Epidemiology of Hookworm Infection in Kintampo North Municipality, Ghana: Patterns of Malaria Coinfection, Anemia, and Albendazole Treatment Failure

Abstract

Abstract.A cross-sectional pilot study of hookworm infection was carried out among 292 subjects from 62 households in Kintampo North, Ghana. The overall prevalence of hookworm infection was 45%, peaking in those 11-20 years old (58.5%). In children, risk factors for hookworm infection included coinfection with malaria and increased serum immunoglobulin G reactivity to hookworm secretory antigens. Risk factors for infection in adults included poor nutritional status, not using a latrine, not wearing shoes, and occupation (farming). Although albendazole therapy was associated with an overall egg reduction rate of 82%, 37 subjects (39%) remained infected. Among those who failed therapy, treatment was not associated with a significant reduction in egg excretion, and nearly one-third had higher counts on repeat examination. These data confirm a high prevalence of low-intensity hookworm infection in central Ghana and its association with poor nutritional status. The high rate of albendazole failure raises concern about emerging resistance.

Intestinal Parasitic Infections among Long-Term-Residents and Settled Immigrants in Qatar in the Period 2005 to 2011

“…8 The possibility of benzimidazole resistance having arisen in human hookworms has been recently reviewed, 12 but there is still no indisputable evidence, although the efficacy of mebendazole in particular has been shown to have declined in some parts of the tropics, notably in Zanzibar, Vietnam, and Mali and instances of failure with albendazole have also been reported in Ghana. [13][14][15][16] Another trend in the current analysis worth commenting on was the age-related increase in the prevalence of B. hominis ( Figure 4B), which was much like that we reported earlier 2 and hence largely unaffected after the addition of data from the three most recent years. Because these data generate some concern over B. hominis infections among the elderly, we also compared data for the first period with the second and we found that there was an overall reduction in all age groups and the upward drift in prevalence was now only evident in the very oldest age class.…”

Malaria and soil-transmitted intestinal helminth co-infection and its effect on anemia: a meta-analysis

“…Seven studies 34,42,43,45,47,49,51 assessed hookworm only, while four studies 25,27,31,50 assessed A. lumbricoides only. Three studies described STH without speciation.…”

“…Three studies described STH without speciation. 35,36,46 Twelve studies 8,26,28,32,33,35,41,43,46,[49][50][51] assessed the impact of co-infection on anemia, using various measurements. Five studies 26,28,32,33,49 quantitatively reported anemia with the mean Hb level in various age groups and pregnant women.…”

“…One study reported anemia with the Hb cut-off level. 8 Out of eight studies 8,28,32,41,43,46,50,51 which reported presence or absence of anemia, one study 32 assessed anemia using the mean PCV. Table 2 provides the number of included studies and the summary results of the co-infection in various age groups as well as in pregnant women.…”

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

“…30 We assessed confounding by a priori determined covariates: data collection round, sex, age, observed shoe wearing, and reported geophagy. 25,32 Because of sex-stratified findings from other trial outcomes, as a sub-analysis, we report sex-stratified estimates of effect. 18 All models controlled for cluster-level baseline worm infection levels.…”