Guinea worm infection of urinary bladder manifesting as obstructive uropathy in rural Maharashtra.

Guinea worm or Dracunculus medinensis is a well-documented helminthic infestation in many areas of Asia. In this report, we describe a rare case of guinea worm infestation in a 25-year-old woman who had developed symptoms of obstructive uropathy, in whom fragments of guinea worm were removed after urethral catheterization. To the best of our knowledge, adult guinea worm occurring in the urinary bladder has not been previously described.

Guinea worm cause of adult onset asthmatic attack, a radiological diagnosis.

A case report of a fifty years old Hausa male from Sokoto town, Nigeria an endemic region of guinea worm infestation, who presented with sudden adult onset of asthmatic attack and was evaluated radiologically and the diagnosis of acute obstructive airway disease was confirmed. It was noted, that there were associated calcified chain of guinea worms in the lung parenchyma. A rare association of acute asthmatic attack. Patient responded there-after to an anti-asthmatic regime of management.

Impact of guineaworm disease on agricultural productivity in Owo local government area, Ondo state.

Of the 500 Cocoa farmers infected with guineaworm in Amurin, 74.3% of the farmers were incapacitated for 3 months without going to their farms while 25.7% mostly those who sought the orthodox form of treatment were incapacitated for about 4 weeks. This resulted in the loss of 9,566 bags of the potential harvest of the farmers which translates to N2,442,000.00 for the period. The sustantial part of this loss was from cocoa (N1, 570,000.00), a major export crop in Nigeria. The losses experienced were as a result of inability to plant and supervise the farm. An average of 45,000 mandays were lost due to guineaworm infection at a value of N54.27 k per individual for incapacitation for a day and a farmer infected with guineaworm loses 19 bags of his potential harvest within the infection duration, which translates to N4,884.00. Guineaworm disease is a major preventable cause of agricultural work loss and significant impediment to agriculture, the dominant occupation in Nigeria, which implies that guineaworm disease poses large threat to food availability.

An introduction to guinea worm on the eve of its departure: dracunculiasis transmission, health effects, ecology and control.

A broad ranging discussion of the basic nature of guinea worm disease, fused with personal field observations in Ghana, shows its long-overlooked serious clinical aspects, and the many environmental and social influences that explain its persistence in the face of control efforts. It is a disease of neglect par excellence in remote rural areas. The global eradication campaign (which is not reviewed here) may be expected to come to closure over the next half decade. This account offers an overview, synthesis, and interpretation of a fascinating example in disease ecology at the time of its global vanishing.

The effect of antibiotic- and hydrocortisone-containing ointments in preventing secondary infections in guinea worm disease.

A randomized, single-blind, controlled study comparing the efficacy of an ointment containing two antibiotics, one containing one antibiotic plus hydrocortisone, and no treatment in reducing secondary infections in patients with patent Guinea worm was undertaken in the northern region of Ghana. Seventy-seven patients were included. Time to complete healing was significantly shorter in the treatment groups compared with the controls (P = 0.044 and P = 0.003, respectively). Secondary infections occurred more often in the controls (P = 0.00014). Ointments containing antibiotics are recommended for application at the early stage of patent Guinea worm infection.

Dermatologic manifestations of parasitic diseases.

The skin being exposed to the environment is commonly the portal of entry for parasites. Infections with parasites characteristically produce cutaneous lesions as well as systemic disease in humans. In the past, parasitic diseases were limited to their endemic areas. With the relative ease of worldwide travel, however, they are appearing with increasing frequency in the United States and other developed countries. This article describes the characteristic cutaneous findings of parasitic diseases that physicians in the United States may encounter in their medical practice.

Long-term disability due to guinea worm disease.

The village-based surveillance system for guinea worm disease (dracunculiasis), which has been established in all endemic villages in Ghana, was used to carry out a retrospective study of long-term disability due to the disease. A sample of 195 cases was interviewed and examined, 12-18 months after emergence of the worm. Currently continuing pain when walking or working, attributable by its location and date of onset to the episode of dracunculiasis, was reported by 55 persons (28.2%). Some difficulty in performing at least one of 6 everyday physical activities, attributable after careful interview to the episode, was reported by 66 respondents (34.0%), of whom 10 (5.1%) were unable to carry out one of the activities. In one case, the disease had caused impairment of movement of the joints of the right thumb. The prevalence of serious permanent physical impairment among the cases in the study was thus 0.5%.

Surgical extraction of guinea worm: disability reduction and contribution to disease control.

Surgical extraction of Guinea worm prior to eruption through the skin has long been performed by traditional healers in India. Using modern aseptic techniques under local anesthesia, unerupted worms can be completely and painlessly removed in several minutes. As a result, the average number of working days lost due to a single worm is reduced from three weeks or more to three days. In the field, the procedure results not only in a dramatic decrease in Guinea worm associated disability, but also in an improvement in detecting cases, and appears to reduce disease transmission.

[Knee contusion with an interesting incidental finding]. / Eine Kniekontusion mit interessantem Zufallsbefund.

During examination of a 42 year old male patient from Mauretania with an injured knee in the emergency ward, a dracunculiasis - Guinea worm disease - was incidentally diagnosed. As travelling is generally increasing, this disease might be encountered more frequently also in Europe.

Two unusual predisposing factors for diabetic pedal ulceration in Nigerians.

Two unusual predisposing factors to indolent foot ulceration seen in Nigerian diabetic patients are presented. These are guinea-worm infestation (dracontiasis) affecting the dorsum of the foot and lichenification with fissuring of the sole of the foot during the cool, dry weather of the harmattan season. These two preventable and treatable conditions are widely prevalent in sub-Saharan African countries. While there was severe hyperglycaemia in both cases, one was associated with diabetic ketoacidosis and resulted in limb amputation. Both patients stayed 4-5 months in hospital. A case is made for early recognition and specific management of these lesions to prevent undue morbidity and prolonged hospitalisation.

Disability from dracunculiasis: effect on mobility.

A study was conducted in northeastern Imo State to define the disability and restriction of mobility associated with dracunculiasis. The study was part of an evaluation of the UNICEF-assisted Drinking Water Supply and Sanitation Project in Imo State, Nigeria. A sample of household units (100 in year 1, 195 in year 2) was visited every two weeks to determine who was affected by dracunculiasis and to characterize the extent of related disability. The average duration of symptoms was 12.7 weeks (range 3-29 weeks). Fifty eight per cent of all episodes of disease resulted in severe disability (with the individual unable to leave the compound) lasting a mean of 4.2 weeks (range 2-12). The mean period of severe disability was significantly higher for those aged 50 years and over than for those less than 50 years old. In the area studied, the disease occurred during the peak yam and rice harvest time and the period of preparation for the planting season. This is the first study to document systematically and prospectively the marked restriction of normal activity in affected individuals and the long duration of the disability. These findings can assist in improving estimates of the costs associated with dracunculiasis and of potential economic benefits if the disease were eradicated.

Guinea worm: an in-depth study of what happens to mothers, families and communities.

This paper reports on the impact of maternal morbidity due to guinea worm, dracunculiasis, on the care and health of children under 24 months old, and the way in which the mothers and the family coped with the often extended periods of disability. This qualitative study is based on observation and in-depth interviewing, supplemented by focus group discussions. Of 42 mothers with guinea worm in two hyperendemic areas of Oyo and Kwara States, 28 were either bedridden or only able to hobble short distances with the help of a stick; the average period of incapacity was almost 9 weeks. Of the four maternal roles identified (child care, self care, domestic tasks, income generation), the women gave priority to child care; 34 of the 42 mothers needed help in child care. Coping networks operated principally within the extended family, but also included women in other households, and women from beyond the community. Thus the impact of a mother's illness extended beyond her children and family to the wider community. This qualitative study thus reveals the multifaceted impact of a disease on individuals and on the community. The study stresses the need for, and availability of, effective methods for controlling guinea worm by utilizing community cooperation to provide protected water sources and other preventive measures against the disease.