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Dracunculiasis is endemic in the Mayo-Sava region, Province of Extreme North, Cameroon. Its incidence has been reduced by half (from 778 cases in 1990 to 394 cases in 1991) thanks to the national eradication program (wells, distribution of filters, use of temephos to treat water collections, sanitary education, cases containment).
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Dracunculiasis has been described since antiquity and will be forever associated with the image of the method of extraction consisting of winding a few centimeters of the worm around a stick every day. For nearly ten years a worldwide effort to eradicate this infection has been under way. Achieving this apparently simple goal is hindered by the difficulties in accessing infected areas and by the dire poverty in the regions involved which include the "poorest of the poor". Spectacular results have been accomplished in Pakistan thanks to the concerted efforts of political, financial, and technical officials from a number of national and international organization. While the rate of infestation has decreased by 90% worldwide, the final push to complete eradication is the most difficult and, as in India and Mali, is being oriented towards a strategy involving an integrated approach. Results are slow and gradual but notable and durable progress has been made in terms of village water supply. It is necessary that intervention in these areas be associated with other poverty-fighting programs. Successful eradication without accompanying improvements would be a technical victory but in terms of public health and welfare such a victory would correspond to an unjustifiably missed opportunity.
During 18 months covering two annual rainy seasons, 338 monthly water samples were taken in 29 ponds of two dracunculosis endemic villages of south-western Burkina Faso. The dynamics of ponds inhabited by Cyclopidae has been surveyed as far as their densities and their species are concerned. We identified a total number of 17 species from 6 genera of which the decreasing order in frequency is: Thermocyclops, Mesocyclops, Metacyclops, Cryptocyclops, Microcyclops and Allocyclops. The dominant species are: Thermocyclops crassus consimilis, Metacyclops margaretae, Thermocyclops oblongatus and Thermocyclops neglectus decipiens. The crowds of these major species during the period of dracunculosis high transmission in the surveyed area (June to July), suggest, in the absence of a search for Dracunculus medinensis larvae, that, they should play the principal part as vector of the parasite in this area.
More than 200,000 patients with parasitic diseases (predominantly helminthisms, zoonotic cutaneous leishmaniasis) are annually notified in Uzbekistan. There are imported cases of malaria and sporadic cases of visceral leishmaniasis. The republic eradicated Filaria medinensis infection (dracunculosis) in 1931, town-type cutaneous leishmaniasis in 1950, malaria in 1960, visceral leishmaniasis in 1968, and hookworm diseases in 1974. Much experience has been accumulated in controlling zoonotic cutaneous leishmaniasis, large-scale social helminthisms: ascariasis, taeniarinchiasis, and hymenolepiasis.
In 6 differnet animal assays in the laboratory, thiabendazole had clear anti-inflammatory effect, though it was less potent than aspirin in all assays. These findings add support to clinical suggestions that the drug may have anti-inflammatory properties in man. Such properties may contribute to the clinical response observed following the use of thiabendazole in cases of trichinosis, cutaneous larva migrans, visceral larva migrans, dracunculosis and scabies. In parasitic infections in which corticosteroids are commonly used in clinical management, notably trichinosis, the fact that thiabendazole does not appear to have immunosuppressive activity may confer an added clinical advantage.
400 cases of dracunculosis were treated with Thiabendazole and the results reported. Thiabendazole appears to be highly effective and its pleasant taste and lack of adverse effects account for its acceptability by the patients. The drug is cheap and can be recommended even for poor patients. The adverse reactions are minimal and do not necessitate stoppage of therapy. We conclude the Mintezol is highly efficacious and should prove a useful weapon against Guinea worm disease.
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.
Five cases of tumoral calcinosis were studied during the period of January-february 1999 in MIMER medical college, Talegaon, a rural place 35kms. from Pune. All the Five patients were females residing in nonendemic area for Dracunculosis. They were from 5th-6th decade. They were otherwise healthy and had normal serum calcium and phosphorus levels and no eosinophilia. All had large, hard subcutaneous lump around hip joint. The skin overlying the swelling was normal. Histologically all cases showed similar morphology, the lesions were composed of large and small deposits of calcium. The foreign-body giant cell reaction was seen in two cases. There were no eosinophils and lymphocytes. On multiple sectioning none of the cases revealed any evidence of dead or living parasite. Old and recent necrosis was absent. These cases are presented since the condition is comparatively rare and it appeared in crops in our Institute.
All the parasitic diseases which may affect the face and the mouth are reviewed. Protozoan and helminths infections are described as well as arthropod bites and envenomation by other animals. Protozoan infections of interest to the oral and maxillofacial specialist are leishmaniasis, trypanosomiasis, cutaneous amebiasis, and toxoplasmosis. Helminth infections are due to nematodes, trematodes, and cestodes. Nematoda (true roundworm) infections include ankylostomiasis, strongyloidiasis, gnathostomiasis, gongylonemiasis, trichinosis, dracunculosis, loaiasis, filariasis, dirofilariasis, and onchocerciasis. Only schistosomiasis has to be considered in Trematoda (flukes) infections. Cestoda (tapeworms) infections are cysticercosis, equinococcosis, and sparganosis. Finally, episodic bites and stings to the face, by arthropods (spiders, ticks, mites, scorpions, etc.) and many other venomous animals are also possible.
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