Hookworm Control as a Strategy to Prevent Iron Deficiency

Abstract

The hookworms Necator americanus and Ancylostoma duodenale infect approximately 1 billion people worldwide. The prevalence of hookworm infection increases with age in children, typically reaching a plateau in late adolescence, whereas the intensity of infection may continue to increase throughout adulthood. Hookworms cause intestinal blood loss in amounts proportional to the number of adult worms in the gut. The relationship between hookworm infection intensity and hemoglobin concentration is evident in epidemiologic studies, but may be apparent only above a threshold worm burden that is related to the iron stores of the population. Current hookworm control efforts are focused on reducing infection load and transmission potential through periodic anthelmintic chemotherapy. Several controlled trials have demonstrated a positive impact of anthelmintic treatment on hemoglobin levels, with best results obtained in settings where iron intakes were also increased. Evidence suggests that anthelmintic programs will have modest impacts on iron deficiency anemia in the short term, with greater impacts on more severe anemia. Hookworms are an important cause of anemia in women, who are often overlooked by current helminth control programs. Current WHO recommendations for use of anthelminthics in schoolchildren and women are reviewed. There is a need to clarify whether hookworms are an important etiology of iron deficiency anemia in preschool children.

PICA with microcytic hypochromic anaemia and hookworm infestation: A case report

“…However, it has been shown that women and young children have the lowest iron stores and are therefore most vulnerable to chroni c blood loss as the result of hookworm infection. 1,12 Infection with A. duodenale causes greater blood loss than infection with N. americanus, therefore the degree of iron-deficiency anaemia induced by hookworms depends on the species. 1 The major clinical manifestations of hookworm disease are the consequences of chronic intestinal blood loss.…”

“…1,12 Infection with A. duodenale causes greater blood loss than infection with N. americanus, therefore the degree of iron-deficiency anaemia induced by hookworms depends on the species. 1 The major clinical manifestations of hookworm disease are the consequences of chronic intestinal blood loss. Iron-deficiency anaemia occurs and hypoalbuminaemia develops when blood loss exceeds the intake and reserves of host iron and protein.…”

“…Iron-deficiency anaemia occurs and hypoalbuminaemia develops when blood loss exceeds the intake and reserves of host iron and protein. 1 Anasarca from extensive plasma hypoproteinaemia may occur with the skin becoming waxy and acquiring a sickly yellowish colour (a feature of tropical chlorosis). In children, chronic hookworm disease retards physical growth 13 in addition to pica.…”

“…Iron-deficiency anaemia may occur and patient may develop pica. 1 Pica is commonly seen in children and it is the ingestion of non nutritive substances which may lead to life threatening conditions. 2 Important laboratory findings of hookworm infestation with iron deficiency anaemia include hypochromic microcytic anaemia and eosinophilia.…”

Evaluation of real-time PCR for Strongyloides stercoralis and hookworm as diagnostic tool in asymptomatic schoolchildren in Cambodia

“…However, severe and life-threatening infections known as hyper-infection syndrome may occur (Marcos et al, 2008). Chronic infection with the hookworm may cause anemia and protein deficiency in both adults and children (Stoltzfus et al, 1997).…”