Dermatology

Infections of the skin?, Skin infestations?, Ulcers?, Rashes?, Dermatitis eczema?, Psoriasis?, Pityriasis rosea?, Lichen planus?, Drug eruptions?, Vasculitis?, Erythema nodosum?, Urticaria?, Erythema multiforme?, Blistering disorders?, Connective tissue diseases?, Disorders of pigmentation?, Skin cancers?, Common cutaneous viral infections?, Varicella zoster virus?, Poxvirus infections?, Cutaneous leishmaniasis?, Lymphoedema elephantiasis?, Lymphatic filariasis?, Onchocerciasis 'river blindness'?, Loiasis Loa loa?, Dracunculiasis Guinea worm?, Other parasites that invade the skin?, Cutaneous larva migrans?, Larva currens?, Podoconiosis?, The non-venereal treponematoses?

Rishta and her treatment

As you know, filariasis (dracontiasis) is caused by an interstitial parasite, which has many names, and in which the most common are: rishta, guinea worm, filaria medinensis.

Assessment of the Chad guinea worm surveillance information system: A pivotal foundation for eradication

Background In the absence of a vaccine or pharmacological treatment, prevention and control of Guinea worm disease is dependent on timely identification and containment of cases to interrupt transmission. The Chad Guinea Worm Eradication Program (CGWEP) surveillance system detects and monitors Guinea worm disease in both humans and animals. Although Guinea worm cases in humans has declined, the discovery of canine infections in dogs in Chad has posed a significant challenge to eradication efforts. A foundational information system that supports the surveillance activities with modern data management practices is needed to support continued program efficacy. Methods We sought to assess the current CGWEP surveillance and information system to identify gaps and redundancies and propose system improvements. We reviewed documentation, consulted with subject matter experts and stakeholders, inventoried datasets to map data elements and information flow, and mapped data management processes. We used the Information Value Cycle (IVC) and Data-Information System-Context (DISC) frameworks to help understand the information generated and identify gaps. Results Findings from this study identified areas for improvement, including the need for consolidation of forms that capture the same demographic variables, which could be accomplished with an electronic data capture system. Further, the mental models (conceptual frameworks) IVC and DISC highlighted the need for more detailed, standardized workflows specifically related to information management. Conclusions Based on these findings, we proposed a four-phased roadmap for centralizing data systems and transitioning to an electronic data capture system. These included: development of a data governance plan, transition to electronic data entry and centralized data storage, transition to a relational database, and cloud-based integration. The method and outcome of this assessment could be used by other neglected tropical disease programs looking to transition to modern electronic data capture systems.

Quantifying conflict zones as a challenge to certification of Guinea worm eradication in Africa: a new analytical approach

ObjectivesTo quantify conflict events and access across countries that remain to be certified free of transmission of Dracunculus medinensis (Guinea worm disease) or require postcertification surveillance as part of the Guinea Worm Eradication Programme (GWEP).Setting and participantsPopulations living in Guinea worm affected areas across seven precertification countries and 13 postcertification sub-Saharan African countries.Outcome measuresThe number of conflict events and rates per 100 000 population, the main types of conflict and actors reported to be responsible for events were summarised and mapped across all countries. Chad and Mali were presented as case studies. Guinea worm information was based on GWEP reports. Conflict data were obtained from the Armed Conflict Location and Event Data Project. Maps were created using ArcGIS V.10.7 and access was measured as regional distance and time to cities.ResultsMore than 980 000 conflict events were reported between 2000 and 2020, with a significant increase since 2018. The highest number and rates were reported in precertification Mali (n=2556; 13.0 per 100 000), South Sudan (n=2143; 19.4), Democratic Republic of Congo (n=7016; 8.1) and postcertification Nigeria (n=6903; 3.4), Central Africa Republic (n=1251; 26.4), Burkina Faso (n=2004; 9.7). Violence against civilians, protests and battles were most frequently reported with several different actors involved including Unidentified Armed Groups and Boko Haram. Chad and Mali had contracting epidemiological and conflict situations with affected regions up to 700 km from the capital or 10 hours to the nearest city.ConclusionsUnderstanding the spatial–temporal patterns of conflict events, identifying hotspots, the actors responsible and their sphere of influence is critical for the GWEP and other public health programmes to develop practical risk assessments, deliver essential health interventions, implement innovative surveillance, determine certification and meet the goals of eradication.

Linked surveillance and genetic data uncovers programmatically relevant geographic scale of Guinea worm transmission in Chad

Background Guinea worm (Dracunculus medinensis) was detected in Chad in 2010 after a supposed ten-year absence, posing a challenge to the global eradication effort. Initiation of a village-based surveillance system in 2012 revealed a substantial number of dogs infected with Guinea worm, raising questions about paratenic hosts and cross-species transmission. Methodology/principal findings We coupled genomic and surveillance case data from 2012-2018 to investigate the modes of transmission between dog and human hosts and the geographic connectivity of worms. Eighty-six variants across four genes in the mitochondrial genome identified 41 genetically distinct worm genotypes. Spatiotemporal modeling revealed worms with the same genotype (’genetically identical’) were within a median range of 18.6 kilometers of each other, but largely within approximately 50 kilometers. Genetically identical worms varied in their degree of spatial clustering, suggesting there may be different factors that favor or constrain transmission. Each worm was surrounded by five to ten genetically distinct worms within a 50 kilometer radius. As expected, we observed a change in the genetic similarity distribution between pairs of worms using variants across the complete mitochondrial genome in an independent population. Conclusions/significance In the largest study linking genetic and surveillance data to date of Guinea worm cases in Chad, we show genetic identity and modeling can facilitate the understanding of local transmission. The co-occurrence of genetically non-identical worms in quantitatively identified transmission ranges highlights the necessity for genomic tools to link cases. The improved discrimination between pairs of worms from variants identified across the complete mitochondrial genome suggests that expanding the number of genomic markers could link cases at a finer scale. These results suggest that scaling up genomic surveillance for Guinea worm may provide additional value for programmatic decision-making critical for monitoring cases and intervention efficacy to achieve elimination.

A CLASSICAL REVIEW ON SNAYUKA ROGA WITH SPECIAL REFERENCE TO DRACUNCULIASIS

Snayuka roga is caused by a kapha-raktaja krimi, named Snayuka. In Ayurveda, reference of Snayuka roga is available in Bhavprakash, Sharangadhara Samhita, Madhava Nidana and Yogaratnakara. This disease is characterised by shotha (swelling), daha (severe burning sensation), discolouration of skin, blisters formation similar to visarpa (Erysipelas) and it further worsens the condition if the jivam (worm) crawls out of ulcer breaks further worsens the condition. On complete exit of worm from body through the wound, the symptoms get reduced. However, it can reoccur in other distant places. These symptoms and presentation of Snayuka roga resembles with Dracunculiasis in modern science, which was endemic in various countries in last century. Dracunculiasis, a vector-borne disease, commonly known as Guinea-worm disease, is caused by the parasite called Dracunculus medinensis, commonly called as "Guinea-worm". Its larvae migrate through the Cyclops containing water to the hosts by drinking and after degeneration of Cyclops in the stomach; they migrate to subcutaneous tissues, causing severe pain along with burning sensation followed by local swelling, blisters and finally an ulcer. In India the GWD was endemic in 89 districts in seven states. India was declared as guinea worm disease free country by WHO in 2000. But intestinal parasitic infection is a main public health problem in developing countries. There is need to create awareness among people about intestinal parasitic infections. Hence, here an effort has been made to understand and review Snayuka roga, caused by Snayuka krimi as explained in Ayurvedic texts, correlating Dracunculiasis (Guinea worm disease- GWD).