Hookworm

The hookworm is a parasitic nematode worm that lives in the small intestine of its host, which may be a mammal such as a dog, cat, or human. Two species of hookworms commonly infect humans, Ancylostoma duodenale and Necator americanus. Necator americanus predominates in the Americas, Sub-Saharan Africa, Southeast Asia, China and Indonesia, while A. duodenale predominates in the Middle East, North Africa, India and (formerly) in southern Europe. Hookworms are thought to infect 800 million people worldwide. The A. braziliense and A. tubaeforme species infect cats, while A. caninum infects dogs. Uncinaria stenocephala infects both dogs and cats.

Hookworms are much smaller than the large roundworm, Ascaris lumbricoides, and the complications of tissue migration and mechanical obstruction so frequently observed with roundworm infestation are less frequent in hookworm infestation. The most significant risk of hookworm infection is anemia, secondary to loss of iron (and protein) in the gut. The worms suck blood voraciously and damage the mucosa. However, the blood loss in the stools is occult blood loss (not visibly apparent).

Ankylostomiasis, alternatively spelled anchylostomiasis and also called helminthiasis, “miners’ anaemia”, “tunnel disease”, “brickmaker’s anaemia”, “Egyptian chlorosis” and is the disease caused by hookworms. It is caused when hookworms, present in large numbers, produce an iron deficiency anemia by voraciously sucking blood from the host’s intestinal walls. The name is derived from Greek ancylo “crooked, bent” and stoma “mouth.”

Hookworm is a leading cause of maternal and child morbidity in the developing countries of the tropics and subtropics. In susceptible children hookworms cause intellectual, cognitive and growth retardation, intrauterine growth retardation, prematurity, and low birth weight among newborns born to infected mothers. Hookworm infection is rarely fatal, but anemia can be significant in the heavily infected individual.

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