesticated cats, and Ethiopia reported 11 infected dogs and 4 infected baboons. Although there is no infection in humans, Mali reported 9 infected dogs and 1 infected cat.
By 2018 at the end of February only one case was reported worldwide and it happened in Chad.
Endemic country
By the end of 2015, South Sudan, Mali, Ethiopia, and Chad still have endemic transmissions. Over the years, the main focus is South Sudan (independence after 2011, formerly southern Sudan), which reports 76% of all cases by 2013. In 2017 only Chad and Ethiopia have cases.
Eradication program
Since humans are the main host for Guinea worms, and there is no evidence that D. medinensis ever introduced to humans in a previously endemic state as a result of non-human infection, the disease can be controlled by identifying all cases and modify human behavior to prevent it from recurring. Over the years, eradication programs have faced several challenges:
- Insufficient security in some endemic countries
- Lack of political will from leaders of some countries where the disease is prevalent
- The need for behavioral changes in the absence of magic bullet treatments such as vaccines or drugs
- Insufficient funding at certain times
- Transmission of newly identified guinea worms via non-human hosts (both pets and wild animals)
History
Dracunculiasis has been a recognized disease for thousands of years:
- Guinea worms have been found in calcified Egyptian mummies.
- The Old Testament description of the "flaming serpent" may refer to the Guinea worm: "And the Lord sends fiery serpents among the people, and they bite the people, and many Israelites die." (Numbers 21: 4-9).
- In the 2nd century BC, the Greek author Agatharchides described this suffering as endemic among certain nomads in what is now Sudan and along the Red Sea.
- In the 18th century, the Swedish naturalist Carl Linnaeus identified D. medinensis in merchants who traded along the Gulf of Guinea (West African Coast).
- The Worm of Guinea was described by Oliver Wendell Holmes Sr as "[digging] into the bare foot of a West Indian slave..."
It has been suggested that Rod of Asclepius (a symbol representing medical practice) is a worm wrapped around a stem. According to this theory, doctors may advertise this public service by posting a mark that describes worms in the stem. But it makes sense, there is no concrete evidence to support this theory.
Russian scientist Alexei Pavlovich Fedchenko (1844-1873) during the 1860s while living in Samarkand was given a number of specimens of worms by a local doctor whom he kept in water. When checking the worm Fedchenko noted the presence of water fleas with embryo guinea worms in it.
In modern times, the first to describe dracunculiasis and its pathogenesis was the Bulgarian physician Hristo Stambolski, during his exile in Yemen (1877-1878). He correctly concluded that the cause is the infected water that people drink.
Etymology
Dracunculiasis once infected many tropical countries in Africa and Asia. His Latin name, Dracunculus medinensis ("small dragon of Medina"), originated from a one-time high incident in the city of Medina, and the common name, Guinea worm, was due to a similar incident high along the coast of Guinea West Africa; Guinea worms are no longer endemic in any of the locations.
Other animals
In March 2016, the World Health Organization held a scientific conference to study the emergence of cases of dog infection. Worms are genetically indistinguishable from Dracunculus medinensis that infects humans. The first case reported in Chad in 2012; by 2016, there are more than 1,000 cases of dogs with worms that appear in Chad, 14 in Ethiopia, and 11 in Mali. It is unclear whether dog and human infections are linked. It is possible that dogs can spread the disease to humans, that a third organism may be able to pass it on to dogs and people, or that this may be a different kind of Dracunculus . The current epidemiological pattern of human infection (per 2014) in Chad appears to be different, with no sign of any clustering of cases around a particular village or water source, and lower number of worms per individual.
References
External links
- "Guinea Worm Disease Recovery Program".
- Nicholas D. Kristof of the New York Times follows a young Sudanese boy with Guinea Cacing parasite infection quarantined for treatment as part of Carter's program
- Tropical Tropical Tropical Resources: "Guinea Worm Infection (Dracunculiasis)"
- World Health Organization about Dracunculiasis
Source of the article : Wikipedia
0 Comments