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November 05, 2016 00:02

Guinea worm disease : causes, symptoms , diagnosis, treatment

Dracunculiasis - biogelmintoz.Sexually mature individuals are located in the subcutaneous tissue, most often of the lower extremities.

What is guinea worm?

Pathogen dracunculiasis - Dracunculus medinensis, guinea worm, with a pronounced sexual dimorphism.Threaded female - large nematode length of 30-129 cm and a width of 0.5-1.7 mm, the male has a length of 12-30 mm, a width of 0.2-0.4 mm.

rear male end is bent on the ventral side.It has 4 pairs of preanal, and 6 pairs postanal papillae, 2 dark brown spicules 0,49-0,73 mm long and 0.2 mm in length gubernaculum.On the rounded front end of the female cuticular elevation is quadrangular with 4 double nipples boundary and located behind them amphids.Roth has a triangular shape, a short esophagus is made up of muscular and glandular sections separated by a narrowing situated at the level of nerve ring.Esophagus enters the cylindrical intestine, anus ending near the rear end of the body.Caudal end of female ends subulate appendage facing ventrally.The

vagina is located in the middle of the body of the uterus leads to the two lying one behind the other.They open fallopian tubes, ovaries coming from the tubular.Females - viviparous.

During long-term development in the body of the final host (11-13 months) primary cavity of the female is almost completely filled with queens stuffed with embryos.The opening of the vagina, the rectum and the opening of the vulva atrophy.The remainder of the intestinal tube shrinks and is pushed aside.Larvae emerge through the uterus and the cuticle breaks at the front end of the body.

cycle of Guinea worm disease dracunculiasis

- biogelmintoz.The final boss - a man, sometimes the animals: a dog, a monkey.Intermediate hosts - freshwater crustaceans kind Cyclops or Eucyclops.

person infected with dracunculiasis, swallowing water cyclops infested mature larvae (microfilariae).In the gastrointestinal tract to digest Cyclops.Larvae penetrate the intestinal wall and migrate through connective tissues in the direction of the lower extremities.3 months after the fertilization of the female invasion occurs.After that the female migrates to the subcutaneous tissue of the lower extremities, increases, reaching 75-100 cm in length. About a year after the larvae penetrate the human body in her womb produces up to 3 million larvae.The head end of the female reaches the skin, causes bubble formation therein of up to 8.5 cm in diameter, filled with liquid.Larvae emerge from the female genital tract through the uterine rupture and helminth body wall near its front end.They are derived from the final host body through an opening formed in the skin by the action of specific secretion glands located at the front end of the female helminth.Small larvae rhabditiform long threadlike end are 0.5-0.75 mm in length, width - 15-25 m.

In contact with water bubble bursts.From it pops out the front end of the female.Throwing out Guinea worm larvae from the body is due to the reduction of its muscles in contact with water, which may be due to the cooling of the front end of helminth by water.Within 2-3 weeks, the female "hatch" into the water to 3 million larvae.Thereafter, the female die.They dissolve or calcify.

larvae that fall into the water and live in it for 3-6 days and ingested by Cyclops, in their body grow, develop, and molt twice at a temperature of 25-30 ° C in 12-14 days reach the infective stage.

The maximum duration of the parasite lives in the human body - less than 18 months.

Epidemiology dracunculiasis

Guinea worm disease is common in countries with hot and dry climate in the tropical regions of Africa, in the south of the Arabian Peninsula, in the south of Iran, Pakistan, India, China and South America.

foci of dracunculiasis are formed in regions where the population uses drinking unboiled water from the small artificial or natural stagnant waters, in which the inhabitants go barefoot (at this time the female guinea worm larvae hatch in the water).The development of the parasite takes place simultaneously in all infested people.Females are able to give birth to larvae at the same time almost all media helminth.This is achieved by a sharp increase in the probability of infection of a huge number of Cyclops, and then the final hosts in a short period of time.This feature of the development cycle has adaptive value in areas with dry climate and sparse rain periods.The spread of dracunculiasis foci revealed a large number of people infected with helminth within a short time interval.

dracunculiasis Infection occurs as a result of accidental ingestion of the Cyclops by drinking stagnant water from open reservoirs.In humans, the parasite develops very slowly.epidemiology The incubation period (time elapsed from the moment of infection until the release of larvae into the environment) for dracunculiasis is very large and is 12 months or more.Invade the final host becomes a source of infection only a year after infection.

main source of infection is infected person.

Guinea worm disease spreads due to unsanitary conditions, poor water supply, lack of water and sanitation.Guinea worm disease is prevalent in poor families living in homes and unimproved drinking raw dirty water using feces for fertilizer gardens.

big role in water pollution guinea worm larvae play water carriers entering bare feet in standing water for the water intake, as well as believing people committing ritual bath in the waters.As a result of entering the waters of a large number of larvae, cyclops, and the multitude of the population due to the habit of drinking unboiled water intensity of transmission of infection in the foci of dracunculiasis great.

Pathogenic action of guinea worm disease is associated with sensitization products exchange helminth, mechanical tissue damage and the addition of a secondary infection.

Symptoms dracunculiasis

The presence of Guinea worm patients will learn in a few months after infection, 8-10 days prior to the formation of blisters on the skin.The first symptoms of dracunculiasis are accompanied by severe allergic reactions.There are itching, rash, nausea, vomiting, asthma phenomenon, fever, swelling of the joints, which are located near the worms.

Shortly after the bubble burst allergic phenomena cease.Further during the invasion is determined by the presence or absence of secondary infection.

specific signs of the disease are erythema, thickening of the skin, blistering and sores at the site exit to the surface of the helminth.The first symptoms of dracunculiasis - forming a small capsule, turning into a bubble.Yellowish transparent bubble filled with liquid, which contains guinea worm larvae, leukocytes, lymphocytes and eosinophils.Education bladder accompanied by itching and burning pain that may weaken from the cold water.Bubble breaks upon contact with water, it protrudes from the front end of the female.In place of bubble appears ulcer surrounded by edematous skin roller and covered with white necrotic mass, which in a few days rejected.In uncomplicated cases, the ulcer heals quickly.In the presence of the body of only one helminth clinical manifestations lasted no more than 4-6 weeks and ends with recovery.Local lesions are localized mainly in the legs and ankles (90%), are sometimes found in other areas of the body: on the back, abdomen, scrotum, buttocks, breasts, tongue, shoulders.

dracunculiasis Symptoms depend on the localization of the parasite.A more severe course of dracunculiasis observed at localization of guinea worm in the large joints, with the death of the parasite in the secondary bacterial infection or a combination thereof.Most occur solitary lesions, but there are cases of parasitism of one person up to 50 worms.The process is painful and deprives the patient of working capacity for a long time.Sometimes there is a destruction of the helminth larvae before hatching.In these cases, symptoms are absent dracunculosis.

Complications dracunculiasis

When localization guinea worm disease in the joints develop severe arthritis, that 1% of cases end in ankylosis.The process may involve other large joints and muscles.Penetration into the place of localization of the parasite can cause bacterial infection festering abscesses, cellulitis, and sometimes gangrene, epididymitis, orchitis, sepsis.Cases of tetanus, recorded in dracunculiasis-endemic areas, are caused by the previous guinea worm infestation.In the absence of complications prognosis.

Diagnostics dracunculiasis

Diagnostics dracunculiasis in endemic foci in the presence of the characteristic skin manifestations is not difficult.Under the skin is felt threadlike education.In place of bubble rupture can detect the front end of guinea worm and its larvae.Calcified parasites detected X-ray examination.

Outside endemic foci requires differential diagnosis of dracunculiasis from boils, abscesses, cellulitis, and to find out the patient the opportunity of his stay in the foci of dracunculiasis.

Treatment dracunculiasis

Traditional treatment of dracunculiasis - winding on the body helminth wand, a few centimeters per day, avoiding breakage.With the development of allergic phenomena prescribe antihistamines.Applied metronidazole 250 mg x 3 x 10 days, for children - 25 mg / kg in three stages, the total daily dose should not exceed the adult dose.Drugs not destroying helminth but facilitates its extraction in conventional manner.

How to prevent guinea worm?

global dracunculiasis eradication program includes:

  • provision of safe drinking water;
  • allocation of special waters for the abstraction of drinking water and protection against contamination;
  • filtering water from open stagnant water bodies in order to prevent the ingress of the Cyclops;
  • detection and treatment of patients;
  • prevent insemination helminth larvae reservoirs by applying dressings rishtozny bubble.