National Guinea Worm Eradication programme in India

1. NATIONAL GUINEA
WORM ERADICATION
PROGRAMME
SOBANA. M., M.Sc(N).

2. INTRODUCTION
• Dracunculosis or Guinea Worm (GW) disease is caused by the
nematode Dracunculus medinensis. The adult female guinea
worm, measuring 60-100 cm in length, emerges through the
skin, usually lower limbs, causing swelling, ulceration
and discomfort to the patients.

3. • The GW infection is transmitted to a person when an
active GW patient with the ulcer enters into unsafe
drinking water - source the anterior end of the
emerging guinea worm is ruptured.
• The contact with water bursts a loop of the uterus
discharges its thousand of embryos into water. Cyclops
present in the water ingests these embryos.

4. • When a person drinks water containing infected Cyclops, the
gastric juice of man kills the Cyclops and activates the
larvae which then penetrate the gut wall and migrate, usually
to the retro peritoneal connective tissues, when they mature
into male and female adult worms in about six months after
entering into human body.
• The male worm is smaller in size, dies immediately after
copulation and gets absorbed in the body. The female then,
migrate to those part of the body which are likely to come in
contact with water.

6. EPIDEMIOLOGY OF GUINEA WORM DISEASE
• Agent Factors
Dracunculus medinensis, nematode worm
M-2cm F-60-120cm
• Reservoir
Infected person
• Host factors
All ages, both sex susceptible
Repeated infection in same individual
(no immunity)
• Environmental factors
Step wells: Summer ,Ponds: June-
Sept, Temp:25-30 C
• Mode of transmission
Oral: Consumption of water
containing cyclops harboring the
infective parasite.

7. • The disease causes incapacitation to the patient who is unable
to perform his regular work, resulting in economics and
production loss to the family.
• Presently it is prevalent in the African continent as well as
India, viz. Andhra Pradesh, Gujarat, Karnataka, Madhya Pradesh,
Maharashtra, Rajasthan, and Tamil Nadu.
• The disease was mostly confined to rural areas with inadequate
safe drinking water supply.
• Peak incidence used to occur in the summer season when there is
scarcity of water, except in the desert areas of Western
Rajasthan where the incidence was more in post-monsoon season.

8. • India is the first country in the world to establish the
National Guinea Worm Eradication Programme in 1983-84 as
a centrally sponsored scheme on 50-50 sharing between
Centre and States with the objective of eradicating
guinea worm disease from the country.
• The National Institute of Communicable Diseases (NICD),
Delhi worked as the nodal agency for planning,
coordination, guidance and evaluation of NGWEP in the
country.
•

9. THE IMPORTANT STRATEGY ADOPTED TO ERADICATE THE GW
IS:
1. GW case detection and continuous surveillance through active case search
operations and regular monthly reporting
2. GW case management
3. Vector Control by the application of Tempos in unsafe water sources eight
times a year and use of fine nylon mesh/double layered cloth strainers by the
community to filter Cyclops in all the affected villages
4. Health education
5. Trained manpower development and
6. Provision and maintenance of safe drinking water supply on priority in GW
endemic villages
7. Concurrent evaluation and operational research

10. IMPLEMENTATION
• The endemic State Health Directorate through Primary Health Care
system implemented the programme.
• The Ministry of Rural Development, Govt. of India and State Public
Health Engineering Departments (Rural Water Supply) assist the
Programme in provision and maintenance of safe drinking water
supplies and conversion of unsafe drinking water sources, like step
wells, and ponds on priority in the guinea worm affected areas.
• District Medical Officer and PHC medical Officer were responsible
for planning, implementation, monitoring and supervision of the
GWEP.

11. • Annually the Task Force Group under the chairmanship
of Director General of Health Services, Govt. of
India, reviewed the GWEP in depth.
• This task Force Group was constituted by:
a) Director and Deputy Director (Helminthology) of NICD
Delhi as convener and coordinator of the work
b) Directors of Health and Medical Services, GWEP-officers,
chief engineers (Rural Water Supply) of GW endemic states
c) Director/Advisor of National Water Mission as members
d) Experts from WHO, UNICEF, Centre Health Education Bureau
(CHEB), Planning Commission and related organizations.

12. ACHIEVEMENT
• At the beginning of the programme i.e. in 1984,
there were around 40,000 GW cases in 12840 villages
in 89 districts of 7 endemic states.
• During 1996 only 9 guinea worm cases have been
recorded in three villages from Jodhpur (Rajasthan),
rest of the country continued to remain free from
GW.
• Banwari Lal 25 years old from Jodhpur in Rajasthan
was the last case in India in 1996 (Lancet 2000).

13. "GUINEA WORM DISEASE FREE"
•"Zero" incidence has been maintained since
August 1996 through active surveillance and
intensified field monitoring in the endemic
areas.
•In the Meeting of WHO in February 2000 the India
has been certified for the elimination of Guinea
Worm Disease and on 15th February 2001
declared India as "Guinea Worm Disease
Free".

14. REFERENCE
National Institute of Health & Family Welfare
http://www.nihfw.org/NationalHealthProgramme/GUINEAWORMERADICATIONPROGRAMME.html

15. THANK
YOU