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 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 13  |  Issue : 3  |  Page : 149-150

2016 global update on dracunculiasis eradication: Where we stand? What else needs to be done?


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication4-Jul-2016

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2468-6859.185253

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. 2016 global update on dracunculiasis eradication: Where we stand? What else needs to be done?. J Clin Sci 2016;13:149-50

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. 2016 global update on dracunculiasis eradication: Where we stand? What else needs to be done?. J Clin Sci [serial online] 2016 [cited 2019 Aug 21];13:149-50. Available from: http://www.jcsjournal.org/text.asp?2016/13/3/149/185253

Sir,

Dracunculiasis is a parasitic disease caused by a nematode Dracunculus medinensis, which though not fatal, cripples infected people for several weeks. [1] The disease predominantly affects the disadvantaged sections of the community (viz. rural, poor socioeconomic status, and dearth of welfare/health services), who are dependent primarily on an open surface water source for drinking. [1]

Since the decision was taken by the World Health Organization to eliminate (early 80s) the disease, significant progress has been made. [2] In fact, in the mid-1980s, almost 3.5 million cases of the disease were reported from the 21 nations endemic for the disease; since then, owing to consistent efforts, especially in the fields of prompt case detection and management, vector control, and health education to avoid drinking contaminated water, filter water from open surface water before drinking, and no wading in water, only four African nations (viz., Chad, Mali, South Sudan, and Ethiopia) have reported 22 indigenous cases in the year 2015. [2],[3],[4]

To declare a nation free from the disease, the nation should report zero instances of transmission (viz. zero cases for 14 consecutive months), and continue surveillance for minimum 3 years from then. [2] Subsequently, an expert team evaluates the nation's surveillance quality, evaluates the response toward rumored cases, ensures the access to improved drinking water sources in the affected regions, and even assess the village to confirm the absence of transmission. [1],[5] In fact, till date, 198 countries-areas have been declared to be free of the disease. [2]

However, it is very important to understand that detection of even a single case will postpone global targets for elimination by 10-14 months (incubation period of the parasite). [2],[5] Further, nations like Ethiopia and Chad, which had earlier interrupted the transmission of the disease for more than 3 years, have reported re-emergence of the cases. Hence, despite achieving certification, nations should continue their surveillance until global eradication is declared. [1],[2]

Moreover, the road for the global eradication of dracunculiasis is not barrier-free, and challenges such asa major economic burden on the affected villages owing to the temporary disability attributed to the disease, secondary infection of the ulcers in most of the cases, limited access to medical care, little or no acquired immunity to this disease and thus definitive probability to acquire the infections on a recurrent basis, no availability of an effective anthelmintic medicine or even a vaccine, sustained monetary support (especially to locate the last few cases in remote rural areas), and detection of dog infections with the parasite in all the four nations which have reported indigenous transmission of the disease, have been identified. [2],[4],[5],[6],[7],[8]

Nevertheless, the disease is completely preventable and thereby eligible for eradication, with the help of interventions such as strengthening of the surveillance to detect every case within 24 h of worm emergence; adequate management/investigation of each of the rumored cases; proper management of the secondary infections; interrupting transmission through appropriate management of the lesion; counseling people to ensure behavior change; enhancing access to the improved drinking water source to prevent acquisition of infection; encouraging the use of temephos for vector control; and promoting research work to develop an effective anthelmintic drug or a vaccine, the disease can be definitely eradicated. [1],[2],[3],[4],[5],[7],[8]

To conclude, if the international stakeholders aim for the eradication of dracunculiasis and really wish to achieve that, there is a great need to coordinate eradication activities, maintain surveillance in the dracunculiasis-free areas, and monitor the ongoing process to implement corrective measures at the earliest.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Dracunculiasis (Guinea-worm disease) - Fact Sheet; 2016. Available from: . [Last accessed on 2016 Feb 04].  Back to cited text no. 1
    
2.
Monthly report on dracunculiasis cases, January-October. Wkly Epidemiol Rec 2015;90:711-2.  Back to cited text no. 2
    
3.
World Health Organization. Historic Low Number of Guinea Worm Cases Reported; 2016. Available from: . [Last accessed on 2016 Feb 04].  Back to cited text no. 3
    
4.
Litvinov SK, Migliorini L, Chernikova EA, Lutsevich OA. Global eradication of dracunculiasis is a reality nowadays. Med Parazitol (Mosk) 2014;2:3-5.  Back to cited text no. 4
    
5.
Hopkins DR, Ruiz-Tiben E, Eberhard ML, Roy SL. Progress toward global eradication of dracunculiasis, January 2014-June 2015. MMWR Morb Mortal Wkly Rep 2015;64:1161-5.  Back to cited text no. 5
    
6.
Ruiz-Tiben E, Hopkins DR. Dracunculiasis (Guinea worm disease) eradication. Adv Parasitol 2006;61:275-309.  Back to cited text no. 6
    
7.
Cairncross S, Muller R, Zagaria N. Dracunculiasis (Guinea worm disease) and the eradication initiative. Clin Microbiol Rev 2002;15:223-46.  Back to cited text no. 7
    
8.
Greenaway C. Dracunculiasis (Guinea worm disease). CMAJ 2004;170:495-500.  Back to cited text no. 8
    




 

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