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USAID's NTD Program
USAID's NTD Program

Hookworm

Symptoms

Hookworm infection may be associated with dermatis, eosinophilia, pulmonary infiltrates, pneumonitis, and urticarial rash. Gastrointestinal symptoms would include mild abdominal pain, nausea, vomiting, and anorexia. Iron-deficiency anemia due to blood loss is often associated with hookworm infection. Cutaneous larva migrants (CLM) condition can be found in humans infected with animal hookworms.1

Infected persons may present papulovesicular dermatis. This condition is caused by repeated percutaneous exposure to infective hookworm larvae. Some species of animal hookworm will migrate in the epidermis and cause local inflammation that follows the sinuous migratory pathways of the larvae. One out of five patients with CLM will develop eosinophilia and/or pulmonary infiltrates.2

Hookworm-associated blood loss results from the destruction of capillaries in the intestinal mucosa. Yet, the level of iron deficiency and anemia depends on three major factors: worm burden, type of hookworm (A. duodenale causes more blood loss than N. americanus) as well as overall patient nutritional status, including the person's iron reserves and diet. Iron deficiency signs will be found in a host with high load of hookworms: fatigue, poor concentration, and exertional dyspnea.1 Increased maternal and neonatal mortality have been found to be associated with hookworm iron-deficiency anemia.3-4

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References

  1. World Health Organization: Prevention and control of schistosomiasis and soil-transmitted helminthiasis. Report of a WHO expert committee, WHO Technical Report Series 912. Geneva, World Health Organization, 2002.
  2. Jelinek T, Maiwald H, Nothdurft HD, et al: Cutaneous larva migrants in travelers: Synopsis of histories, symptoms, and treatment of 98 patients. Clin Infect Dis. 19:1062-1066, 1994.
  3. Brooker S, Bethony J, Hotez PJ: Human hookworm infection in the 21st century. Adv Parasitol. 58:197-288, 2004.
  4. Bundy DAP, Chan MS, Savioli L: Hookworm infection in pregnancy. Trans R Soc Trop Med Hyg. 89:521-522, 1995.