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PubMed2003

Random spatial distribution of Schistosoma mansoni and hookworm infections among school children within a single village.

Schistosomes and soil-transmitted helminths currently infect a third of the world's human population. An important feature of these parasitic infections is their focal distribution, which has significant implications for control. Only a few studies have been carried out at the microepidemiological scale, comparing infection levels among individuals or households within a single village. In this study, data are presented from a cross-sectional survey, examining all children attending a primary school in rural Côte d'Ivoire over several consecutive days for Schistosoma mansoni, soil-transmitted helminths, and intestinal protozoa. All houses in the main village were mapped, and school children were linked to these households for small-area spatial analyses. Comparison between the 260 school children who live within the main village and the 89 children who reside in nearby settlements revealed significant differences in the overall prevalence and intensity of infections with S. mansoni and hookworm, confirming the focal nature of these 2 parasites. On the other hand, S. mansoni and hookworm infections exhibited random spatial patterns within the main village. The validity of these results is discussed in the context of this epidemiological setting, drawing attention to the issue of scale. Our findings have direct implications for intervention because they call for a uniform, community-wide approach to control schistosomiasis and soil-transmitted helminthiasis. Implementation can be relatively straightforward, and the proposed control approach might be cost-effective and prove sustainable.

Adolescent↗

PubMed2006

Heart failure caused by hookworm infection possibly associated with organic food consumption.

An 87-year-old man with heart failure caused by severe anemia was referred to our hospital. Gastroenteroscopy revealed the existence of several parasites in the duodenum. Examination of the stool by a formalin-ethyl acetate concentration technique detected hookworm eggs. After a single dose of pyrantel pamoate, his symptoms including dyspnea on exertion and edema diminished. And also hemoglobin and B-type natriuretic peptide (BNP) had improved dramatically. Hookworm infection is an extremely rare cause of heart failure, and furthermore this parasitic infection is not common in advanced countries. We suggest the possible relationship between parasite infection and organic foods.

Aged, 80 and over↗

PubMed1985

Relationships of Schistosoma haematobium, hookworm and malarial infections and metrifonate treatment to growth of Kenyan school children.

Relationships of S. haematobium, hookworm and malarial infections to growth 6 months after metrifonate treatment were studied in Kenyan primary school children in an area where poor growth, S. haematobium and hookworm were common and malaria was endemic. All children with light-moderate S. haematobium infections (1-500 eggs/10 ml adj) in 4 schools were examined (Exam 1), allocated at random to either placebo (MIP, n = 198) or metrifonate treatment (MIT, n = 201) groups, treated, and examined again 6 months later (Exam 2). An additional 19 heavily infected children (HIT group greater than 500 eggs/10 ml adj) were treated immediately after Exam 1 and also followed. The MIT and HIT groups exhibited more rapid growth between Exam 1 and 2 than did the placebo group. The MIT group gained significantly (P less than 0.001) more than the MIP group in weight (0.8 kg), percent weight for age (2.3 percentage points), weight for height squared (0.04 units), arm circumference (0.4 cm), percent arm circumference for age (1.7 percentage points) and in triceps and subscapular skinfold thicknesses. In addition, the placebo group showed statistically significant decreases between exams in percentage weight for age, percent arm circumference for age, both skinfold thicknesses for age and no significant increase in percent height for age while the MIT group exhibited highly significant increases in all anthropometric parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

Metrifonate or praziquantel treatment improves physical fitness and appetite of Kenyan schoolboys with Schistosoma haematobium and hookworm infections.

We studied physical fitness, as determined by the Harvard Step Test (HST), and appetite, as measured by the consumption of a morning snack (maize meal porridge), in primary school boys infected with Schistosoma haematobium (100% baseline prevalence) and hookworm (94-100% prevalence) who received a single dose of metrifonate (MT, 10 mg/kg body weight) or praziquantel (PR, 40 mg/kg body weight), or a placebo (PL). Five weeks after treatment, HST scores and porridge intake increased significantly in the MT and PR groups, but the PL group did not change. At the second examination, the MT group showed a significant decrease in S. haematobium egg counts (mean = 180 vs. 14 eggs/10 ml adj, P less than 0.0002, 82% egg reduction in arithmetic means) as did the PR group (mean = 198 vs. 0.1 eggs/10 ml adj, P less than 0.0002, 99.9% reduction); the egg counts in the PL group did not change. The MT group also exhibited a significant decrease in hookworm egg counts (mean = 1,550 vs. 75 eggs per gram feces [epg], P less than 0.0005, 80% reduction). Treatment with either drug may allow improved physical fitness and appetite in areas where S. haematobium and protein-energy malnutrition are highly prevalent.

Adolescent↗

PubMed2001

Short report: Hookworm infection is associated with decreased body temperature during mild Plasmodium falciparum malaria.

Malaria's pyrogenic threshold seems to depend on factors such as age and transmission patterns. We studied the temperature at admission of 200 patients with mild malaria and observed that after adjusting for body mass index, the presence of other helminths, and other confounders, only hookworm-infected patients had lower fever at admission that those without hookworm infection (37.5 +/- 0.9 and 38 +/- 0.8, respectively; P < 0.001). Thus, we suggest the age dependence of the pyrogenic threshold could have been confounded by the epidemiology of iron deficiency.

Adolescent↗

PubMed1980

Variable activity of disophenol against hookworms and lice of northern fur seal pups on St. Paul Island, Alaska.

Six critical tests with disophenol were conducted in July, 1978, in fur seal pups (Callorhinus ursinus) naturally-infected with adult hookworms, Uncinaria lucasi, and infested with various stages of two species of sucking lice, Proechinopthirus fluctus (Ferris) and Antarctophthirus callorhini (Osborn). Disophenol at a dose rate of 12.5 mg/kg was administered subcutaneously to each of six pups. Each pup was contained in an individual cage for 60 h posttreatment at which time pups were exmained at necropsy. Efficacy against hookworms ranged from 2% to 88% and of both species of lice ranged from 26% to 90% for the six pups. Disophenol removed approximately 90% of all adult lice but only slightly more than 60% of all nymphs. The only sign of toxicosis was a probable drug related fluid-like feces for four pups from 12 to 60 h posttreatment.

Alaska↗

PubMed1975

Serum and red cell folate activity and folic acid absorption in patients with hookworm infection.

Red cell and serum folate levels and folic acid absorption were studied in patients with hookworm infection. The mean value of serum folic acid level was found to be significantly lower than that of the normal subjects and 32% of cases had serum folic acid level less than 4 ng/ml. The red cell folate content in all patients studied were within the normal limits. The mean value of the folic acid absorption was also lower than that of the normal. Six out of 13 patients absorbed folic acid less than 38%, the lowest value obtained from the normal subjects. These findings indicated that there was a negative balance of folic acid in some patients with hookworm infection which was probably due to impairment in absorption.

Adolescent↗

PubMed1990

Gastrointestinal lesions in patients over 40 years of age with iron deficiency anemia and hookworm infection.

A prospective study of 41 patients (24 male and 17 female) aged over 40 years with iron deficiency anemia and hookworm infection was performed by endoscopy and barium enema to determine the incidence of GI lesions. Alcohol ingestion, smoking, abdominal pain, anorexia, loss in weight, bowel habit change, analgesic consumption and stool occult blood test were analyzed for their positive predictive value of GI lesions. The mean age of the patients was 62.8 years (SD = 10.1). The mean hemoglobin was 5.99 gm.% (SD = 1.9). Twenty patients (48.8%) had GI lesions. The lesions included 10 erosive gastritis, 1 erosive duodenitis, 5 gastric ulcers, 2 duodenal ulcers, 1 carcinoma of stomach and 1 carcinoma of colon. Gastric ulcer, duodenal ulcer and carcinoma were regarded as significant lesions. Abdominal pain was found in 16 of the 20 patients with GI lesions and 8 of the 21 without GI lesion (Chi square with Yate's correction, x2 = 5.78 p = 0.02). Four of the 17 patients without pain had GI lesions but only one of these 4 (5.8%) had gastric ulcer. Abdominal pain had an 80% sensitivity and 62% specificity for the positive prediction of GI lesions based on the above findings. GI investigation is recommended for all patients with abdominal pain. In those without pain, treatment of hookworm and iron therapy with follow-up may be justified.

Adult↗

PubMed1989

An outbreak of hookworm infection associated with military operations in Grenada.

During 1983, a multinational military intervention took place on Grenada. After deployment, troops from several U.S. Army units noted signs and symptoms consistent with soil-transmitted helminthic infection. Of 684 soldiers screened five to seven weeks post-deployment, over 20% reported abdominal pain and/or diarrhea during or after the action. Eosinophilia of at least 10% was observed in 119 (22.5%) of 529 soldiers evaluated further; eosinophilia of 5-9% was documented in another 126 (23.8%) of the 529 soldiers. Stool examinations confirmed hookworm infection in 35 soldiers. One case of strongyloidiasis was also documented. Infection was attributed to ground exposure near homes with compromised sanitation. Units that joined the operation after the initial assault phase were at low risk of hookworm infection.

Disease Outbreaks↗

PubMed1982

Field trials of pyrantel pamoate (Combantrin) in Ascaris, hookworm and Trichuris infections.

In a trial involving 185 school children, pyrantel pamoate (Combantrin) at a dose of 20 mg/kg body weight for 1-3 days was found to be very effective against the Ascaris and moderately effective against the hookworm, with mean cure rates ranging from 93.3-96.7% and 53.3-73.3% respectively. No apparent action against the Trichuris was detected, a mean cure rate of between 34.2 and 46.1% being only slightly, but not significantly, better than the 33.8% cure for a placebo-treated control group. Single and multiple doses of the suspension and tablet formulations of the drug were well tolerated. From the series of randomized and controlled trials conducted, we recommend that, in this area, the appropriate dose of the drug to use for treating ascariasis is 10 mg/kg per day for 1 day, and for infections which include hookworm, 20 mg/kg per day for 3 days.

Adolescent↗

PubMed1984

Zinc in the pathogenesis of hookworm anaemia.

Serum zinc levels in 90 patients with hookworm infection were compared with those of 26 uninfected controls. The severity of infection was graded in terms of haemoglobin levels as well as egg loads. The results showed that the serum zinc levels in anaemic patients with hookworm infection were significantly lower than those of the controls (p less than 0.01).

Adolescent↗

PubMed1980

Clinical trial of flubendazole on hookworm, Trichuris trichiura and Ascaris lumbricoides infections.

Flubendazole, a parafluoro analoque of mebendazole, was given to 89 service men with hookworm, Trichuris trichiura and Ascaris lumbricoides infections. The drug was given either as two doses of 300 mg at 12 hour interval (regimen A) or as two doses of 300 mg at 24 hour interval (regimen B). At four weeks follow-up the mean percentage egg reduction for hookworm was 88% and 96% in regimen A and B respectively. There were too few cases of Trichuris and Ascaris infection to allow comparison of the two regimens, but flubendazole appeared to be as effective and the single day regimen more convenient than difetasone for trichuriasis and levamisole for ascariasis. Side effects were few, mild and transient.

Adult↗

PubMed1993

Efficacy of single-dose mebendazole, polymorphic forms A and C, in the treatment of hookworm and Trichuris infections.

A therapeutic trial of single mebendazole, 300 mg polymorph A, 300 mg polymorph C and 500 mg polymorph C, in the treatment of hookworm and Trichuris infections was carried out at primary schools in Southern Thailand. The total of 958 children were randomly allocated in seven treatment groups including the placebo control and the standard dose control (100 mg polymorph C bid for 3 days). The egg reduction rates and the cure rates of 300 mg and 500 mg polymorph C were similar, but inferior to those of the standard dose in both hookworm and Trichuris infections. The efficacy of single dose 300 mg polymorph A was not different from that of the placebo control (alpha = 0.05) in both infections.

Child↗

PubMed1994

Ascariasis, hookworm infection and serum retinol amongst children in Nepal.

The study reports on the association between serum retinol levels and prevalence of two intestinal helminths in a random sample of 592 children, 6-120 months of age. Faecal analyses were performed by Kato thick-smear technique, recording the presence of hookworm and Ascaris lumbricoides eggs. Serum retinol levels were determined by high pressure liquid chromatography (HPLC) and expressed in micrograms/dl. The presence of Ascaris lumbricoides eggs was associated with lower levels of serum retinol in children below 60 months of age (p < 0.05). The presence of hookworm eggs was not associated with lower levels of serum retinol in any age group. In addition children who received at least one course of mebendazole during the past 12 months recorded higher serum retinol levels than children who did not receive it (p < 0.01).

Animals↗

PubMed1993

Hookworm disease: Puerto Rico's secret killer.

Drs. Bailey Ashford and Pedro Gutiérrez, with the economic aid of the United States and Puerto Rican governments, were able to implement a program to reduce the incidence of hookworm infestations in Puerto Rico during the turn of the century. The program was conducted in three phases. The first phase consisted of evaluating the prevalence of infestations among the population. The second phase was concerned with treating patients and reducing further infestations. The last phase of the program was the implementation of prevention programs whose goals were to educate the population on the mechanisms of contaminations and to help implement improvements in the waste disposal systems so as to reduce the exposure to contaminated soil. The programs greatly improved the level of health of many Puerto Ricans. The incidence of hookworm infestations was reduced from 90% to 15% among members of the population. The program obtained world-wide recognition and serves as a model for similar programs.

Ancylostomatoidea↗

PubMed1995

Hookworm infection and reinfection following treatment among Orang Asli children.

In hookworm endemic areas where sanitation is often wanting, reinfection of treated children is a problem. This study was conducted to enumerate the prevalence and the reinfection rate of hookworm in 193 Orang Asli children following treatment with stat dose of 400mg of albendazole at 2 and 4 months post-treatment. All samples were examined using the Kato-Katz and Harada Mori techniques. The overall initial prevalence was 31.0%, with 27.0% in males and 34.0% in females although there was no statistical difference. Only 7.0% of the children had moderate intensity of infection. The overall infection rate at 2 and 4 months post-treatment was 11.0% and 8.0%. New cases were detected at 1.0% and 5.0% at 2 and 4 months post-treatment period. Reinfection rate 2 months post-treatment was 24.0%, and it was 30.0%, 4 months after treatment. All infection at 2 and 4 months post-treatment were light. Long-term strategies incorporating health education on personal hygiene, provision of toilets and safe water supply need to be adopted in these Orang Asli villages to control rapid reinfection.

Adolescent↗

PubMed2001

Ancylostoma caninum: the finger cell neurons mediate thermotactic behavior by infective larvae of the dog hookworm.

Bhopale, V. M., Kupprion, E. K., Ashton, F. T., Boston, R., and Schad, G. A. 2001. Ancylostoma caninum: The finger cell neurons mediate thermotactic behavior by infective larvae of the dog hookworm. Experimental Parasitology 97, 70-76. In the amphids (anteriorly positioned, paired sensilla) of the free-living nematode Caenorhabditis elegans, the so-called finger cells (AFD), a pair of neurons, each of which ends in a cluster of microvilli-like projections, are known to be the primary thermoreceptors. A similar neuron pair in the amphids of the parasitic nematode Haemonchus contortus is also known to be thermoreceptive. The hookworm of dogs, Ancylostoma caninum, has apparent structural homologs of finger cells in its amphids. The neuroanatomy of the amphids of A. caninum and H. contortus is strikingly similar, and the amphidial cell bodies in the lateral ganglia of the latter nematode have been identified and mapped. When the lateral ganglia of first-stage larvae (L1) of A. caninum are examined with differential interference contrast microscopy, positional homologs of the recognized amphidial cell bodies in the lateral ganglia of H. contortus L1 are readily identified in A. caninum. The amphidial neurons in A. caninum were consequently given the same names as those of their apparent homologs in H. contortus. It was hypothesized that the finger cell neurons (AFD) might mediate thermotaxis by the skin-penetrating infective larvae (L3) of A. caninum. Laser microbeam ablation experiments with A. caninum were conducted, using the H. contortus L1 neuronal map as a guide. A. caninum L1 were anesthetized and the paired AFD class neurons were ablated. The larvae were then cultured to L3 and assayed for thermotaxis on a thermal gradient. L3 with ablated AFD-class neuron pairs showed significantly reduced thermotaxis compared to control groups. The thermoreceptive function of the AFD-class neurons associates this neuron pair with the host-finding process of the A. caninum infective larva and shows functional homology with the neurons of class AFD in C. elegans and in H. contortus.

Ancylostoma↗

PubMed1978

A comparative in vitro study of antibody binding to different stages of the hookworm Ancylostoma caninum.

The Indirect Fluorescent Antibody Technique (IFAT) and the Indirect Immuno Peroxidase Technique (IIPT) have been applied to cryostat sections and intact stages of the hookworm species Ancylostoma caninum with sera from infected dogs. Especially the role of the body surface (= cuticle (cortex, matrix, basal layer) and hypodermis) in immunity was studied. Using cryostat sections and dead intact stages as the antigen, specific antibody binding was demonstrated round the ovum membrane and the cuticle of all stages of this hookworm species. Cryostat sections of adult worms showed, that it probably is not the cuticle itself that is antigenic, but that the specific reaction that is observed consisted of a layer, covering the cortex of the cuticle. Infective and parasitic living stages, however, showed no antibody binding in contrast to the free-living stages in which specific antibody binding was demonstrated.

Ancylostoma↗