Walden University Public Health Waterborne Infectious Diseases Prevention of Guinea Worm and Post Guinea Worm Eradication Management Presented by Daniel Yawo Akrodou Walden University Public Health Ph.D. Student Ladies and Gentlemen, Welcome to The Waterborne Infectious Disease Guinea Worm Prevention presentation. I am Daniel Yawo Akrodou student at Walden University in Public Health Epidemiology Ph.D.Program. Thank you for coming.

Waterborne Disease Definition Waterborne infectious diseases are caused by the ingestion of water contaminated by human or animal excrements, which contain pathogenic microorganisms Examples : Guinea Worm, Schistosomiasis, and Intestinal Nematode. Waterborne infectious diseases, generally they are caused by the ingestion of water contaminated by human or animal excrements, which contain pathogenic microorganisms. These are some examples: Guinea Worm, Schistosomiasis, Malaria, and Intestinal Nematode.

Contaminated Water with dangerous germs.

Schistosomiasis Schistosomiasis Life Cycle, worms at different stages and diseases manifestation

Intestinal Nematode Intestinal Nematode Life Cycle and worm in stomach.

Waterborne Infectious Diseases Social Impacts Waterborne diseases cause 39% of diarrheal diseases 3.5 to 18 million children deaths per year worldwide. Malaria represents 14% of waterborne diseases 526 million deaths per year Waterborne diseases create enormous health problems and cause millions deaths worldwide, every year. For example, they cause 39% of diarrheal diseases which are responsible for 3.5 to 18 million children deaths per year. Malaria represents 14% of waterborne diseases and causes 526 million deaths per year. Others such as intestinal nematode, trachoma, schistosomia, and guinea worm affect million of people per year.

Waterborne Infectious Diseases Social Impacts Intestinal nematode 2% of waterborne diseases( ascariasis, trichuriasis and hookworm) 2 billion of infections per year world wide Trachoma 2%, schistosomiasis and Guinea worm 1% of waterborne diseases Affect 1 million of people per year Others such as intestinal nematode, trachoma, schistosomia, and guinea worm affect million of people per year also.

Overview of Guinea Worm Guinea worm disease is a parasitic disease transmitted through drinking water contaminated with infected water fleas. Guinea worm exits through the body after one year growth, causing painful blisters in the skin (The Carter Center, 2008). Let learn about typical waterborne infectious diseases’ life cycle, symptoms and its effective prevention. Example Guinea worm. It is a parasitic disease transmitted through drinking water contaminated with infected water fleas. Guinea worm exits through body after one year growth, causing painful blisters in the skin.

Guinea Worms Guinea Worm germs, larvae and full grown female exiting the body.

Fully Grown Female Guinea Worm It can reach 3 feet long in one year ! This is a fully grown female guinea worm in the body after one year growth, it can reach 3 feet.

Guinea Worm Symptoms Once ingested, the female worm grows up to 3 feet in one year and causes when ready to exit fever, nausea, chills, lethargy followed by painful skin ulcers when the worm emerges Once ingested the female worm grows up to a 3 feet in one year and causes when ready to exit fever, nausea, chills, and lethargy followed by painful skin ulcers when the worm emerges.

Guinea Worm Chain of Infection 1- How Do we Get Guinea Worm ? Guinea worms enter the body when a person drinks water containing tiny fleas that are infected with guinea worm larvae. Guinea worm enters body when a person drinks a water containing tiny fleas that are infected with guinea worm larvae.

Guinea Worm Chain of Infection 2-Guinea Worm Multiplication The fleas digested release larvae into abdominal tissues where they mate and start their development process. Growing Larva The fleas digested release larvae into abdominal tissues where they mate and start their development process.

Guinea Worm Chain of Infection 3-Growing Phase Female worms growing up to 3 feet long move through the body mostly to the lower limbs. Before exiting out of the infected body the female worm grows up to 3 feet long, move through the body mostly to lower limbs.

Guinea Worm Chain of Infection 4-Exiting Phase After one year, the mature worm emerges from the blister it creates. The victim, in pain rushes to cool in the water. After one year, the mature worm emerges from the blister it creates. The victim in pain rushes to cool in the water

Guinea Worm Infesting Water . 5-Phase of water infesting Once the person infected contacts water, the worm releases clouds of larvae into the water. 6-Phase Infecting Fleas Water fleas consume the larvae which resists digestion and will be able to infect people who will drink the contaminated water. The life cycle continues through these phases Phase of The water infesting. Once the person infected contacts water the worm releases clouds of larvae in to the water. Phase Infecting Fleas Water fleas consume the larvae which resists digestion and will be able to infect people who will drink the contaminated water.

Guinea Worm Life Cycle Guinea worm chain of infection can be broken. This is Guinea Worm Life Cycle. It exposes its chain of infection, which can be broken.

Guinea Worm Socioeconomical Impacts Physical incapacity to work for months or permanently. Lack of human resources to work in the farm. Tremendous economical losses when entire families and villages are crippled . Increasing rate of school dropped out. The infection of guinea worm prevents infected persons to walk and work for months. Its create physical incapacities which can be permanent for severe cases. Consequently, it creates lack of human resources to work in the farm and tremendous economical lost, when entire families and villages are crippled, since the outbreak occurred essentially during planting and harvesting seasons.

Guinea Worm Prevention Is there a cure for guinea worm? The answer is no. Also, there is no vaccine or medication for its cure. No Cure ! No Vaccine! No Medication! There is no cure, vaccine or medication to prevent Guinea Worm.

Good New Guinea Worm Can be Prevented Major Prevention Campaigns’ Works are underway with: Better results. Considerable decreases of new cases of Guinea Worm. In 1986 there were more than three million cases of the disease, almost all in Africa; in 2005 only just over 16,000. The good new is that it can be prevent. And major prevention campaigns have been proven effective. The results are encouraging. In 1986 there were more than three million cases of the disease, almost all in Africa; in 2005 only just over 16,000

Basic Prevention Methods Instructing targeted population to: Avoid drinking contaminated water Filtering water before using it. Monitored infected person to avoid contact with water sources These are some effective basic prevention methods. Instructing to targeted population to avoid drinking contaminated water. And they must filter water before using, or drinking it. Monitored infected persons to avoid contact with water sources.

Basic Prevention Methods Use of safe sources of water. Water treatment with portable filters. Also people must use safe sources of water and treat it with portable filters.

Solving Behavioral Issues Begin forming culturally appropriate interventions Local guinea worm education committee as eradication effort support Cultural group to convince local people that guinea worm is not a curse Creation of incentive programs to encourage people It is necessary to begin forming culturally appropriate interventions such as: local guinea worm education committee as eradication effort support and to convince local people that guinea worm is not curse. And create incentive programs to encourage people.

Guinea Worm Selective Campaigns Special group of guinea worm education for women in targeted areas where women are in charge of domestic tasks Special education program for young people, and children Also we must focus on selective campaigns by targeting women and children

Current Major Obstacles to Eradicate Guinea Worm Security problems in some endemic countries (Example Sudan). Lack of political leaders’ wills in some endemic countries. Difficulty in behavioral change of people. Absence of real clinical treatment like a vaccine or medication treatment. Inadequate funding at certain times. Even though we have witnessed a success in the combat against guinea worn, there are some current major obstacles to face such as: -Security problems in some endemic countries (Example Sudan) -Lack of political leaders’ wills in some endemic countries -Difficulty in behavioral change of people -Absence of real clinical treatment like a vaccine or medication -Inadequate funding at certain times.

Solving Current Problems Creation of advocacy groups to support major institutions which are already working on the field. Convincing governments, local authorities, and organizing meetings, workshops to inform people worldwide. Organizing concerts, cultural games and fund raisings to advance guinea worm eradication. Solving these problems will need to take this following actions: -Creation of advocacy groups to support major institutions which are already working on the field. -Convincing governments, local authorities, and organizing meetings or workshops to inform people abroad -Organizing concerts, cultural games and fund raisings to advance guinea worm eradication

Long Term Solutions Clinical researches to find medication and vaccine to treat guinea warm Tight guinea worm programs surveillance in the zone where the disease is stubborn Some long term actions need to be taken such as: -Clinical Researches to find medication and vaccine to guinea warm -Establishment of continual education programs for local people -Adequate water supply system must be created to solve water scarcity problems -Tight guinea worm surveillance programs in the zone where the disease is stubborn

Long Term Solutions Adequate water supply system must be created to solve water scarcity problems Adequate water supply system must be created to solve water scarcity problems in many urban, rural and villages.

Long Term Solutions Establishment of continual education programs for local people. Establishment of continual education programs for local people

Long Term Solutions Tight guinea worm programs surveillance in the zones where the disease is stubborn Tight guinea worm programs surveillance in the zones where the disease is stubborn

Acknowledgements Special thanks to Dr. Raymond Thron to give us this opportunity to realize this presentation Thanks you very much. Special thank to Professor Raymond Thron to give us this opportunity to realize this presentation Thank you very much. Thank you all.

References Barry, M.(2007),"The Tail End of Guinea Worm — Global Eradication without a Drug or a Vaccine", New England Journal of Medicine 356 (25): 2561–2564  Bern. C. (1992). The magnitude of the global problem of diarrheal disease: a ten year update. Bulletin of the World Health Organization, 70:705-14. Henning, B. (2008). Efficient water market mechanisms to cope with water scarcity. International Journal of Water Resources Development, Volume 19, Issue 4 December 2003 , pages 553 - 567 Snow, M., White, G.L., & Kim, H.S.(2008). Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates. Journal of School Health, v78 n4 p230-233 Apr 2008 The Carter Center, (2008) "Guinea Worm Eradication Program", T, http://www.cartercenter.org/health/guinea_worm/index.html, retrieved on 2008-07-15 References Barry, M.(2007),"The Tail End of Guinea Worm — Global Eradication without a Drug or a Vaccine", New England Journal of Medicine 356 (25): 2561–2564  Bern. C. (1992). The magnitude of the global problem of diarrheal disease: a ten year update. Bulletin of the World Health Organization, 70:705-14. Henning, B. (2008). Efficient water market mechanisms to cope with water scarcity. International Journal of Water Resources Development, Volume 19, Issue 4 December 2003 , pages 553 - 567 Snow, M., White, G.L., & Kim, H.S.(2008). Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates. Journal of School Health, v78 n4 p230-233 Apr 2008 The Carter Center, (2008) "Guinea Worm Eradication Program", T, http://www.cartercenter.org/health/guinea_worm/index.html, retrieved on 2008-07-15

References U.S. Centers for Disease Control and Prevention.(2008). Dracunculiasis, http://www.cdc.gov/ncidod/dpd/parasites/dracunculiasis/factsht_dracunculiasis.htm#treatment Retrieved 2008-07-15 WHO.(2008). Safer water, better health Costs, benefits and sustainability of interventions to protect and promote health. Retrieved July 15, 2009 from http://whqlibdoc.who.int/publications/2008/9789241596435_eng.pdf World Health Organization.(2007). World moves closer to eradicating ancient worm disease. http://www.who.int/mediacentre/news/notes/2007/np15/en/index.html. Retrieved July 15,2008. References U.S. Centers for Disease Control and Prevention.(2008). Dracunculiasis, http://www.cdc.gov/ncidod/dpd/parasites/dracunculiasis/factsht_dracunculiasis.htm#treatment Retrieved 2008-07-15 WHO.(2008). Safer water, better health Costs, benefits and sustainability of interventions to protect and promote health. Retrieved July 15, 2009 from http://whqlibdoc.who.int/publications/2008/9789241596435_eng.pdf World Health Organization.(2007). World moves closer to eradicating ancient worm disease. http://www.who.int/mediacentre/news/notes/2007/np15/en/index.html. Retrieved July 15,2008.