๐ About Hookworm Infection
- Hookworm affects an estimated 576โ740 million people worldwide.
- Together with Ascaris and whipworm, it is one of the key soil-transmitted helminths (STH) causing major global morbidity.
- Prevalent in tropical & subtropical regions, especially in areas with poor sanitation and barefoot exposure.
๐ฆ Aetiology
- Species:
- Ancylostoma duodenale (more pathogenic, higher blood loss per worm).
- Necator americanus (wider global distribution, milder blood loss per worm).
โ๏ธ Pathophysiology
- Infection occurs when larvae penetrate the skin ๐ฃ (usually bare feet).
- Larvae travel via bloodstream to lungs โ cross alveoli โ ascend trachea โ swallowed.
- They mature in the small intestine โ attach to mucosa โ suck blood ๐ฉธ.
- Adult worms release eggs into faeces โ contaminate soil โ cycle continues.
- Transmission risk โ where people defecate outdoors or use human waste as fertiliser.
๐ฉบ Clinical Features
- Most infections are asymptomatic.
- Symptomatic phases:
- Skin phase: โGround itchโ โ itchy rash at entry site.
- Pulmonary phase: Cough, wheeze, eosinophilic pneumonia = Lรถfflerโs syndrome ๐ซ.
- Intestinal phase:
- Chronic iron-deficiency anaemia โ pallor, fatigue, weakness.
- GI upset: abdominal pain, nausea, diarrhoea.
- Severe cases in children โ growth stunting, cognitive impairment.
๐ฌ Investigations
- Stool microscopy: Characteristic hookworm eggs (diagnostic).
- FBC: Microcytic, hypochromic anaemia + eosinophilia (esp. migratory phase).
๐ Management
- Antiparasitic drugs:
- Albendazole 400 mg single dose.
- Mebendazole 100 mg BD ร 3 days OR 500 mg single dose.
- Iron supplementation: Correct iron deficiency.
- Dietary advice: Iron-rich foods (meat, beans, green vegetables).
๐ก๏ธ Prevention
- Improved sanitation & safe disposal of faeces.
- Encourage wearing footwear ๐ to prevent skin penetration.
- Regular deworming programmes in endemic regions (esp. children & women of reproductive age).
- Community health education on hygiene practices.
๐ Public Health Impact
- Hookworm contributes to malnutrition, anaemia, impaired growth & cognition in children.
- Mass drug administration (MDA) + sanitation improvements = key WHO strategy for STH control.
๐ Exam Tip
๐ Triad to remember:
Skin entry (โground itchโ) โ Lรถfflerโs syndrome ๐ซ โ chronic iron-deficiency anaemia ๐ฉธ.
๐ Always link hookworm to microcytic anaemia + eosinophilia in exam questions.