Guinea worm eradication program

Guinea worm eradication program

1. NATIONAL GUINEA
WORM ERADICATION
PROGRAMME

3. The Life Cycle of Guinea Worm Disease

@ The cycle starts...

Seeking relief from pain, sufferer soaks a
blister with exposed worm in nearby water
source. On contact with water, the worm 3 Another person drinks the water containing the water fleas
bursts, releasing hundreds of thousands of with the infective larvae. The water fleas are digested, releas-
immature first-stage larvae into the water. ing the larvae in the stomach.

@ The cycle continues...
4 The larvae, which resist diges-

tion, migrate to the small intestine
and penetrate the intestinal wall
into the body cavity, where they
grow into worms and mate.

5 Fertlized female
2 Tiny water fleas ingest the 5 worms, up 10 3 feet
larvae which, molt twice, long, move through

mt, ‘connective tissue to

oe various areas of the

LARVRE y body, usually the

lower limbs.

6 Approximately a year later, after the larvae were
ingested, the worm forms a painful blister near the skin
surface. The blister bursts, exposing the worm.

>

The Carter Center Graphic by Al Granberg

4. INTRODUCTION

*Dracunculosis or Guinea Worm (GW) disease is caused by the
nematode Dracunculus medinensis. The adult female guinea
worm, measuring 60-100 cm in length, emerges through the
skin, usually lower limbs, causing swelling, ulceration

and discomfort to the patients.

5. OF GUINEA WORM DISEAS

gent Factors + Environmental factors

; . : an Step wells: Summer , Ponds: June-
Dracunculus medinensis, nematode worm Sept, Temp:25-30 €
MNr2cm F-60-120cm
, + Mode of transmission
* Reservoir Oral: Consumption of water
Infected person

containing cyclops harboring the
infective parasite.

* Host factors
All ages, both sex susceptible

Repeated infection in same individual
(no immunity)

6. SIGN/SYMPTOMS :

> Intense burning pain localized t
path of travel of worm(the fiery
serpent).

> Fever

> Nausea

> Vomiting
Allergic reaction

7. > Arthritis and paralysis (due to
death of adult worm in joint),

> Skin blisters , which when
rupture form ulcers.

> Adult worms protrude from the
ulcers. |

9. rst country in the world to establish the
ational Guinea Worm Eradication Programme in 1983-84 as
a centrally sponsored scheme on 50-50 sharing between

Centre and States with the objective of eradicating
guinea worm disease from the country.

«The National Institute of Communicable Diseases (NICD),

Delhi worked as the nodal agency for planning,
coordination, guidance and evaluation of NGWEP in the
country.

10. IMPLEMENTATIO

c State Health Directorate through Primary Health Care
system implemented the programme.

« The Ministry of Rural Development, Govt. of India and State Public
Health Engineering Departments (Rural Water Supply) assist the
Programme in provision and maintenance of safe drinking water
supplies and conversion of unsafe drinking water sources, like step
wells, and ponds on priority in the guinea worm affected areas.

+ District Medical Officer and PHC medical Officer were responsible
for planning, implementation, monitoring and supervision of the
GWEP.

11. ually the Task Force Group under the chairmanship
of Director General of Health Services, Govt. of
India, reviewed the GWEP in depth.

«This task Force Group was constituted by:
a) Director and Deputy Director (Helminthology) of NICD
Delhi as convener and coordinator of the work
b) Directors of Health and Medical Services, GWEP-officers,
chief engineers (Rural Water Supply) of GW endemic states
c) Director/Advisor of National Water Mission as members
d) Experts from WHO, UNICEF, Centre Health Education Bureau

(CHEB), Planning Commission and related organizations.

12. ACHIEVEMENT

t the beginning of the programme i.e. in 1984,
there were around 40,000 GW cases in 12840 villages
in 89 districts of 7 endemic states.

«During 1996 only 9 guinea worm cases have been
recorded in three villages from Jodhpur (Rajasthan),
rest of the country continued to remain free from
GH.

*Banwari Lal 25 years old from Jodhpur in Rajasthan
was the last case in India in 1996 (Lancet 2000).

13. GUINEA WORM DISEASE FREE”

“Zero” incidence has been maintained since
August 1996 through active surveillance and
intensified field monitoring in the endemic
areas.

«In the Meeting of WHO in February 2000 the India
has been certified for the elimination of Guinea
Worm Disease and on /5th February 2001
declared India as “Guinea Worm Disease
Free”.

14. TREATMENT

* Niridazole, Mebandazole,
Metronidazole.

* These drugs no effect in
preventing transmission.

15. * Provision and maintenance of safe
drinking water supply on priority in
GW endemic villages

* Trained manpower development

and
e Intensive health education
e Concurrent evaluation and
operational research.

16. PREVENTION: Two preventive measu
are:

1.Prevent people from drinking
contaminated water containing the
cyclops which can be seen in clear wat
as swimming white specks . This can Al
done by using:

> Piped water

4 Water from borehole

17. > Boiled water.
>Filter all drinking water , using af
mesh cloth filter to remove the guin
worm containing crustaceans.
> Filter the water through ceramic or
sand filters.
Treat water sources with larvicides
kill the water fleas.

18. 2.Prevent people with emerging Gui
worms from wading into water source
used for drinking:
> Community-level case detection and'
containment is key. Staff must go door
to door looking for cases, and |
population must be willing to help ani
not hide their cases.

19. >Immerse emerging worms in buc
water to reduce the number of la
those worms and discard this watel
dry ground. |

> Guard local water sources to prevent
people with emerging worms from
entering.

20. Following activities are
continuing as per
recommendations of ICCDE:
>Health education activities with
special emphasis on school childre
and women in rural areas.

> Rumour registration and rumour
investigation.

21. >Maintenance of guineaworm
disease on list of notifiable disea
and continuation of surveillance
previously infected areas.
>Careful supervision of the
functioning of hand pumps and
other sources of safe drinking
water.