Abstract
Guinea worm disease (GWD) is a neglected tropical disease that was targeted for eradication several decades ago because of its limited geographical distribution, predictable seasonality, straightforward diagnosis, and exclusive infection of humans. However, a growing body of evidence challenges this last attribute and suggests that GWD can affect both humans and animal populations. The One Health approach emphasizes the relatedness of human, animal, and environmental health. We reviewed epidemiological evidence that could support the utility of a One Health approach for GWD control in the six countries that have reported human GWD cases since 2015—Angola, Cameroon, Chad, Ethiopia, Mali, and South Sudan. Human GWD cases have dramatically declined, but recent years have seen a gradual increase in human case counts, cases in new geographies, and a rapidly growing number of animal infections. Taken together, these suggest a need for an adjusted approach for eradicating GWD using a framework rooted in One Health, dedicated to improving disease surveillance and in animals; pinpointing the dominant routes of infection in animals; elucidating the disease burden in animals; determining transmission risk factors among animals and from animals to humans; and identifying practical ways to foster horizontal and multidisciplinary approaches.
Highlights
Guinea worm disease (GWD), known as dracunculiasis or Medina worm disease, is a neglected tropical disease (NTD) caused by a nematode, Dracunculus medinensis
While the copepods are killed in the stomach, the larvae mature into adult Guinea worms and copulate
We reviewed and analyzed the identified peer-reviewed literature and surveillance data to synthesize a conceptual framework for how such an approach that emphasizes the nexus of human, animal, and environmental health could enhance efforts to eradicate GWD
Summary
Guinea worm disease (GWD), known as dracunculiasis or Medina worm disease, is a neglected tropical disease (NTD) caused by a nematode, Dracunculus medinensis. Humans usually become infected by ingesting water containing copepods (small aquatic crustaceans) infected with Dracunculus larvae [1]. While the copepods are killed in the stomach, the larvae mature into adult Guinea worms and copulate. Male worms die following copulation, but approximately one-year post-infection, adult female Guinea worms migrate to the skin and breach the surface through a blister. When these wounds are exposed to a water source, the female worm releases embryos (i.e., L1 larvae) and the cycle repeats. Case management is limited to carefully and safely removing the whole worm and tending the exit wound to prevent infection
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