Hookworm disease (also called uncinariasis), a helminthic infection of the upper intestine, is chronic and debilitating. The disease's major sign is anemia. Sandy soil, high humidity, a warm climate, and failure to wear shoes all favor its transmission.
Hookworm disease is present in one-fourth of the world's population. Although it can cause cardiopulmonary complications, it's seldom fatal, except in debilitated people and in infants.
Hookworm disease is caused by Ancylostoma duodenale in southern Europe, North Africa, and northern Asia, and Necator americanus in the Western Hemisphere and equatorial Africa. Both forms of hookworm disease are transmitted to humans through direct skin penetration
Larvae travel through the lymphatic system to the pulmonary capillaries, where they penetrate alveoli and move up the bronchial tree to the trachea and epiglottis. There they are swallowed and enter the GI tract. When they reach the small intestine, they mature, attach to the jejunal mucosa, and suck blood, oxygen, and glucose from the intestinal wall. These mature worms then deposit ova, which are excreted in the stool, starting the cycle anew. Hookworm larvae mature in 5 to 6 weeks.
Signs and symptoms
Itching and a rash at the site of where skin touched soil or sand is usually the first sign of infection. These symptoms occur when the larvae penetrate the skin. While a light infection may cause no symptoms, heavy infection can cause anemia, abdominal pain, diarrhea, loss of appetite, and weight loss. Heavy, chronic infections can cause stunted growth and mental development.
Diagnosis of hookworm disease involves collecting a stool sample for examination under a microscope. Hookworm eggs have a characteristic appearance. Counting the eggs in a specific amount of feces allows the healthcare provider to estimate the severity of the infection.
TreatmentMebendazole or pyrantel pamoate is prescribed for hookworm infection. The patient also needs an iron-rich diet or iron supplements to prevent or correct anemia.
Prevention of hookworm disease involves improving sanitation and avoiding contact with soil in areas with high rates of hookworm infection. Children should be required to wear shoes when playing outside in such areas, and people who are gardening should wear gloves.
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