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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
"first case"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
canavan disease
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
fabry disease
familial mediterranean fever
focal myositis
gm1 gangliosidosis
harlequin ichthyosis
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
systemic capillary leak syndrome
thoracic outlet syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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