Contributions of the Guinea Worm Disease Eradication Campaign toward Achievement of the Millennium Development Goals

Callahan, Kelly; Bolton, Birgit; Hopkins, Donald R.; Ruiz‐Tiben, Ernesto; Withers, P. Craig; Meagley, Kathryn

doi:10.1371/journal.pntd.0002160

Cited by 16 publications

(18 citation statements)

References 34 publications

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“…In most infectious diseases that have been considered for elimination, a vaccine has been available. However, this is not essential as evidenced by the near eradication of the Guinea worm without even drug therapy . Of course vaccine development seems logical.…”

Section: Eradication – Can It Be Achieved?mentioning

confidence: 99%

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Leask

Dillon

2016

Aliment Pharmacol Ther

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Summary Background Hepatitis C virus (HCV) is a leading cause of chronic liver disease worldwide. HCV predominates in people who inject drugs; a group in whom anti‐viral therapy has previously been withheld on the basis of chaotic lifestyles and associated risks of reinfection. New research has emerged which suggests that by specifically targeting HCV‐infected people who inject drugs for treatment, the pool of HCV would deplete, thus reducing overall transmission and eventually leading to HCV eradication. Aim To outline the requirements for HCV eradication and review the evidence that this is achievable. Methods Expert review of the literature. Results The achievement of HCV eradication using ‘treatment as prevention’ is supported by numerous epidemiological modelling studies employing a variety of models in several contexts including people who inject drugs, men who have sex with men and prisoners. More recent studies also incorporate the newer, more efficacious direct‐acting anti‐viral drugs. These drugs have been shown to be safe and effective in people who inject drugs in clinical trials. There is no empirical evidence of the impact of treatment as prevention strategies on population prevalence. Conclusions This review highlights the efforts to control HCV and evaluates the possibilities of achieving eradication of HCV. Currently, the technologies required to achieve HCV eradication exist, but the infrastructure to deliver them is not generally available or of insufficient scale outside of specific areas. Such areas are yet to demonstrate that elimination is possible, but results of studies in these areas are awaited. Such a demonstration would be proof of principle for eradication. Although we are aspiring towards HCV eradication, elimination is the more realistic prospect.

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Section: Eradication – Can It Be Achieved?mentioning

confidence: 99%

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Leask

Dillon

2016

Aliment Pharmacol Ther

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“…Infected persons often seek relief from the burning sensation by immersing the wound in a water source, at which point the worm releases its larvae. [5]There is no known medical treatment available to kill the parasitic nematode while it is inside the host, and on average GWD incapacitates its victims for about 8.5 weeks [5,6] Eradication efforts for GWD primarily use behavioral and environmental interventions to break the cycle of transmission to prevent contamination of drinking water sources and by improving access to clean drinking water [7] The eradication of GWD requires that every case must be found and contained, making surveillance and case finding a priority for countries on the verge of elimination.…”

Section: Introductionmentioning

confidence: 99%

Achieving the endgame: Integrated NTD case searches

et al. 2018

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Trachoma and Guinea Worm Disease (GWD) are neglected tropical diseases (NTD) slated for elimination as a public health problem and eradication respectively by the World Health Organization. As these programs wind down, uncovering the last cases becomes an urgent priority. In 2010, Ghana Health Services, along with The Carter Center, Sightsavers, and other partners, conducted integrated case searches for both GWD and the last stage of trachoma disease, trachomatous trichiasis (TT), as well as providing surgical treatment for TT to meet elimination (and eradication targets). House to house case searches for both diseases were conducted and two case management strategies were explored: a centralized referral to services method and a Point of Care (POC) delivery method. 835 suspected TT cases were discovered in the centralized method, of which 554 accepted surgery. 482 suspected TT cases were discovered in the POC method and all TT cases accepted surgery. The cost per TT case examined was lower in the POC searches compared to the centralized searches ($19.97 in the POC searches and $20.85 in the centralized searches). Both strategies resulted in high surgical uptake for TT surgery, with average uptakes of 72.4% and 83.9% for the centralized and POC searches respectively. We present here that house to house case searches offering services at POC are feasible and a potential tool for elimination and eradication programs nearing their end.

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“…Complete eradication has proved difficult and costly in the past; smallpox and rinderpest are the only examples of successful campaigns thus far (Barrett 2004;Mariner et al 2012). For example, approximately US$350 million have been spent on the effort to eradicate Guinea worm disease (Dracunculus medinensis), a macroparasite that infected nearly 3.5 million people each year when the effort first began (Callahan et al 2013). In cases in which human health is not directly affected, maintaining parasite population levels, rather than advocating for increase as one would for most other threatened species, may represent the most cost-effective and acceptable strategy.…”

Section: Including Parasites In Economic Valuationmentioning

confidence: 99%

Paradigms for parasite conservation

Dougherty

Carlson

Bueno

et al. 2015

Conservation Biology

110

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Parasitic species, which depend directly on host species for their survival, represent a major regulatory force in ecosystems and a significant component of Earth's biodiversity. Yet the negative impacts of parasites observed at the host level have motivated a conservation paradigm of eradication, moving us farther from attainment of taxonomically unbiased conservation goals. Despite a growing body of literature highlighting the importance of parasite‐inclusive conservation, most parasite species remain understudied, underfunded, and underappreciated. We argue the protection of parasitic biodiversity requires a paradigm shift in the perception and valuation of their role as consumer species, similar to that of apex predators in the mid‐20th century. Beyond recognizing parasites as vital trophic regulators, existing tools available to conservation practitioners should explicitly account for the unique threats facing dependent species. We built upon concepts from epidemiology and economics (e.g., host‐density threshold and cost‐benefit analysis) to devise novel metrics of margin of error and minimum investment for parasite conservation. We define margin of error as the risk of accidental host extinction from misestimating equilibrium population sizes and predicted oscillations, while minimum investment represents the cost associated with conserving the additional hosts required to maintain viable parasite populations. This framework will aid in the identification of readily conserved parasites that present minimal health risks. To establish parasite conservation, we propose an extension of population viability analysis for host–parasite assemblages to assess extinction risk. In the direst cases, ex situ breeding programs for parasites should be evaluated to maximize success without undermining host protection. Though parasitic species pose a considerable conservation challenge, adaptations to conservation tools will help protect parasite biodiversity in the face of an uncertain environmental future.

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Contributions of the Guinea Worm Disease Eradication Campaign toward Achievement of the Millennium Development Goals

Cited by 16 publications

References 34 publications

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Achieving the endgame: Integrated NTD case searches

Paradigms for parasite conservation

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