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Ministry of Health

Kenya Guinea Worm Eradication Programme

Laico Regency Hotel - 26th August 2015

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White Worm Emerging from the skin

Guinea Worm - a white worm emerging from a skin lesion.

Its length is between 60cm-120cm (≈1m)

Infection occurs when a person drinks contaminated water containing water fleas (Cyclops) infected with guinea worm larvae

Guinea Worm Disease(Dracunculus medinensis)

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Life Cycle

Water fleas (cyclops)with GW larvae

Contaminated pond/dam

1

2

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Life Cycle cont.

The worm emerges from the skin after one year

This is accompanied by a lot of pain that forces the infected person to immerse the affected part in water

The worm in turn releases larvae into the water - thus continuing the cycle

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Prevention and Control There is no drug or vaccine to prevent guinea worm

Prevention of GWD is through

Environmental management – protecting water

sources using vectorcides such as temephos

(Abate™)

Preventing infected persons from contaminating

water sources

Health education

Active & passive surveillance

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Prevention and Control cont.• Water obtained from dams & ponds

should be boiled or filtered before drinking

• The infected person should not step into water dams and ponds to avoid infecting the water fleas with larvae of GWD

• Contaminated sources of water – ponds & dams should be disinfected with temephos (Abate™)

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Treatment & management of cases

• There is no drug to cure guinea worm

• On suspicion of guinea worm infection the patient should be CONTAINED – i.e.

• The worm should not be allowed to enter water in ponds or dams

• The part of the body from where the worm is emerging should be bandaged to prevent damage to the worm until it has been completely removed

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Treatment & management of cases• When the worm emerges, it should be slowly rolled

onto a small stick or piece of gauze by a health worker.

• NB: this is the main way of removing the worm but it is

very painful to the patient so it is done slowly in phases

• Complete removal of the worm can take days or weeks

• If the worm breaks before it has been fully removed – the remaining worm will have to be removed surgically!

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GLOBAL SITUATION

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Countries currently endemic for dracunculiasisCountries at precertification stagePreviously endemic countries certified free of dracunculiasisOther countries and territories certified free of dracunculiasis

Countries and territories not known to have dracunculiasis but yet to be certifiedNot applicable

Status of certification of dracunculiasis eradication worldwide, 2013

197 countries, areas and territories certified free of dracunculiasis

4 endemic countries

3 countries in precertification stage

2 countries not known to have dracunculiasis

9 countries yet to be certified

5

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Status of endemicity and number of cases reported by countryin the WHO Africa Region*

   

  

 

 

 

     (11)

    

 

  

  

 

 

 

   

   

 

 

  

 

 

 

 

  

  

    

  

   

 

 

 

 

  

 

 

          

 

 

  

  

 

 

(   (2) 

 

 

  

 

 

 

 

(31)

 

   

  

 

 

 

 

 

  

 

 

 

       

 

(81)

 

 

 

 

 

 

4 ENDEMIC countries with 125 reported cases Jan-Oct 2014

1 PRE-CERTIFICATION country

1 PRE-CERTIFICATION country with ICT visit

39 Certified GWD-free countries

2 Countries to be VERIFIED

 

 

 

 

 

Ethiopia

South Sudan

ChadMali

Ghana

DRC

Angola

Kenya

*At October 2014

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GWD GLOBAL No. of cases

1986 - 3,600,000 cases2012 - 542 cases2013 - 148 cases2014 - 126 cases (in Mali, Chad,

S. Sudan & Ethiopia)

2015 - 5 (January to May)

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Distribution of remaining cases

Reported Cases by Country in 2014

Chad: 13

Ethiopia: 3

Mali: 40

South Sudan: 70

Jan 2015 to Date - 5 cases discovered so far

4 in Chad & 1 in Ethiopia

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Guinea worm about to become the second disease to be eradicated from the world – 37 years after small pox was eradicated in 1978

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Kenyan Situation Kenya is in precertification phase of

dracunculiasis eradication

The last indigenous and imported cases were reported in 1994 and 2005 respectively

Main Activities towards certification are active surveillance, reporting and documentation

Main Focus- formerly endemic Counties of Turkana, West Pokot and Trans Nzoia

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Risk of Importation into Kenya

Risk of importation exists due to proximity to endemic countries of South Sudan and Ethiopia

Current civil strife in South Sudan poses a major risk due to influx of refugees to Kakuma camp, Turkana county

Cross border interactions between the Turkana and Toposa communities also increases risk of importation

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Surveillance for GWD During and after the communication

campaign, Health workers will be expected to ask for GWD cases in during health talks at health facilities – esp. in Turkana County

Community Health Workers will also sensitize their Units on GWD and follow up any suspected cases

ALL suspected cases must be reported immediately to the nearest health facility

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Surveillance for GWD cont.Details of suspected cases are to

be entered into a special investigation form at the health facility as soon as a case is reported

ALL SUSPECTED CASES MUST BE PHOTOGRAPHED – even with a phone camera

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REWARD FOR FINDING A CASE OF GUINEA WORM DISEASEKShs.100,000/=

From the Ministry of Health

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WHY we need you to spread the message of guinea worm disease We want Kenya certified as a guinea worm free

country by 2016

Therefore we need all Kenyans to

Have heard of the disease

Have an idea of what it looks like & look out for it

Know that it must be reported to a health facility

Know that there is a reward of ksh.100,000 for every case

found

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Mass media communication campaign on GWD

Starts today 26th August 2015, intensively for three months

Information on GWD will be

disseminated nationwide to all

social strata and especially

through primary schools in

Turkana County

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Counting on all of us to spread the word &