1. Walden University Public Health
Waterborne Infectious Diseases Prevention of Guinea Worm and Post Guinea Worm Eradication Management
Presented by Daniel
Yawo Akrodou
Walden University Public Health
Ph.D. Student
Ladies and Gentlemen,
Welcome to The Waterborne Infectious Disease Guinea Worm Prevention presentation.
I am Daniel Yawo Akrodou student at Walden University in Public Health Epidemiology Ph.D.Program. Thank you for coming.

2. Waterborne Disease Definition
Waterborne infectious diseases are
caused by the ingestion of water
contaminated by human or animal
excrements, which contain
pathogenic microorganisms
Examples : Guinea Worm,
Schistosomiasis, and Intestinal Nematode.
Waterborne infectious diseases, generally they are caused by the ingestion of water contaminated by human or animal excrements, which contain
pathogenic microorganisms. These are some examples: Guinea Worm, Schistosomiasis, Malaria, and Intestinal Nematode.

3. Contaminated Water with dangerous germs.

4. Schistosomiasis
Schistosomiasis Life Cycle, worms at different stages and diseases manifestation

5. Intestinal Nematode
Intestinal Nematode Life Cycle and worm in stomach.

6. Waterborne Infectious Diseases Social Impacts
Waterborne diseases cause 39% of diarrheal diseases
3.5 to 18 million children deaths per year worldwide.
Malaria represents 14% of waterborne diseases
526 million deaths per year
Waterborne diseases create enormous health problems and cause millions deaths worldwide, every year. For example, they cause 39% of diarrheal diseases which are responsible for 3.5 to 18 million children deaths per year. Malaria represents 14% of waterborne diseases and causes 526 million deaths per year. Others such as intestinal nematode, trachoma, schistosomia, and guinea worm affect million of people per year.

7. Waterborne Infectious Diseases Social Impacts
Intestinal nematode 2% of waterborne diseases( ascariasis, trichuriasis and hookworm)
2 billion of infections per year world wide
Trachoma 2%, schistosomiasis and Guinea worm 1% of waterborne diseases
Affect 1 million of people per year
Others such as intestinal nematode, trachoma, schistosomia, and guinea worm affect million of people per year also.

8. Overview of Guinea Worm
Guinea worm disease is a parasitic disease transmitted through drinking water contaminated with infected water fleas. Guinea worm exits through the body after one year growth, causing painful blisters in the skin (The Carter Center, 2008).
Let learn about typical waterborne infectious diseases’ life cycle, symptoms and its effective prevention. Example Guinea worm. It is a parasitic disease transmitted through drinking water contaminated with infected water fleas. Guinea worm exits through body after one year growth, causing painful blisters in the skin.

9. Guinea Worms
Guinea Worm germs, larvae and full grown female exiting the body.

10. Fully Grown Female Guinea Worm
It can reach 3 feet long in one year !
This is a fully grown female guinea worm in the body after one year growth, it can reach 3 feet.

11. Guinea Worm Symptoms
Once ingested, the female worm grows up to 3 feet in one year and causes when ready to exit fever, nausea, chills, lethargy
followed by painful skin ulcers when the worm emerges
Once ingested the female worm grows up to a 3 feet in one year and causes when ready to exit fever, nausea, chills, and lethargy followed by painful skin ulcers when the worm emerges.

12. Guinea Worm Chain of Infection
1- How Do we Get Guinea Worm ?
Guinea worms enter the body when a person drinks water containing tiny fleas that are infected with guinea worm larvae.
Guinea worm enters body when a person drinks a water containing tiny fleas that are infected with guinea worm larvae.

13. Guinea Worm Chain of Infection
2-Guinea Worm Multiplication
The fleas digested release larvae into abdominal tissues where they mate and start their development process.
Growing Larva
The fleas digested release larvae into abdominal tissues where they mate and start their development process.

14. Guinea Worm Chain of Infection
3-Growing Phase
Female worms growing up to 3 feet long move through the body mostly to the lower limbs.
Before exiting out of the infected body the female worm grows up to 3 feet long, move through the body mostly to lower limbs.

15. Guinea Worm Chain of Infection
4-Exiting Phase
After one year, the mature worm emerges from the blister it creates. The victim, in pain rushes to cool in the water.
After one year, the mature worm emerges from the blister it creates. The victim in pain rushes to cool in the water

16. Guinea Worm Infesting Water.
5-Phase of water infesting
Once the person infected contacts water, the worm releases clouds of larvae into the water.
6-Phase Infecting Fleas
Water fleas consume the larvae which resists digestion and will be able to infect people who will drink the contaminated water.
The life cycle continues through these phases
Phase of The water infesting.
Once the person infected contacts water the worm releases clouds of larvae in to the water.
Phase Infecting Fleas
Water fleas consume the larvae which resists digestion and will be able to infect people who will drink the contaminated water.

17. Guinea Worm Life Cycle Guinea worm chain of infection can be broken.
This is Guinea Worm Life Cycle. It exposes its chain of infection, which can be broken.

18. Guinea Worm Socioeconomical Impacts
Physical incapacity to work for months or permanently.
Lack of human resources to work in the farm.
Tremendous economical losses when entire families and villages are crippled .
Increasing rate of school dropped out.
The infection of guinea worm prevents infected persons to walk and work for months. Its create physical incapacities which can be permanent for severe cases. Consequently, it creates lack of human resources to work in the farm and tremendous economical lost, when entire families and villages are crippled, since the outbreak occurred essentially during planting and harvesting seasons.

19. Guinea Worm Prevention
Is there a cure for guinea worm?
The answer is no. Also, there is no vaccine or medication for its cure.
No Cure ! No Vaccine!
No Medication!
There is no cure, vaccine or medication to prevent Guinea Worm.

20. Good New Guinea Worm Can be Prevented
Major Prevention Campaigns’ Works are underway with:
Better results.
Considerable decreases of new cases of Guinea Worm.
In 1986 there were more than three million cases of the disease, almost all in Africa; in 2005 only just over 16,000.
The good new is that it can be prevent. And major prevention campaigns have been proven effective. The results are encouraging. In 1986 there were more than three million cases of the disease, almost all in Africa; in 2005 only just over 16,000

21. Basic Prevention Methods
Instructing targeted population to:
Avoid drinking contaminated water
Filtering water before using it.
Monitored infected person to avoid contact with water sources
These are some effective basic prevention methods. Instructing to targeted population to avoid drinking contaminated water. And they must filter water before using, or drinking it. Monitored infected persons to avoid contact with water sources.

22. Basic Prevention Methods
Use of safe sources of water.
Water treatment with portable filters.
Also people must use safe sources of water and treat it with portable filters.

23. Solving Behavioral Issues
Begin forming culturally appropriate interventions
Local guinea worm education committee as eradication effort support
Cultural group to convince local people that guinea worm is not a curse
Creation of incentive programs to encourage people
It is necessary to begin forming culturally appropriate interventions such as:
local guinea worm education committee as eradication effort support and to convince local people that guinea worm is not curse. And create incentive programs to encourage people.

24. Guinea Worm Selective Campaigns
Special group of guinea worm education for women in targeted areas where women are in charge of domestic tasks
Special education program for young people, and children
Also we must focus on selective campaigns by targeting women and children

25. Current Major Obstacles to Eradicate Guinea Worm
Security problems in some endemic countries (Example Sudan).
Lack of political leaders’ wills in some endemic countries.
Difficulty in behavioral change of people.
Absence of real clinical treatment like a vaccine or medication treatment.
Inadequate funding at certain times.
Even though we have witnessed a success in the combat against guinea worn, there are some current major obstacles to face such as:
-Security problems in some endemic countries (Example Sudan)
-Lack of political leaders’ wills in some endemic countries
-Difficulty in behavioral change of people
-Absence of real clinical treatment like a vaccine or medication
-Inadequate funding at certain times.

26. Solving Current Problems
Creation of advocacy groups to support major institutions which are already working on the field.
Convincing governments, local authorities,
and organizing meetings, workshops to inform people worldwide.
Organizing concerts, cultural games and fund raisings to advance guinea worm eradication.
Solving these problems will need to take this following actions:
-Creation of advocacy groups to support major institutions which are already working on the field.
-Convincing governments, local authorities, and organizing meetings or workshops to inform people abroad
-Organizing concerts, cultural games and fund raisings to advance guinea worm eradication

27. Long Term Solutions
Clinical researches to find medication and vaccine to treat guinea warm
Tight guinea worm programs surveillance in the zone where the disease is stubborn
Some long term actions need to be taken such as:
-Clinical Researches to find medication and vaccine to guinea warm
-Establishment of continual education programs for local people
-Adequate water supply system must be created to solve water scarcity problems
-Tight guinea worm surveillance programs in the zone where the disease is stubborn

28. Long Term Solutions
Adequate water supply system must be created to solve water scarcity problems
Adequate water supply system must be created to solve water scarcity problems in many urban, rural and villages.

29. Long Term Solutions
Establishment of continual education programs for local people.
Establishment of continual education programs for local people

30. Long Term Solutions
Tight guinea worm programs surveillance in the zones where the disease is stubborn
Tight guinea worm programs surveillance in the zones where the disease is stubborn

31. Acknowledgements
Special thanks to Dr. Raymond Thron to give us this opportunity to realize this presentation
Thanks you very much.
Special thank to Professor Raymond Thron to give us this opportunity to realize this presentation
Thank you very much.
Thank you all.

32. References
Barry, M.(2007),"The Tail End of Guinea Worm — Global Eradication without a Drug or a Vaccine", New England Journal of Medicine 356 (25): 2561–2564 
Bern. C. (1992). The magnitude of the global problem of diarrheal disease: a ten year update. Bulletin of the World Health Organization, 70: Henning, B. (2008). Efficient water market mechanisms to cope with water scarcity. International Journal of Water Resources Development, Volume 19, Issue 4 December 2003 , pages Snow, M., White, G.L., & Kim, H.S.(2008). Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates. Journal of School Health, v78 n4 p Apr 2008 The Carter Center, (2008) "Guinea Worm Eradication Program", T, retrieved on
References
Barry, M.(2007),"The Tail End of Guinea Worm — Global Eradication without a Drug or a Vaccine", New England Journal of Medicine 356 (25): 2561–2564 
Bern. C. (1992). The magnitude of the global problem of diarrheal disease: a ten year update. Bulletin of the World Health Organization, 70: Henning, B. (2008). Efficient water market mechanisms to cope with water scarcity. International Journal of Water Resources Development, Volume 19, Issue 4 December 2003 , pages Snow, M., White, G.L., & Kim, H.S.(2008). Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates. Journal of School Health, v78 n4 p Apr 2008 The Carter Center, (2008) "Guinea Worm Eradication Program", T, retrieved on

33. References
U.S. Centers for Disease Control and Prevention.(2008). Dracunculiasis, Retrieved
WHO.(2008). Safer water, better health Costs, benefits and sustainability of interventions to protect and promote health. Retrieved July 15, 2009 from
World Health Organization.(2007). World moves closer to eradicating ancient worm disease. Retrieved July 15,2008.
References
U.S. Centers for Disease Control and Prevention.(2008). Dracunculiasis, Retrieved
WHO.(2008). Safer water, better health Costs, benefits and sustainability of interventions to protect and promote health. Retrieved July 15, 2009 from
World Health Organization.(2007). World moves closer to eradicating ancient worm disease. Retrieved July 15,2008.