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Ruiz-Tiben, E.

Publications and source records attributed to Ruiz-Tiben, E..

2 recordsLinked to original sources

Population genomic evidence that human and animal infections in Africa come from the same populations of Dracunculus medinensis

BackgroundGuinea worm - Dracunculus medinensis - was historically one of the major parasites of humans and has been known since antiquity. Now, Guinea worm is on the brink of eradication, as efforts to interrupt transmission have reduced the annual burden of disease from millions of infections per year in the 1980s to only 30 human cases reported globally last year. Despite the enormous success of eradication efforts to date, one complication has arisen. Over the last few years, hundreds of dogs have been found infected with this previously apparently anthroponotic parasite, almost all in Chad. Moreover, the relative numbers of infections in humans and dogs suggests that dogs may be key in maintaining transmission in that country.\n\nResultsIn an effort to shed light on this peculiar epidemiology of Guinea worm in Chad, we have sequenced and compared the genomes of worms from dog, human and other animal infections. Confirming previous work with other molecular markers, we show that all of these worms are D. medinensis, and that the same population of worms are causing both infections, can confirm the suspected transmission between host species and detect signs of a population bottleneck due to the eradication efforts. The diversity of worms in Chad appears to exclude the possibility that there were no, or very few, worms present in the country during a 10-year absence of reported cases.\n\nConclusionsThis work reinforces the importance of adequate surveillance of both human and dog populations in the Guinea worm eradication campaign and suggests that control programs should stay aware of the possible emergence of unusual epidemiology as they approach elimination.

genomics↗

Achieving the Endgame: Integrated NTD Case Searches

Trachoma and Guinea Worm Disease (GWD) are neglected tropical diseases (NTDs) slated for elimination as a public health problem and eradication respectively by the World Health Organization. As these programs wind down, uncovering the last remaining cases becomes an urgent priority. In 2010, The Ghana Health Service, along with The Carter Center, Sightsavers, and other partners, conducted integrated case search for cases of both GWD and the last stage of trachoma disease, trachomatous trichiasis (TT), as well as providing treatment for trachoma to meet elimination and eradication targets. House to house case search for both diseases was 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 in the POC searches. 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 search offering services at POC are feasible and a potential tool for elimination and eradication programs nearing their end.\n\nAuthor SummaryTrachoma and Guinea Worm Disease (GWD) are neglected tropical diseases (NTDs) slated for elimination as a public health problem and eradication respectively by the World Health Organization. As these programs wind down, uncovering the last remaining cases becomes an urgent priority in order to confirm that eradiation/elimination targets have been reached. Active case searches are one method of finding these last vestiges of disease. Searches for that look for multiple diseases are referred to as integrated searches. We piloted here integrated case searches for GWD and Trachoma with two case management strategies, a referral approach to a central location, and point of care approach (POC). POC approaches can difficult to implement in low resource settings because they require extensive personnel, financial, and logistical, support. However, POC approaches remove one of the biggest barriers to treatment, time spent traveling to a health center, and thus can improve treatment uptake. We found here that integrated active cases searches with a POC case management approach can be implemented in a low resource setting; and improve acceptance and uptake of trachoma examination and trichiasis surgery respectively without costing much more than the referral case management approach.

epidemiology↗