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The Challenge of Parasite Control
Published in Eric S. Loker, Bruce V. Hofkin, Parasitology, 2023
Eric S. Loker, Bruce V. Hofkin
This all changed in 2014 with the discovery of D. medinensis-infected dogs in Chad. Since then, infected dogs, along with a few cats and non-human primates have been reported from a handful of African countries. In 2020, in Chad alone, 1,570 infected dogs were identified. Because of this new and unexpected development, the World Health Organization has once again moved the target date for Guinea Worm eradication, this time from 2020 to 2030. Time will tell whether or not this objective is achieved, but the sudden appearance of animal reservoirs certainly makes total eradication more arduous. It is now recognized that eradication efforts must also eliminate infections in dogs as well as humans.
Dracunculus medinensis
Published in Eric S. Loker, Bruce V. Hofkin, Parasitology, 2015
Eric S. Loker, Bruce V. Hofkin
Control Control measures have been very effective and eradication within a decade seems possible. The measures include filtration of drinking waters to remove infected copepods, provision of clean borehole water, treatment of water in transmission foci with Temephos to kill copepods, education to inform people how infection can be prevented, prevention of female worms from expelling progeny into water bodies, monitoring and case control efforts, and use of media and local celebrities to help promote control efforts. Control has been facilitated by the lack of reservoir hosts. The work of the Carter Center to spearhead the Global Guinea Worm Eradication Program with involvement by the WHO, CDC, UNICEF, and others has been exemplary.
Social determinants of tuberculosis: context, framework, and the way forward to ending TB in India
Published in Expert Review of Respiratory Medicine, 2021
Anurag Bhargava, Madhavi Bhargava, Anika Juneja
The TB program was a low priority program in India with poor funding, low levels of case-finding, sub-optimal regimes and supervision with low cure rates and high death rates. For an estimated 1.5 million patients, had an allocation of INR 20 million in 1981 (USD 2.6 million, then), which rose only up to INR 120 million in 1990,(USD 7 million, then) [10].The only communicable disease program with a lower allocation was guinea-worm eradication [11]. The case finding efficiency was only 30% of the potential,most of it based on radiologic grounds [12]. The shortage of drugs was common, isoniazid and thiacetazone combination for 18 months was often used till early 1990s, with completion rates of only 30% [12]. As a result, the NTP was effectively curing merely 10% of the patients. The introduction of shorter regimes was expected to improve cure rates, but the completion rates remained under 50% [13]. The overall mortality was 28%, treatment failure was 22% on short course and 48% on conventional regimes and there was significant emergence of DR-TB [13]. A poor programme with poor funding support led to continuing transmission of disease, as well as promoted DR-TB.