The document summarizes India's National Guinea Worm Eradication Programme. It provides background on the Guinea worm parasite and disease. The program was launched in 1983-1984 with the goal of eradicating Guinea worm from India. Key strategies included active surveillance, case management, vector control through water treatment and filters, and increasing access to safe drinking water. These efforts led to a dramatic reduction in cases from around 40,000 at the start to just 79 cases in 1996, with the last case reported that year. India was then declared free of Guinea worm disease by WHO and nationally in 2000-2001.
The document summarizes India's National Guinea Worm Eradication Programme. It provides background on the Guinea worm parasite and disease. The program was launched in 1983-1984 with the goal of eradicating Guinea worm from India. Key strategies included active surveillance, case management, vector control through water treatment and filters, and increasing access to safe drinking water. These efforts led to a dramatic reduction in cases from around 40,000 at the start to just 79 cases in 1996, with the last case reported that year. India was then declared free of Guinea worm disease by WHO and nationally in 2000-2001.
The document summarizes India's National Guinea Worm Eradication Programme. It provides background on the Guinea worm parasite and disease. The program was launched in 1983-1984 with the goal of eradicating Guinea worm from India. Key strategies included active surveillance, case management, vector control through water treatment and filters, and increasing access to safe drinking water. These efforts led to a dramatic reduction in cases from around 40,000 at the start to just 79 cases in 1996, with the last case reported that year. India was then declared free of Guinea worm disease by WHO and nationally in 2000-2001.
health problem in many states of India before it was eradicated in 2000. INTRODUCTION • Dracunculosis or Guinea Worm (GW) disease is caused by the
nematode Dracunculus medinensis.
• The adult female guinea worm, measuring 60-100 cm in length,
emerges through the skin, usually lower limbs, causing swelling,
ulceration and discomfort to the patients.
ENDEMIC AREAS TO GW GUINEA WORM CASES 1984 INDIAN SCENARIO LIFE CYCLE OF CYCLOPS • Dracunculus medinensis, which passes its life cycle in two hosts – Man and Cyclops. Man harbours the adult parasites in the subcutaneous tissues, especially of legs, arms and back, which are likely to come in contact with water. • A blister appears on the skin when the gravid 60- 100 cm long adult female worm is ready to discharge its larvae BLISTER • The GW infection is transmitted to a person when an GW patient with the ulcer enters into active drinking water unsafe
• The contact with water bursts a loop of the uterus
discharges its thousand of embryos into water. Cyclops present in the water ingests these embryos. • When a person drinks water containing infected Cyclops, the gastric juice of man kills the Cyclops and activates the larvae which then penetrate the gut wall and migrate, usually to the retro peritoneal connective tissues, when they mature into male and female adult worms in about six months entering into human body. after
• The male worm is smaller in size, dies after
immediately copulation and gets absorbed in the body. The female migrate to those part of the body which are likely to comethen, in contact with water. CYCLOPS CYCLOPS WITH EGG SACKS • The escape of larvae into the water takes place in batches and the parturition is usually complete in about 2-3 weeks. • These larvae are ingested by Cyclops and develop into infective stage in about 2 weeks. People swallow the infected Cyclops in drinking water from step wells or ponds • The larvae are liberated in the stomach, cross the duodenal wall, and enter the retro-peritoneal connective tissues where they grow and mature. • The males die after mating. The females migrate in about 6 months to parts which come in contact with water. WORM IN THE BLISTER EPIDEMIOLOGY OF GUINEA WORM DISEASE • Agent Factors • Environmental factors Dracunculus medinensis, nematode worm Step wells: Summer ,Ponds: June- Sept, Temp:25-30 C M-2cm F-60-120cm •Mode of transmission • Reservoir Oral: Consumption of water Infected person containing cyclops harboring the infective parasite. • Host factors All ages, both sex susceptible Repeated infection in same individual (no immunity) GUINEA-WORM ERADICATION IN INDIA
• Government of India launched the National
Guinea Worm Eradication Programme (GWEP) in 1983-84 as a centrally sponsored scheme on a 50:50 sharing basis between Centre and States with the objective of eradicating guinea worm disease from the country. •. • The National Institute of Communicable Diseases (NICD), Delhi worked as the nodal agency for planning, coordination, guidance of NGWEP in the country • The Programme was implemented by the endemic State Health Directorates through the Primary Health Care system STRATEGY • Based on the life cycle of the worm and well defined prevention and control measures, Guinea Worm Eradication Programme envisaged the efficient implementation of strategies. REMOVING GW FROM ANKLE EMERGENCE OF GW • Guinea worm case detection and continuous surveillance through three active case search operations and regular monthly reporting • GW case management • Vector control by the application of Temephos in unsafe water sources eight times a year and use of fine nylon mesh/double layered cloth strainers by the community to filter cyclops in all the affected villages •Trained manpower development •Provision and maintenance of safe drinking water supply on priority in GW endemic villages •Concurrent evaluation and operational research ACTIVE TREATMENT IMPLEMENTATIO • The endemic State Health N through Primary Health Care Directorate system implemented the programme. • The Ministry of Rural Development, Govt. of India and State Public Health Engineering Departments (Rural Water Supply) assist the Programme in provision and maintenance of water supplies and conversion of unsafe drinking water sources, like safe wells, and ponds on priority in the guinea worm affected areas. step drinkingwere responsible • District Medical Officer and PHC medical Officer for planning, implementation, monitoring and supervision of the GWEP. • Annually the Task Force Group under the chairmanship of Director General of Health Services, Govt. of India, reviewed the GWEP in depth.
• This task Force Group was constituted by:
a)Director and Deputy Director (Helminthology) of NICD Delhi as convener and coordinator of the work b)Directors of Health and Medical Services, GWEP-officers, chief engineers (Rural Water Supply) of GW endemic states c) Director/Advisor of National Water Mission as members d)Experts from WHO, UNICEF, Centre Health Education Bureau (CHEB), Planning Commission and related organizations. ACHIEVEMENT • At the of the programme i.e. in 1984, beginning there were around 40,000 GW cases in 12840 villages • in 89 districts During of 79 endemic only guinea states. worm cases have been recorded 1996 in three villages from Jodhpur (Rajasthan), rest of the country continued to remain free from GW. • Banwari Lal 25 years old from Jodhpur in Rajasthan was the last case in India in 1996 (Lancet 2000). "GUINEA WORM DISEASE FREE" • "Zero" incidence has been maintained since August 1996 through active surveillance and intensified field monitoring in the endemic areas. • In the Meeting of WHO in February 2000 the India has been certified for the elimination of Guinea Worm Disease and on 15th February 2001 declared India as "Guinea Worm Disease Free". REFERENCE
National Institute of Health & Family Welfare
http://www.nihfw.org/NationalHealthProgramme/GUINEA WORMERADICATIONPROGRAMME.html THAN K YOU