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3.
MMWR Morb Mortal Wkly Rep ; 69(43): 1563-1568, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33119555

RESUMEN

Dracunculiasis (Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination. Other interventions to prevent infection include health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). The worldwide eradication campaign began in 1980 at CDC (1). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly (WHA) called for dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with dracunculiasis. This report, based on updated health ministry data (4), describes progress made during January 2019-June 2020 and updates previous reports (2,4,5). With only 54 human cases reported in 2019, 19 human cases reported during January 2019-June 2020, and only six countries currently affected by dracunculiasis (Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon), the achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic concerns, including 2,000 reported animal cases in 2019 and 1,063 animal cases in 2020, mostly in dogs. All national GWEPs remain fully operational, with precautions taken to ensure safety of program staff members and community members in response to the coronavirus disease 2019 (COVID-19) pandemic.


Asunto(s)
Erradicación de la Enfermedad , Dracunculiasis/prevención & control , Salud Global/estadística & datos numéricos , Animales , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Perros , Dracunculiasis/epidemiología , Dracunculiasis/veterinaria , Humanos
4.
Am J Trop Med Hyg ; 103(5): 1942-1950, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32901603

RESUMEN

The campaign to eradicate dracunculiasis (Guinea worm [GW] disease) and its causative pathogen Dracunculus medinensis (GW) in Chad is challenged by infections in domestic dogs, which far outnumber the dwindling number of human infections. We present an agent-based simulation that models transmission of GW between a shared water source and a large population of dogs. The simulation incorporates various potential factors driving the infections including external factors and two currently used interventions, namely, tethering and larvicide water treatments. By defining and estimating infectivity parameters and seasonality factors, we test the simulation model on scenarios where seasonal patterns of dog infections could be driven by the parasite's life cycle alone or with environmental factors (e.g., temperature and rainfall) that could also affect human or dog behaviors (e.g., fishing versus farming seasons). We show that the best-fitting model includes external factors in addition to the pathogen's life cycle. From the simulation, we estimate that the basic reproductive number, R 0, is approximately 2.0; our results also show that an infected dog can transmit the infection to 3.6 other dogs, on average, during the month of peak infectivity (April). The simulation results shed light on the transmission dynamics of GWs to dogs and lay the groundwork for reducing the number of infections and eventually interrupting transmission of GW.


Asunto(s)
Simulación por Computador , Enfermedades de los Perros/transmisión , Dracunculiasis/veterinaria , Dracunculus/fisiología , Animales , Chad/epidemiología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Perros , Dracunculiasis/epidemiología , Dracunculiasis/parasitología , Dracunculiasis/transmisión , Dracunculus/crecimiento & desarrollo , Ambiente , Femenino , Estadios del Ciclo de Vida , Modelos Teóricos , Estaciones del Año , Temperatura , Agua
5.
PLoS Negl Trop Dis ; 14(9): e0008620, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32925916

RESUMEN

Few human infectious diseases have been driven as close to eradication as dracunculiasis, caused by the Guinea worm parasite (Dracunculus medinensis). The number of human cases of Guinea worm decreased from an estimated 3.5 million in 1986 to mere hundreds by the 2010s. In Chad, domestic dogs were diagnosed with Guinea worm for the first time in 2012, and the numbers of infected dogs have increased annually. The presence of the parasite in a non-human host now challenges efforts to eradicate D. medinensis, making it critical to understand the factors that correlate with infection in dogs. In this study, we evaluated anthropogenic and environmental factors most predictive of detection of D. medinensis infection in domestic dog populations in Chad. Using boosted regression tree models to identify covariates of importance for predicting D. medinensis infection at the village and spatial hotspot levels, while controlling for surveillance intensity, we found that the presence of infection in a village was predicted by a combination of demographic (e.g. fishing village identity, dog population size), geographic (e.g. local variation in elevation), and climatic (e.g. precipitation and temperature) factors, which differed between northern and southern villages. In contrast, the presence of a village in a spatial infection hotspot, was primarily predicted by geography and climate. Our findings suggest that factors intrinsic to individual villages are highly predictive of the detection of Guinea worm parasite presence, whereas village membership in a spatial infection hotspot is largely determined by location and climate. This study provides new insight into the landscape-scale epidemiology of a debilitating parasite and can be used to more effectively target ongoing research and possibly eradication and control efforts.


Asunto(s)
Enfermedades de los Perros/epidemiología , Dracunculiasis/epidemiología , Dracunculiasis/veterinaria , Animales , Chad/epidemiología , Clima , Erradicación de la Enfermedad/estadística & datos numéricos , Enfermedades de los Perros/parasitología , Perros , Dracunculiasis/transmisión , Dracunculus/aislamiento & purificación , Geografía , Aprendizaje Automático
8.
PLoS Negl Trop Dis ; 14(5): e0008207, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32463811

RESUMEN

After a ten-year absence of reported Guinea worm disease in Chad, human cases were rediscovered in 2010, and canine cases were first recorded in 2012. In response, active surveillance for Guinea worm in both humans and animals was re-initiated in 2012. As of 2018, the Chad Guinea Worm Eradication Program (CGWEP) maintains an extensive surveillance system that operates in 1,895 villages, and collects information about worms, hosts (animals and humans), and animal owners. This report describes in detail the CGWEP surveillance system and explores epidemiological trends in canine Guinea worm cases during 2015-2018. Our results showed an increased in the number of canine cases detected by the system during the period of interest. The proportion of worms that were contained (i.e., water contamination was prevented) improved significantly over time, from 72.8% in 2015 to 85.7% in 2018 (Mantel-Haenszel chi-square = 253.3, P < 0.0001). Additionally, approximately 5% of owners of infected dogs reported that the dog had a Guinea worm-like infection earlier that year; 12.6% had a similar worm in a previous year. The proportion of dogs with a history of infection in a previous year increased over time (Mantel-Haenszel chi-square = 18.8, P < 0.0001). Canine cases were clustered in space and time: most infected dogs (80%) were from the Chari Baguirmi (38.1%) and Moyen Chari Regions (41.9%), and for each year the peak month of identified canine cases was June, with 78.5% occurring during March through August. Findings from this report evoke additional questions about why some dogs are repeatedly infected. Our results may help to target interventions and surveillance efforts in terms of space, time, and dogs susceptible to recurrent infection, with the ultimate goal of Guinea worm eradication.


Asunto(s)
Enfermedades de los Perros/epidemiología , Dracunculiasis/veterinaria , Dracunculus/aislamiento & purificación , Animales , Chad/epidemiología , Enfermedades de los Perros/parasitología , Perros , Dracunculiasis/epidemiología , Dracunculiasis/parasitología , Dracunculus/clasificación , Dracunculus/genética , Monitoreo Epidemiológico , Femenino , Humanos , Masculino
10.
PLoS Negl Trop Dis ; 14(4): e0008170, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32310976

RESUMEN

Global eradication of human Guinea worm disease (dracunculiasis) has been set back by the emergence of infections in animals, particularly domestic dogs Canis familiaris. The ecology and epidemiology of this reservoir is unknown. We tracked dogs using GPS, inferred diets using stable isotope analysis and analysed correlates of infection in Chad, where numbers of Guinea worm infections are greatest. Dogs had small ranges that varied markedly among villages. Diets consisted largely of human staples and human faeces. A minority of ponds, mostly <200 m from dog-owning households, accounted for most dog exposure to potentially unsafe water. The risk of a dog having had Guinea worm was reduced in dogs living in households providing water for animals but increased with increasing fish consumption by dogs. Provision of safe water might reduce dog exposure to unsafe water, while prioritisation of proactive temephos (Abate) application to the small number of ponds to which dogs have most access is recommended. Fish might have an additional role as transport hosts for Guinea worm, by concentrating copepods infected with worm larvae.


Asunto(s)
Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Dracunculiasis/epidemiología , Dracunculiasis/veterinaria , Dracunculus/patogenicidad , Ecología , Animales , Chad/epidemiología , Dieta , Reservorios de Enfermedades/veterinaria , Perros , Composición Familiar , Heces/parasitología , Femenino , Peces , Humanos , Agua
12.
Int J Infect Dis ; 95: 216-220, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32173575

RESUMEN

INTRODUCTION: The global Guinea Worm Eradication Program has reduced numbers of human infections of Guinea worm disease (dracunculiasis) to 49 cases in four countries. However, infections of domestic animals (dogs and cats) have recently been recognized and are increasing. Typically, Guinea worm (Dracunculus medinensis) transmission occurs via the ingestion of copepods from water. Despite several interventions, including tethering of dogs while worms emerge, the number of infected dogs continue to increase. One hypothesis is that dogs could be infected through the ingestion of copepods in provisioned water. OBJECTIVES: The purpose of this study was to determine whether copepods can survive in water containers under typical Chadian temperatures. METHODS: Four container types (plastic, glass, gourd, and metal) were seeded with copepods and exposed to simulated Chadian temperatures. RESULTS: All copepods in the metal containers died within 4 h. Conversely, after 8 h live copepods were still present in plastic, glass, and gourd containers. CONCLUSIONS: If provisioned water is provided to potential hosts of D. medinensis, metal containers create the most inhospitable environment for copepods. Plastic containers have little effect on copepod mortality. The use of metal containers for water provisions could be a useful tool assisting with the interruption of D. medinensis transmission among dogs.


Asunto(s)
Copépodos/parasitología , Enfermedades de los Perros/transmisión , Dracunculiasis/veterinaria , Animales , Chad , Enfermedades de los Perros/parasitología , Perros , Dracunculiasis/transmisión , Dracunculus , Control de Infecciones , Agua
14.
Sci Rep ; 10(1): 1430, 2020 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-31996759

RESUMEN

Dracunculus medinensis, the causative agent of Guinea worm disease in humans, is being reported with increasing frequency in dogs. However, the route(s) of transmission to dogs is still poorly understood. Classical transmission to humans occurs via drinking water that contains cyclopoid copepods infected with third stage larvae of D. medinensis, but due to the method of dog drinking (lapping) compared to humans (suction and/or retrieval of water into containers), it seems unlikely that dogs would ingest copepods readily through drinking. We exposed lab raised beagles to varying densities of uninfected copepods in 2 liters of water to evaluate the number of copepods ingested during a drinking event. We confirmed dogs can ingest copepod intermediate hosts while drinking; however, low numbers were ingested at the densities that are typically observed in Chad suggesting this transmission route may be unlikely. Overall, the relative importance of the classic transmission route and alternate transmission routes, such as paratenic and transport hosts, needs investigation in order to further clarify the epidemiology of guinea worm infections in dogs.


Asunto(s)
Perros , Dracunculiasis/transmisión , Dracunculus/fisiología , Animales , Chad/epidemiología , Control de Enfermedades Transmisibles , Copépodos , Vectores de Enfermedades , Dracunculiasis/epidemiología , Ingestión de Alimentos , Femenino , Humanos , Masculino
16.
Natl Med J India ; 32(1): 22-23, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31823935

RESUMEN

Dracunculiasis or guinea-worm infection is a water-borne, parasitic disease that can cause major morbidity. Dracunculiasis in patients with diabetes can be misdiagnosed as a diabetic foot abscess, which is a common complication of poorly controlled diabetes. This is a report of guinea-worm disease (GWD) in a 57-year-old man with diabetes from a rural area of Kerala. There is need for awareness among physicians about the occurrence of GWD in people with diabetes and the need to ensure supply of safe drinking water to prevent its re- emergence. Though WHO has declared India free of GWD, a few cases have been reported from the country.


Asunto(s)
Absceso/diagnóstico , Diabetes Mellitus Tipo 2/complicaciones , Pie Diabético/diagnóstico , Dracunculiasis/diagnóstico , Dracunculus/aislamiento & purificación , Absceso/parasitología , Animales , Pie Diabético/etiología , Diagnóstico Diferencial , Dracunculiasis/parasitología , Agua Potable/parasitología , Pie , Humanos , India , Masculino , Persona de Mediana Edad
18.
MMWR Morb Mortal Wkly Rep ; 68(43): 979-984, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31671082

RESUMEN

Dracunculiasis (also known as Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination and other interventions to prevent infection, including health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). In 1986, with an estimated 3.5 million cases† occurring each year in 20 African and Asian countries§ (3), the World Health Assembly called for dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by The Carter Center and supported by the World Health Organization (WHO), CDC, the United Nations Children's Fund, and other partners, began assisting ministries of health in countries with dracunculiasis. This report, based on updated health ministry data, describes progress to eradicate dracunculiasis during January 2018-June 2019 and updates previous reports (2,4,5). With only five countries currently affected by dracunculiasis (Angola, Chad, Ethiopia, Mali, and South Sudan), achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic questions.


Asunto(s)
Erradicación de la Enfermedad , Dracunculiasis/prevención & control , Salud Global/estadística & datos numéricos , Dracunculiasis/epidemiología , Humanos
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