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PubMed2003

Reducing burden of hookworm disease in the management of upper abdominal pain in the tropics.

A prospective study of the stool samples of 129 rural patients with symptoms of upper abdominal pain, tenderness and indigestion was carried out from 2 February 1998 to 31 December 1998 and followed up to June 1999. The age range was 11-85 years, female:male ratio 2.4:1: 102 specimens were positive for helminths--Ancylostoma duodenale (hookworm) 80 (62%); Trichuris trichuria (threadworm) 12 (9.3%); Ascaris lumbricoides (large roundworm) 10 (7.76%); Strongyloides stercoralis three (2.3%); Taenia saginata (tapeworm) three (2.3%). The female:male ratio for hookworm was 3:1. Treatment with appropriate anthelminthic agents were given serially at each visit according to the result of faecal examination. At 6 months follow up 88 patients were free of symptoms, 60 of which were caused by helminths the hookworm group. Stool 'test and treat' strategy appears to be a cost-effective approach in the management of these patients.

Abdominal Pain↗

PubMedDate not supplied

An increase in hookworm infection temporally associated with ecologic change.

This report describes a significant increase in the prevalence of hookworm infection in an area of Haiti where intestinal parasites are common, but hookworm has not been common. Changing environmental conditions, specifically deforestation and subsequent silting of a local river, have caused periodic flooding with deposition of a layer of sandy loam topsoil and increased soil moisture. We speculate that these conditions, conducive to transmission of the infection, have allowed hookworm to reemerge as an important human pathogen.

Animals↗

PubMed2024

Investigating Environmental Determinants of Hookworm Transmission using GPS Tracking and Metagenomics Technologies.

To identify potential sources of hookworm infections in a Ghanaian community of endemicity that could be targeted to interrupt transmission, we tracked the movements of infected and noninfected persons to their most frequented locations. Fifty-nine participants (29 hookworm positives and 30 negatives) wore GPS trackers for 10 consecutive days. Their movement data were captured in real time and overlaid on a community grid map. Soil samples were collected and divided into two parts: one for determining the physical and chemical properties and the other for culture of helminth larvae. Soil parameters were determined using standard methods, and the number of larvae recovered from Baermann cultures (expressed as larvae per gram of soil) was recorded. We found no significant difference in the larval counts between sites of infected and noninfected participants (P = 0.59). Sandy-loam soil, pH, and effective cation exchange capacity were associated with high larval recovery counts (P <0.001), whereas nitrogen and clay content were associated with low counts (P <0.001). Genomic DNA was extracted from helminth larvae, and species were identified using metagenomic analysis of DNA sequences. The dominant helminth species identified were Panagrolaimus superbus, Parastrongyloides trichosuri, Trichuris trichiura (human whipworm), and Ancylostoma caninum (dog hookworm). Despite Necator americanus being the predominant species in the community, no larvae of this species were identified. This study, however, demonstrates the feasibility of applying molecular tools for identifying environmental factors and places associated with exposure to human and zoonotic helminths, including areas that may be targeted to break transmission in communities where infection is endemic.

Humans↗

PubMed1978

Activities of dichlorvos or disophenol against the hookworm (Uncinaria lucasi) and sucking lice of northern fur seal pups (Callorhinus ursinus) on St. Paul Island, Alaska.

One controlled and six critical tests were conducted in July, 1977 with northern fur seal pups (Callorhinus ursinus) to determine the efficacies of a single dose of dichlorvos capsules at 29.3 to 32.8 mg/kg, tablets at 10.5 to 11.5 mg/kg, or disophenol at 9.9 mg/kg given subcutaneously against natural infections of adult Uncinaria lucasi. In the controlled test, 20 pups were treated and 10 pups were nontreated. Removal of hookworms in this test was 99% for five pups receiving dichlorvos capsules, 99% for five pups receiving dichlorvos tablets, and 77% for 10 pups receiving disophenol. Also, both formulations of dichlorvos and the formulation of disophenol were highly active against natural infestations of two species of sucking lice (Proechinophthirus fluctus and Antarctopthirus callorhini). In critical tests with four pups treated with dichlorvos capsules at 28.6 to 30.6 mg/kg, removal of hookworms was uniformly 100%. Disophenol at 9.9 mg/kg removed 100% and less than 1% of hookworms in two pups, respectively, in critical tests.

Alaska↗

PubMed2001

[A case of hookworm infestation with dissociation values between FDP-E and FDP-D dimer].

We previously reported a five-year-old girl showing bleeding tendency and transient morphological and functional platelet abnormalities probably due to a hookworm, Necator Americanus, infestation. In this report, we describe the rarely accelerated fibrinogenolysis and/or fibrinolysis in this patient whose value of fibrinogen and/or fibrin degradation products(FDP) determined with an FDP-E assay was much higher than that determined with a D-dimer assay. Namely, on day-1 and day-13 of hospitalization, her D-dimer values were only 10 to 20% of the prospected values from FDP-E values. We speculated this phenomenon was induced by circulating protease(-like) agent(s) produced by hookworm, because the only slightly participation of plasmin and/or granulocyte elastase was evaluated by the determination of enzyme-inhibitor complexes. And the other possibility of fibrinogen degradation by blast- or tumor-associated protease was excluded by the clinical manifestations and primary disorders. In conclusion, we report a very rare case with the accelerated fibrinogenolysis and/or fibrinolysis in a patient with the hookworm infestation. We are interested in the mechanism that manifested the patient's bleeding tendency accompanied with morphological and functional platelet abnormalities.

Child, Preschool↗

PubMed2002

Hookworm infections of schoolchildren in southern Thailand.

A study of hookworm infections of schoolchildren was conducted in Nakhon Si Thammarat Province, southern Thailand. Of the 2,940 hookworms that were recovered from the children, almost all (99.9%), were Necator americanus, only three (0.1%) were identified as Ancylostoma duodenale, and all were female worms. An estimation of the worm burden of and the worm expulsion from the schoolchildren indicated there were 17 cases of light intensity hookworm infection. Fifteen cases (88.2%) expelled worms in numbers that corresponded with the worm burden that was estimated from the number of eggs per gram of feces. Two cases (11.8%) expelled more worms than predicted. In 16 moderate intensity cases, five (31.3%) expelled worms in a quantity that corresponding with the estimated worm burden. Eleven cases (68.7%) expelled fewer worms than predicted. All cases of heavy intensity infection expelled fewer worms than predicted.

Animals↗

PubMed2005

Ecologic covariates of hookworm infection and reinfection in rural Kwazulu-natal/south Africa: a geographic information system-based study.

Information on hookworm infection and re-infection in a cohort of primary school children and interview data on their socioeconomic background and behavior were combined with environmental data using a geographic information system (GIS). Multivariate models served to explore the covariation of environmental and infection patterns adjusted for possible confounders. Our aim was to identify environmental factors that might serve to predict infection and thus guide control efforts when epidemiologic information is insufficient. Furthermore, we wanted to establish whether soil type has a genuine influence on hookworm infection. Prevalence maps and spatial statistics showed considerable spatial clustering of infection in the small ( approximately 28 x 16 km) study area. The multivariate logistic regression models showed strong positive associations of infection at baseline (baseline prevalence = 83.2%) with settlement density (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.10-1.38) and vegetation density (OR = 1.66, 95% CI = 1.25-2.22) and a strong negative association with the clay content of the soil (OR = 0.67, 95% CI = 0.62-0.73). Similar but weaker correlations were found after re-infection. Socioeconomic status and behavior did not seem to confound these associations. Spatial analysis of the model residuals suggested that because the models accounted for most of the spatial pattern, the model standard errors were not affected by spatial clustering. Our study shows that the pattern of hookworm infection is strongly influenced by several environmental factors. The GIS-aided prediction of areas in need of treatment is therefore a promising tool to guide control efforts when epidemiologic information is insufficient.

Child↗

PubMedDate not supplied

Should deworming be included in antenatal packages in hookworm-endemic areas of developing countries?

BACKGROUND: WHO recommends antenatal (after the first trimester) deworming for pregnant women who live in areas where the prevalence of hookworm infection exceeds 20-30%. However, deworming has not been included in antenatal care packages in most developing countries. METHODS: A review of articles publishing original data identified primarily through Medline was conducted using subject heading terms and text words for "deworming", "pregnant women", "hookworm", "anthelminthic", "anthelmintic", "albendazole", "mebendazole", "pregnancy" and their combinations. Bibliographies of retrieved articles were scanned to identify any additional relevant documents. RESULTS: Five articles examined the benefits of antenatal deworming. All provided evidence favourable to deworming, in terms of both maternal and infant outcomes. Comparison of outcome measures could be improved with a more standardized approach to outcome ascertainment and reporting. CONCLUSION: The evidence base for the inclusion of deworming in antenatal care packages in hookworm-endemic areas is mostly observational in nature. Future research should be directed towards 1) strengthening the evidence base with empirical data from randomized controlled trials, and 2) furthering our understanding related to government uptake of the WHO policy on deworming.

Albendazole↗

PubMed1990

Hookworm infection and protein-energy malnutrition: transverse evidence from two Malaysian ecological groups.

Anthropometric and parasitological data from cross-sectional studies of two groups of primary school children (Group I of Indian origin, 325 boys and 259 girls, age = 7 years; Group II of Malay origin, 284 boys and 335 girls, age = 7-9 years) from two different ecological settings in Peninsular Malaysia were examined for epidemiological evidence of an association between hookworm infection and protein-energy malnutrition. In both ecological groups, significant weight, height and haemoglobin deficits were observed in children with hookworm infection after adjustment for covariables including Ascaris and Trichuris infection intensities and other child and family characteristics. The deficits were related to the intensity of infection based on egg counts. These findings suggest that hookworm may be an important determinant of chronic protein-energy malnutrition, as well as anaemia, in areas where diets are generally inadequate in protein, energy, and iron. Well-controlled intervention studies are needed to confirm these observations.

Anthropometry↗

PubMed1989

[Mebendazole-medicated-salt in the control of hookworm infection].

From 1984-1987, mass application of mebendazole-medicated salt was studied for the control of hookworm infection in 5 pilot areas (Wuming, Shanlin, Bobai, Guilin and Rongxian Counties) in Guangxi Zhuang Autonomous Region. The dosages of mebendazole (mixed with salt) administered were 15mg, 25mg, 30mg, 40mg, 50mg, 30mg, 70mg, 80mg, 100mg or 200mg per person per day for 15, 20 or 30 days. The results showed that 40mg/day for 15-20 days could result in stool egg negative conversion rates of 92.3 to 94.4%, while 50mg/day for 30 days resulted in 96.9 to 100%. Concurrently, the hookworm infection rate in pilot areas dropped by 57.9-71.7% in a short time; whereas the stool egg negative conversion rate of Ascaris lumbricoides was as high as 99.1% to 100% at the same dosage, when the dosage of 100mg/day for 30 days was given, the egg negative reversion rate for Trichuris trichiura was 97.6%. Promising result was also recorded concerning the tolerance of the medicated salt, as the side effects in the inhabitants were mild. In conclusion, the authors considered that the application of mebendazole-medicated salt was a simple and effective measure in controlling hookworm infection, especially in the light of solving the problem of incomplete mass detection and selected mass treatment. Furthermore, it is much more economic from the cost-effect point of view.

Female↗

PubMed1979

The efficacy of amidantel, a new anthelmintic, on hookworms and ascarids in dogs.

Amidantel is a new anthelmintic from a new chemical class with an interesting anthelmintic spectrum. In dogs amidantel is highly effective in a single oral dose of 25 mg/kg against both hookworm species, Ancylostoma caninum and Unicinaria stenocephala. In Toxascaris leonina infected dogs a complete cure rate was achieved with a single oral dose of 50 mg/kg. Similar results were obtained with 8 mg/kg administered three times per day. The most sensitive parasite to amidantel was found to be Toxocara canis with a 100 per cent cure rate after a single oral treatment with 10 mg/kg. In preliminary trials amidantel was also effective against hookworms and ascarids after subcutaneous administration. All hookworms and almost all of the ascarids were eliminated with the faeces within 2 days after treatment. Amidantel was tolerated in all dosages tested by all the dogs without any symptoms.

Ancylostoma↗

PubMed1984

Hookworms and the species infecting man in Zambia.

The rate of hookworm infections, determined by stool examination over a 7-month period, was 16.56% in medical examinees and 19.91% in in-patients in an urban hospital population in Zambia. The egg-load though was low. Culture of ova to the filariform larval stage, examination of adult worms expelled after anthelminthic treatment and collected at autopsy confirmed that the dominant species was Necator americanus. However, we report, perhaps for the first time, the presence of Ancylostoma duodenale in man in Zambia. Such information is important in assessing the clinical significance of hookworm infection in the country and for formulating a rational chemotherapeutic policy. No cases of infection with the 'false' hookworm Ternidens deminutus were identified.

Ancylostoma↗

PubMed1982

Epidemiological study and comparison of pyrantel and levamisole in the treatment of roundworm and hookworm infestations.

Stool examined for presence of nematodes from 467 school students in Dacca city showed 48% ova positive cases with 22% among them cases of mixed nematode infection. Highest prevalence of 58% was observed with roundworm and 5% was hookworm infestations. Among hookworm cases, Necator americana (68%) appears to be the predominant species. Two anthelmintics-pyrantel and levamisole achieved similar high cure rate (around 97%) and Egg reduction rate of 99% in roundworm infection. However, pyrantel was observed to be more effective in hookworm infestation (87% against 60%) particularly in Necator americana cases.

Adolescent↗

PubMed1994

Evaluation of hookworm control program in southern Thailand.

An intensive hookworm control program providing the rural population of southern Thailand with mass treatment with 300 mg Mebendazole and health education commenced in 1989 with a yearly budget of over US$ 1.2 million. The current research aimed to evaluate the coverage of health education and mass treatment, the effectiveness of mass treatment and the administrative process of the control program, two years after its commencement. This evaluation consisted of three studies. In the first study, 120 villages were randomly selected, from which 840 school children, 843 adults aged between 15-59 and 844 subjects aged over 60 years were interviewed to assess awareness of hookworm, latrine availability, receipt of and compliance with antihelminthics provided, and self-treatment. In the second study, 8 villages from each of the 14 provinces were randomly chosen. Stool samples from randomly selected 4,434 subjects were examined. The third study consisted of interviewing key health planners in Bangkok and 71 health officers/workers from 32 samples villages of 8 sampled provinces. Latrine availability was 80%. Percentages of subjects who had ever heard of hookworm ranged from 70 to 95 in school children, 55 to 80 in adults and 25 to 58 in the older age group. While 63 to 85% had latrines in their homes, 27% to 47% admitted defecation outside in the past month. Percentages of coverage of drug treatment ranged from 82 to 91 in school children, 68 to 80 in adults and 54 to 59 in the older age group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

Vitamin B1, B2 and B6 deficiency in primary school children infected with hookworm.

One thousand and seven hundred thirty-six school children from two districts in Nakhon Si Thammarat Province were screened for hookworm infection using the Kato-Katz stool examination technic. Two hundred students who have at least 2,000 eggs per g of stool were recruited into the program. The students were divided into six groups: groups 1, 2 and 3 were from Tha Sala district while groups 4, 5 and 6 were from Ronpibul district. Three milliliter blood samples were obtained from the cubital vein of each subject and were evaluated for erythrocyte transketolase activity (ETK) for vitamin B1, erythrocyte glutathione oxidoreductase activity (EGR) for vitamin B2, and erythrocyte aspartate aminotransferase activity (EAST) for vitamin B6. The school children were divided into three groups: those infected only with hookworm, those with both hookworm and Trichuris trichiura, and those whose stools show no parasite eggs. The results show that 10-20% of the school children are vitamin B1 deficient, about 40% to 80% are vitamin B2 deficient, and about 14% to 23% are vitamin B6 deficient. No correlation could be made between vitamin deficiencies and parasitic infection.

Causality↗

PubMed1976

Changes in hookworm distribution in Surinam.

During the months May-July, 1974, a follow-up investigation was carried out on hookworm infections in dogs and cats in order to study changes in the hookworm distribution in Surinam since 1967. Fifty-two cats and 152 dogs were examined for the presence of helminths in the oesophagus, small intestine, coecum and heart. In total 15,942 helminths were isolated; most of these (14,006) were hookworms belonging to the species Ancylostoma caninum, A. tubaeforme, A. ceylanicum and A. braziliense. The average size of the hookworn load in dogs and cats appeared to have decreased since 1967, especially as regards A. ceylanicum. The distribution area of A. braziliense had extended largely by 1974 to the east and south in Surinam. In west Surinam A. braziliense infection was not found, just as in 1967.. The remaining parasites were Dipylidium caninum, Toxocara sp., Dirofilaria immitis, Spirocerca sanguinolenta, Spirometra mansonoides, Taenia taeniaeformis and Trichurisvulpis.

Ancylostomatoidea↗

PubMed1998

Hookworms (Uncinaria sp.) in Juan Fernandez fur seal pups (Arctocephalus philippii) from Alejandro Selkirk Island, Chile.

Sixty Juan Fernandez fur seal pups (Arctocephalus philippii) found dead on Alejandro Selkirk Island, Chile, during the breeding seasons of 1991 and 1992 were examined for the presence of hookworms (Uncinaria sp.). Hookworms were found in 60% of the pups examined, at a mean intensity of 17 parasites per infected host. Intensity of infection did not differ among years or sexes. There was a significant positive relationship between thickness of subcutaneous fat and number of hookworms.

Ancylostomatoidea↗

PubMed2002

Single-strand conformation polymorphism-based analysis of mitochondrial cytochrome c oxidase subunit 1 reveals significant substructuring in hookworm populations.

Sequence heterogeneity in a portion of the mitochondrial cytochrome c oxidase subunit 1 gene (pcox1) was measured for the hookworms, Ancylostoma caninum from Australia, A. duodenale from China, and Necator americanus from China and Togo using single-strand conformation polymorphism (SSCP) analysis combined with DNA sequencing. The pcox1 sequences were characterised for individual nematodes displaying genetic variation within each of the three species, and those were compared with pcox1 sequences of four other species of hookworm. While intraspecific variation in the pcox1 sequence ranged from 0.5 to 8.6% for A. caninum, 0.3 to 3.3% forA. duodenale, and 0.3 to 4.3% for N. americanus, interspecific differences varied from 4.8 to 12.9%. Sequence data also provided information on nucleotide compositions and substitution patterns. Genetically distinct groups were detected within A. caninum and A. duodenale, indicating significant population substructuring within these species. Also, N. americanus individuals from China all differed from those from Togo at four nucleotide positions, supporting a previous proposal (based on ribosomal DNA sequence data) that N. americanus may represent a species complex. The findings indicated the value of pcox1 sequence data and the mutation scanning approach for studying the genetic structures of hookworm populations, which should have important epidemiological relevance.

Ancylostomatoidea↗