DRACUNCULIASIS

Question 1

LEVELS OF PREVENTION: DRACUNCULIASIS
Primordial level

Answer 1

Primordial (TOMM)
Target population: The general public
Objective: To prevent onset of illness and development of risk factors.
Means: Social media, radio and television stations, community outreaches, seminars, traditional and religious leaders.
Method: I will educate the general public about the disease
Definition: Dracunculiasis, also known as Guinea worm disease is a parasitic infection caused by Dracunculus Medinensis. It is spread by drinking water contaminated with the larvae/eggs of dracunculus medinensis. It is more common in remote parts of Africa and Asia that do not have safe drinking water.
Transmission: People get infected by drinking unfiltered stagnant water containing copepods (tiny water fleas ) that have swallowed the Guinea worm larvae. Transmission occurs mainly during droughts or dry season in warm regions of the world.
People do not usually develop symptoms until about one year after becoming infected. A worm is seen coming out of the skin which may be preceded by pain and swelling in the area with fever. More than 90% of worms come out of the legs and feet, but they can appear in any body part.
I will also encourage environmental hygiene, personal hygiene and protection of water sources

Question 2

PRIMARY (TOMM)

Answer 2

Target population: General public with focus on healthy and high risk individuals
Objective: To prevent onset of illness
Means: Community outreach, social media, religious leaders, traditional rulers
Methods: Vaccination - There is no vaccine for Guinea worm disease at the moment. Prevention strategies however include increased surveillance for the disease, proper water treatment and availability of water for daily consumption.

Question 3

SECONDARY (TOM)

Answer 3

Target population: Sick and high risk individual
Objective: Early diagnosis and prompt treatment
Methods: Identify people with blisters on the skin, indicating site chose by
female worm to erupt. Blister may be preceded with allergic-type symptoms like wheezing, coughing, peri-orbital edema, pruritus.
Diagnosis of Guinea worm disease is made when the head of the worm is identified within an ulcer.
Mainstay of treatment is with stick therapy, i.e. extraction of the worm carefully and winding it around a stick, a few centimeters each day. This is because the worm can be as long as a meter, and full extraction may take several days to weeks.

Question 4

TERTIARY (TOM)

Answer 4

Target population: Sick individuals
Objective: Limiting complications and disability/damage from the disease
Methods: Surgical excision where available if the worm gets calcified or breaks.
Metronidazole in addition to stick therapy
Involvement of infectious disease specialist in management and follow-up care.

Question 5

QUATERNARY (TOM)

Answer 5

Target population: Convalescent or recovering individuals
Objective: Rehabilitation and prevention of overmedicalization
Method: Aid recovery with physiotherapy, vocational therapy, and counselling of family members to provide social support.
Educate relatives and community to assist in rehabilitation process.
Avoid overdosing and unlicensed management practices like use of anti-parasitic or anthelminthic therapy.