The jaguar (Panthera onca) as a potential new host of Dracunculus sp

Nematode species of the genus Dracunculus (Spirurida: Dracunculoidea) infect tissues and body cavities of reptiles, domestic and wild carnivores, and humans. The definitive hosts acquire the infection by ingesting intermediate (i.e., cyclopoid copepod) or paratenic (i.e., amphibians and fishes) hosts. Here we report the jaguar (Panthera onca) as a potential new host for Dracunculus sp. The nematode was collected from an ulcerated cutaneous nodule on the left anterior limb of a female jaguar in the municipality of Miranda, Mato Grosso do Sul state, Brazil. Based on the morphology of first stage larvae collected from a small fragment of the uterus of the adult nematode, the species was identified as Dracunculus sp. Reichard, 1759. Additionally, the morphological identification was molecularly confirmed by sequencing the cox1 gene. This report advocates for further investigations into the transmission cycle of this parasite in the Brazilian Pantanal wetland, considering the role of wildlife hosts and the zoonotic potential of Dracunculus species in that area.

Participating in eradication: how Guinea worm redefined eradication, and eradication redefined Guinea worm, 1985-2022

Guinea worm disease (dracunculiasis) is a debilitating waterborne disease. Once widespread, it is now on the brink of eradication. However, the Guinea Worm Eradication Programme (GWEP), like guinea worm itself, has been under-studied by historians. The GWEP demonstrates an unusual model of eradication, one focused on primary healthcare (PHC), community participation, health education and behavioural change (safe drinking). The PHC movement collided with a waterborne disease, which required rapid but straightforward treatment to prevent transmission, creating a historical space for the emergence of village-based volunteer health workers, as local actors realigned global health policy on a local level. These Village Volunteers placed eradication in the hands of residents of endemic areas, epitomising the participation-focused nature of the GWEP. This participatory mode of eradication highlights the agency of those in endemic areas, who, through volunteering, safe drinking and community self-help, have been the driving force behind dracunculiasis eradication. In the twenty-first century, guinea worm has become firstly a problem of human mobility, as global health has struggled to contain cases in refugees and nomads, and latterly a zoonotic disease, as guinea worm has shifted hosts to become primarily a parasite of dogs. This demonstrates both the potential of One Health approaches and the need for One Health to adopt from PHC and the GWEP a focus on the health of humans and animals in isolated and impoverished areas. Guinea worm demonstrates how the biological and the historical interact, with the GWEP and guinea worm shaping each other over the course of the eradication programme.

Unusual cutaneous manifestations of dracunculiasis: Two rare case reports

A nematode parasite, Dracunculus medinensis, causes dracunculiasis. Despite being non-fatal, this condition causes significant morbidity. Dracunculiasis is considered an eradicated disease in India since 1999. We report two cases that document the unusual linear morphea-like morphology of the calcified D. medinensis and the rare periorbital location of the worm. The cases presented here are rare and a diagnostic challenge, considering the eradicated status of dracunculiasis.

Characterization of the genetics and epidemiology of Brugia sp. in domestic dogs in Chad, Africa

Neglected tropical diseases pose a threat to domestic animal health, as domestic animals can serve as reservoirs for certain zoonotic parasitic infections, including Guinea worm (Dracunculus medinensis) and lymphatic filariasis. Surveillance for these parasites in domestic animals is needed to understand infection prevalence and transmission cycles, with the goal of instituting appropriate interventions. The goal of this research was to report our finding of Brugia sp. infection in dogs from Chad, Africa, and to characterize the genetics and epidemiology of the parasite. During a recent Chadian canine pathogen surveillance project, we identified Brugia sp. infections in a total of 46 out of 428 dogs (10.7%) sampled at three time points in 2019-2020. We found high levels of sequence similarity to B. malayi and B. pahangi based on amplification of 18S rRNA, 5.8S rRNA, and ITS-2 regions. Phylogenetic analysis of 18S rRNA gene sequences placed the Chadian Brugia sp. in a clade with other Brugia spp. but grouped it separately from both B. malayi and B. pahangi. Analysis of Hha I sequences showed the greatest similarity with B. patei, a parasite previously reported from dogs, cats, and wildlife hosts in Kenya. Epidemiologic analysis using generalized linear regression modeling found significantly higher odds of Brugia sp. detection among dogs in villages in southern Chad compared to those in the northern region. Further, within the northern region, there were higher odds of detection in the dry season, compared to the wet season, which is consistent with the ecology of a presumably mosquito-borne parasite. The same 428 dogs were tested for Dirofilaria immitis antigen using a commercial assay (IDEXX SNAP 4Dx) at the earliest time point of the study, with 119 dogs testing positive. However, no association was noted between Brugia infection and a dog being positive for Di. immitis antigen, with only seven of the 119 Di. immitis antigen-positive dogs being Brugia-positive. This is the first report of Brugia sp. in domestic dogs in Chad and additional research is needed to definitively identify the species present, elucidate transmission, and understand potential risks to canine and human health.

Quantifying conflict zones as a challenge to certification of Guinea worm eradication in Africa: a new analytical approach

OBJECTIVES

To quantify conflict events and access across countries that remain to be certified free of transmission of Dracunculus medinensis (Guinea worm disease) or require postcertification surveillance as part of the Guinea Worm Eradication Programme (GWEP).

SETTING AND PARTICIPANTS

Populations living in Guinea worm affected areas across seven precertification countries and 13 postcertification sub-Saharan African countries.

OUTCOME MEASURES

The number of conflict events and rates per 100 000 population, the main types of conflict and actors reported to be responsible for events were summarised and mapped across all countries. Chad and Mali were presented as case studies. Guinea worm information was based on GWEP reports. Conflict data were obtained from the Armed Conflict Location and Event Data Project. Maps were created using ArcGIS V.10.7 and access was measured as regional distance and time to cities.

RESULTS

More than 980 000 conflict events were reported between 2000 and 2020, with a significant increase since 2018. The highest number and rates were reported in precertification Mali (n=2556; 13.0 per 100 000), South Sudan (n=2143; 19.4), Democratic Republic of Congo (n=7016; 8.1) and postcertification Nigeria (n=6903; 3.4), Central Africa Republic (n=1251; 26.4), Burkina Faso (n=2004; 9.7). Violence against civilians, protests and battles were most frequently reported with several different actors involved including Unidentified Armed Groups and Boko Haram. Chad and Mali had contracting epidemiological and conflict situations with affected regions up to 700 km from the capital or 10 hours to the nearest city.

CONCLUSIONS

Understanding the spatial-temporal patterns of conflict events, identifying hotspots, the actors responsible and their sphere of influence is critical for the GWEP and other public health programmes to develop practical risk assessments, deliver essential health interventions, implement innovative surveillance, determine certification and meet the goals of eradication.

Canine Dracunculus Nematode Infection, Toledo, Spain

A fragment of a Dracunculus-like worm was extracted from the hind limb of a 2-year-old dog from Toledo, Spain. Cytochrome oxidase I and rRNA sequences confirmed an autochthonous mammalian Dracunculus worm infection in Europe. Sequence analyses suggest close relation to a parasite obtained from a North American opossum.

Progress in dracunculiasis eradication in Oyo state, South-west Nigeria: a case study

BACKGROUND

Dracunculiasis currently occurs in only 5 countries, Nigeria inclusive.

OBJECTIVE

To study the prevalence and management of the guinea worm disease at the threshold of its eradication in Oyo state.

METHODS

KAP questionnaires were administered to head of households and cyclopoid copepods in domestic water sources were identified and checked for infection. Prevalence of infection in the study population was monitored and reasons for continued transmission in the area ascertained.

RESULTS

Fifty three cases were reported in study area in 2004 and 2005 but no cases in 2006. Five hundred head of households were interviewed in ten villages. 43.9% believe the disease is in the blood and further probing shows that 54.6% believe infection is due to inherited susceptibility. 1.8% used antibiotics for treatment while 37.1% used herbs. Boreholes, wells, treatment of ponds with Abate™, filter distribution and health education were interventions in place. Un-infected Halicyclops korodiensis and Africyclops curticornis were recovered from ponds.

CONCLUSION

Ignorance especially belief in inherited susceptibility, lack of sustained safe water sources and influx of infected immigrant farmers are major variables responsible for the continued presence of the disease in the state.

[Imported dracunculiasis: four cases confirmed in the south of Algeria]

The authors report for the first time, in the south of Algeria, four imported cases of dracunculiasis in Malian Touaregs. The patients came from Mali. They remained two months in Tamanrasset before settling in Illizi where they have been working illegally for more than nine months. In August 2007, because of infected lesions appearing on their legs a month earlier, the patients decided to go to the Illizi hospital for treatment The diagnosis of dracunculiasis was made by direct observation of worms emerging from lesions and by microscopic examination of larvae. The patients were then isolated and treated. The Ministry of Health immediately took measures to avoid local transmission of the disease, never seen in the region. The measures consisted in increasing awareness campaign among medical and paramedical staff about dracunculiasis and in pointing out the importance of detection of new cases among nomadic populations. The risk of emergence of a new dracunculiasis indigenous focus in the south of Algeria should be seriously considered, especially as the number of immigrants from endemic countries is increasing considerably

Uganda's successful Guinea Worm Eradication Program

Having begun its national Guinea Worm Eradication Program (UGWEP) in 1991 (1991 population, 16.6 million) with the third-highest number of cases reported by any endemic country, and ranked as the second-highest endemic country in the world in 1993, by 2004, Uganda celebrated its first full calendar year with no indigenous cases of the disease. Systematic interventions began in 1992 and were gradually intensified until the final indigenous case occurred in July 2003. The favorable concentration of most cases in relatively few northern districts of the country was partly offset by chronic insecurity in much of the endemic area and by repeated importations of cases from neighboring Sudan. Strong support and dedicated leadership by government officials and external partners were keys to this program's dramatic success. This program cost approximately US dollar 5.6 million.

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.

Disinfectants/antiseptics in the management of guinea worm ulcers in the rural areas

The effectiveness of trichlorophenol (TCP), chlorhexidine gluconate plus cetrimide (Savlon) and Izal in inhibiting the growth of bacterial isolates from guinea worm ulcers was investigated. Using an adaptation of the method of Russell and Furr (Russell, A.D., Furr, J.R., 1977. The antibacterial activity of a new chloroxylenol preparation containing ethylenediamine tetraacetic acid. J. Appl. Bacteriol. 43, 253-260) the minimum inhibitory concentration (MIC) values of the three anti-microbial agents for each of the isolated bacteria was determined. Water drawn from the rural guinea worm endemic sites was autoclaved and used for the various dilutions of the anti-microbial agents. At the manufactures' recommended use-dilutions in cases of wounds/cuts/sores, Savlon showed greater effectiveness than Izal and TCP in this order. Probable organic and inorganic inhibitors in water that is usually employed in diluting anti-microbial agents in the rural areas for the dressing of guinea worm ulcers very likely had greatest effect(s) on TCP and least effect(s) on Savlon.

The intermediate hosts of Dracunculus medinensis in northern region, Ghana

Cyclopoid copepods were collected over a period of 17 months from six man-made water reservoirs in an area of northern Ghana where dracunculiasis is endemic. The numbers and species of cyclopoid copepods as well as the species naturally infected with Dracunculus medinensis larvae were recorded at fortinightly intervals. The occurrence of copepods was compared with concurrent rainfall and with monthly incidences of dracunculiasis in the year after the reservoir survey. Seven species and two subspecies of copepods were found in the study area: Thermocyclops neglectus decipiens, T. crassu' consimilis, T. incisus, T. inopinus, T. emini, Mesocyclops major, M. ogunnus, M. kieferi and Cryptocyclops linjanticus. More than 60% of all the cyclopoids found were T. n. decipiens and only four species (T. incisus, T. inopinus, T. n. decipiens and M. kieferi) were found infected. Infection rates were very low (< or = 0.3%). The seasonal fluctuations of cyclopoid copepods showed different patterns in the six reservoirs, perhaps related to local circumstances not investigated in the present study. As the people in the study area are very mobile during the dracunculiasis transmission season, it seems likely that some of them become infected at water sources other than the ones investigated. It was therefore difficult to correlate occurrence of cyclopoid copepods in the local water sources with the prevalence of the human infection in the catchment area. No conclusion as to the most important intermediate host(s) in the area could be made.

Surveillance for dracunculiasis, 1981-1991

In 1986 the World Health Organization (WHO) designated dracunculiasis (guinea worm disease) as the next disease scheduled to be eradicated (by 1995) after smallpox. Dramatic improvement in national and international surveillance has played a key role in the global eradication campaign, which was initiated at CDC in 1980. About 3 million persons are still affected by the disease annually, with adverse effects on their health as well as on agricultural production and education. Over 100 million persons are at risk of having the disease in more than 20,000 villages in India, Pakistan, and 17 African countries. At least one nationwide, village-by-village search to detect all villages with endemic dracunculiasis and count cases is recommended at the outset of each national campaign, followed by monthly reporting by village-based health workers in the targeted villages during the implementation phase. Rapid dissemination of the results of the surveillance is critical. Intensive case detection and containment--with rewards for reporting of cases--are most appropriate near the end of each campaign. Cameroon, Ghana, India, Nigeria, and Pakistan have pioneered the various surveillance methods for this disease in recent years. Methods for conducting surveillance of dracunculiasis and other important diseases must continue to be developed and improved as countries now believed to be free of dracunculiasis prepare to apply to WHO for certification of elimination of dracunculiasis.

Testicular dracunculosis--a distinct clinical entity

Testicular involvement in dracunculosis is extremely rare, although intrascrotal abscesses do occur in this infestation. Two cases of testicular abscess are reported. In both cases the guinea worm had penetrated the tunica albuginea to be lodged in the testicular as well as the paratesticular tissue. Dracunculosis should be included in the differential diagnosis of testicular swellings in areas where it is endemic.

The existence of Dracunculus medinensis (Linnaeus, 1758) in Turkana, Kenya

Dracontiasis has been previously reported in southern Sudan, northern Uganda and north-west Eritrea but this is the first report of autochthonous cases in Turkana, Kenya. Five Turkana tribesmen, three females from the same family, one young boy and an adult male were being treated for guinea-worm at the dispensary in Lokichogio, northern Turkana District. The three women had recently returned from southern Sudan, where the disease is endemic, but the two male tribesmen had only lived in and around the Lokichogio region. The methods used in obtaining water from water-holes dug in dry river beds provide an ideal situation for Dracunculus transmission amongst the tribesmen; this parasite may therefore become a problem in this remote impoverished area.

[Dracunculus medinensis (guinea worm disease): a rare cause of calcification (author's transl]

Tangled whorly calcifications were seen in the abdominal subcutaneous tissues of a negro patient from Africa. The differential diagnosis of such calcifications - rarely observed in Europe - includes a variety of parasities. In this patient, dracunculus medinensis (guinea worm disease) was the cause.

Abate--its value as a cyclopscide

Guinea worm disease is highly endemic in Kurnool district in Andhra Pradesh. The effect of Abate on the vector cyclops was studied and was found to be very encouraging.

[Acute arthritis of knee with intra-articular presence of D.medinensis. Comparative clinical and immunologic evolution. 1 case]

The authors report a case of knee acute arthritis with intra-articular presence of microfilariae D. medinensis observed in a black African worker immigrated in France. It is a classical manifestion of dracunculosis articular complications which are however less frequent than intra-articular reaction arthritis without microfilariae, or than pyogenes arthritis due to neibourhood superinfections. The authors emphasize the significance of a double clinical and immunological supervision in the course of a convenient treatment including antibiotics, anti-inflammatory agents, local treatment, and rehabilitation.

The control of guineaworm with abate: a trial in a village of North-West Ghana

In the village of Gbegru guineaworm infection is contracted by drinking the water of a man-made pond during the dry season. The lethal effect on the vector cyclops of each application of Abate to a concentration of 1 mg/litre lasted 5-7 weeks and was clearly reflected in the following year's incidence of guineaworm cases. This indicates that Abate is potentially useful in the chemical control of guineaworm infection.

Dracunculus insignis (Leidy, 1858) and larval Eustrongylides sp. in a muskrat from Ontario, Canada

A muskrat, Ondatra zibethica, from northcentral Ontario harbored Dracunculus insignis (Leidy, 1858) Chandler, 1942 subcutaneously. This is the fifth report of Dracunculus sp. in muskrat and the first record of D. insignis males in this host; they are described briefly. The occurrence of Eustrongylides sp. larvae intramuscularly in this muskrat is the first reported natural infection of a mammal by nematodes of this genus.