From the Guidelines
Hookworms are parasitic nematodes that infect the small intestine of humans, typically acquired through skin penetration by larvae in contaminated soil, and can cause asymptomatic to severe infections with symptoms such as nausea, vomiting, diarrhea, and abdominal pain, particularly in areas with limited access to adequate sanitation. The two main species affecting humans are Ancylostoma duodenale and Necator americanus, with a prepatent period of 5–9 weeks 1. Some key points about hookworm infections include:
- Distribution: Worldwide, but most common in areas with poor sanitation 1
- Mode of transmission: Larvae penetrate the skin of humans walking barefoot or lying on affected soil or sand, and some species can also be acquired orally 1
- Clinical presentation: Usually asymptomatic, but can include a transient itch, maculopapular rash, nausea, vomiting, diarrhea, and abdominal pain, with heavy infections potentially resulting in anemia, particularly in young children 1
- Investigations: Concentrated stool microscopy or faecal PCR 1
- Treatment: Albendazole 400 mg daily for 3 days is recommended, with prednisolone suggested in severe disease 1. It is essential to seek specialist advice, as management in an intensive care setting may be needed in severe cases 1.
From the Research
Characteristics of Hookworms
- Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts 2
- The predominant infecting species is Necator americanus 2
- Adult worms feed on the blood of a host and can cause iron deficiency anaemia, especially in high-risk populations such as children and women of childbearing age 2, 3, 4
Health Impacts of Hookworm Infection
- Hookworm infection is responsible for iron-deficiency anaemia, which can be prevented and treated by administration of iron 3
- Hypoproteinemia may be associated with hookworm infection, resulting from either protein malnutrition or increased intestinal loss of protein 3
- Hookworm infection can contribute to micronutrient deficiency, including vitamin A and iron deficiency, through subtle reduction in digestion and absorption, chronic inflammation, and loss of nutrients 5
Prevalence and Control of Hookworm Infection
- Almost 500 million people in developing tropical countries are infected with hookworms 2
- Anthelmintic drugs are available and widely used, but their efficacy varies and they do not prevent reinfection 2
- Other control strategies aimed at improving water quality, sanitation, and hygiene are needed to control hookworm infection 2
- Efforts are underway to develop a human hookworm vaccine through public-private partnerships 2