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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
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.
Contaminated Water with dangerous
germs.
Schistosomiasis
Intestinal Nematode
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 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
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).
Guinea Worms
Fully Grown Female Guinea Worm

It can reach 3 feet long in one year !
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

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 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
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.
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.
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.
Guinea Worm Life Cycle

Guinea worm chain of infection 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.
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!
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.
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
Basic Prevention Methods


Use of safe
sources of water.
Water treatment
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
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
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.

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.
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
Long Term Solutions

Adequate water
supply system
must be created
to solve water
scarcity
problems
Long Term Solutions

Establishment of
continual
education
programs for local
people.
Long Term Solutions

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.
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 TimeEfficient 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/fa
ctsht_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/2008/978924159643
5_eng.pdf
World Health Organization.(2007). World moves closer to
eradicating ancient worm disease.
http://www.who.int/mediacentre/news/notes/2007/np15/e
n/index.html. Retrieved July 15,2008.