Guinea worm disease (GWD) or dracunculiasis is a parasitic infection with the worm Dracunculus medinensis that afflicts mostly the people of Africa. It is not as “notorious” as HIV, but brings about a lot of pain and suffering to a continent that God seems to have forgotten. Some useful facts about the disease are offered by the Directors of Health Promotion and Education below:
"People get infected when they drink standing water containing a tiny water flea that is infected with the even tinier larvae of the Guinea worm. Inside the human body, the larvae mature, growing as long as 3 feet. After a year, the worm emerges through a painful blister in the skin, causing long-term suffering and sometimes crippling after-effects".
For the time being, no drug can efficiently treat Guinea worm disease and no vaccine can prevent people from being infected, but there is a series of low-cost strategies that could be implemented in order to prevent Guinea worm infection and transmission. Three of them are described briefly here.
- Teaching people living in endangered areas to filter their own water is a first inexpensive strategy against GWD. More specifically, a significant number of pipe filters can be distributed in the endemic areas of GWD. These pipes are hard plastic straws which have nylon filters at one end and can easily be carried around the neck by locals. In addition, a nylon monofilament filtration fabric can be used to filter the infested crustacean before water is consumed . Boiling or sterilizing water may also prove useful, but both these strategies are rather costly.
- Another effective (though more expensive than the first) strategy to prevent GWD is to employ approved insecticides in order to kill larvae. An approved larvicide that is harmless to both humans and wildlife can be applied to treat water sources. Temefos or Temephos is an organophosphate larvicide that is as functional as organophosphates. Organophosphates are produced by the chemical reaction of alcohol and phosphoric acid and function via the following way: they target the central nervous system of larvae via inhibition of cholinesterase ( cholinisterase is an enzyme that catalyzes the hydrolysis of the neurotransmitter acetylcholine into choline and acetic acid; it is via this reaction that the cholinergic neuron comes to rest after first having been activated). Through this, larvae die before reaching the adult stage. Temephos can have maximum results if it is applied every 4 weeks during the transmission season to possibly infested water sources.
- Quite often, infected individuals rush to alleviate their aching boils in ponds, with the aim of relieving the pain that the emerging worm causes. The victims are unaware of the fact that the guinea worm releases more larvae into the water and that, in this way, they contribute to the continuation of the disease. Consequently, a third low-cost strategy would be a communication one: people with an open guinea worm wound should not enter ponds or wells used by the wider public for drinking water and all locals should be in alert for the detection of possible GWD cases among their vicinity.
Low-cost or easy to apply and communicate are some of the characterizations that best describe the aforementioned strategies against the transmission of GWD. To a citizen of the West, the implementation of these strategies may seem like a piece of cake. To a citizen of Africa, however, where survival is at stake due to famine, drought and severe diseases and where economic and cultural barriers have created communities of poverty-stricken individuals, these strategies are occasionally implemented and in a rather hit-and-miss way.
Stavroula Dimitropoulos - MSc, BSc
