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[Water contacts in dracunculiasis-infected patients in Mali: transmission risk activities].
[dracunculiasis]
The
aim
of
this
study
lies
in
the
identification
of
human
activities
responsible
for
the
transmission
of
the
Guinea
worm
in
an
endemic
village
in
Diema
Region
in
Mali
.
Human
water
contacts
observations
started
after
a
census
followed
by
the
implementation
of
a
bi
-monthly
notification
system
,
carried
out
from
May
to
November
1993
.
Water
contacts
were
noticed
and
observed
from
the
mid-
July
to
the
end
of
November
of
the
same
year
.
The
first
case
of
dracunculiasis
observed
was
randomly
drawn
out
of
a
list
of
the
families
with
obvious
cases
.
The
patent
case
activities
involving
either
surface
water
,
traditional
wells
or
bore-hole
water
were
recorded
for
10
consecutive
days
.
During
this
observation
period
,
contacts
made
by
other
patients
with
the
same
water
sources
were
also
recorded
.
After
14
days
,
the
case
list
was
updated
and
a
new
case
selected
out
of
families
previously
selected
.
This
cycle
was
repeated
until
the
end
of
the
study
period
.
A
"
contact
at
risk
for
transmission
"
was
defined
by
a
close
correspondence
between
the
location
of
the
worm
's
emergence
and
the
surface
of
the
skin
exposed
to
water
,
within
two
weeks
following
emergence
.
Contacts
were
described
according
to
water
sources
,
activities
in
relation
to
water
,
date
,
gender
and
age
.
Observations
were
made
on
103
patients
who
had
2506
activities
in
relation
with
a
water
body
:
1132
of
these
activities
implied
a
skin
contact
with
the
water
.
Only
133
(
9
%
)
of
these
water
contacts
were
at
risk
for
transmission
,
75
%
took
place
during
the
months
of
August
and
September
,
80
%
were
related
to
surface
waters
and
20
%
to
traditional
wells
.
Woman
household
activities
and
boys
games
were
the
major
activities
at
risk
,
in
contrast
to
economic
activities
(
watering
cattle
)
.
The
low
proportion
of
"
at
risk
activities
"
evaluated
in
this
study
suggests
that
a
small
number
of
water
contacts
is
sufficient
to
maintain
the
transmission
.
The
case
implications
of
the
current
eradication
strategy
might
not
be
sufficient
alone
to
break
the
transmission
and
should
therefore
be
associated
with
a
reinforcement
of
the
use
of
filters
for
drinking
water
together
with
an
health
education
.
Diseases
Validation
Diseases presenting
"low proportion"
symptom
dracunculiasis
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