Ancylostomiasis
Disease Details
Family Health Simplified
- Description
- Ancylostomiasis, also known as hookworm infection, is a parasitic disease caused by nematodes of the Ancylostoma and Necator genera, leading to gastrointestinal and nutritional issues.
- Type
- Ancylostomiasis is an infectious disease caused by hookworms, specifically Ancylostoma duodenale and Necator americanus. It is not genetically transmitted, as it spreads through contact with contaminated soil.
- Signs And Symptoms
- Depending on the organism, the signs and symptoms vary. Ancylostoma duodenale and Necator americanus can enter the blood stream while Ancylostoma braziliensis cannot. Signs and symptoms of Ancylostoma duodenale and Necator americanus are given in corresponding page.In Ancylostoma braziliensis as the larvae are in an abnormal host, they do not mature to adults but instead migrate through the skin until killed by the host's inflammatory response. This migration causes local intense itching and a red serpiginous lesion. Treatment with a single dose of oral ivermectin results in cure rates of 94–100%.
- Prognosis
- Ancylostomiasis, caused by hookworm infection, generally has a good prognosis with prompt and appropriate treatment. Antihelminthic medications, such as albendazole or mebendazole, are effective in eradicating the infection. If left untreated, severe cases can lead to chronic anemia, malnutrition, and developmental issues, particularly in children. Prevention through improved sanitation and wearing footwear in endemic areas plays a crucial role in reducing incidence.
- Onset
- The typical onset of ancylostomiasis, a parasitic infection caused by hookworms, is gradual. Symptoms usually appear weeks after the initial infection. The larvae penetrate the skin, often through bare feet, and it takes some time for the worms to mature and begin causing significant symptoms such as abdominal pain, anemia, and gastrointestinal issues.
- Prevalence
- Ancylostomiasis, also known as hookworm infection, is prevalent in tropical and subtropical regions, particularly in sub-Saharan Africa, Southeast Asia, and Latin America. It affects hundreds of millions of people globally, with an estimated 576 to 740 million individuals infected, primarily affecting populations with poor sanitation and hygiene conditions.
- Epidemiology
- Hookworm anaemia was first described by Wilhelm Griesenger in Egypt, Cairo in 1852. He found thousands of adult ancylostomes in the small bowel of a 20-year old soldier who was suffering from severe diarrhoea and anaemia (labelled at the time as Egyptian chlorosis). The subject was revisited in Europe when there was an outbreak of "miner's anaemia" in Italy. During the construction of the Gotthard Tunnel in Switzerland (1871–81), a large number of miners suffered from severe anaemia of unknown cause. Medical investigations let to the understanding that it was caused by Ancylostoma duodenale (favoured by high temperatures and humidity) and to "major advances in parasitology, by way of research into the aetiology, epidemiology and treatment of ancylostomiasis".Hookworms still account for high proportion of debilitating disease in the tropics and 50–60,000 deaths per year can be attributed to this disease.
- Intractability
- Ancylostomiasis, commonly known as hookworm infection, is generally not considered intractable. It can be effectively treated with antiparasitic medications such as albendazole or mebendazole. Proper sanitation and hygiene are crucial in preventing reinfection. To ensure successful treatment, follow-up might be needed to confirm the eradication of the parasites.
- Disease Severity
- Ancylostomiasis, commonly known as hookworm infection, typically causes mild to moderate disease severity, but it can lead to significant health issues in severe cases. Severe infections can result in intense abdominal pain, anemia, protein deficiency, and growth retardation in children.
- Healthcare Professionals
- Disease Ontology ID - DOID:12841
- Pathophysiology
-
Ancylostomiasis, also known as hookworm infection, is caused by the intestinal parasites Ancylostoma duodenale and Necator americanus.
### Pathophysiology:
1. **Larval Penetration**: Infection begins when infective larvae in contaminated soil penetrate the skin, typically through bare feet.
2. **Migration**: The larvae enter the bloodstream, travel to the lungs, ascend the bronchial tree, and are swallowed to reach the intestine.
3. **Intestinal Attachment**: In the small intestine, the larvae mature into adult worms and attach to the intestinal mucosa using their mouthparts.
4. **Blood Feeding**: Adult hookworms feed on the host’s blood, causing localized tissue damage, blood loss, and release of anticoagulant substances.
5. **Egg Production**: Mature worms produce eggs, which are excreted in the host's feces, continuing the life cycle when they reach soil under suitable conditions.
### Symptoms and Impact:
- **Anemia**: Chronic blood loss due to the feeding activity of the worms can lead to iron deficiency anemia.
- **Gastrointestinal Symptoms**: These may include abdominal pain, diarrhea, and weight loss.
- **Nutritional Deficiencies**: Blood and protein loss can lead to malnutrition, especially in children, resulting in growth retardation and cognitive impairment.
Effective treatment involves the use of anthelmintic drugs, along with addressing nutritional deficiencies and improving sanitation to prevent re-infection. - Carrier Status
- Ancylostomiasis, also known as hookworm infection, does not involve a carrier status in the traditional sense, as it is caused by an active infection with parasitic worms, specifically Ancylostoma duodenale or Necator americanus. Therefore, the carrier_status for ancylostomiasis is not applicable (nan).
- Mechanism
-
Ancylostomiasis, commonly known as hookworm infection, is caused by parasitic nematodes, primarily *Ancylostoma duodenale* and *Necator americanus*.
**Mechanism:**
1. **Entry and Migration:** Infective larvae (filariform larvae) in contaminated soil penetrate the skin, usually through the feet.
2. **Circulatory System:** The larvae enter the bloodstream and are carried to the lungs.
3. **Pulmonary Phase:** In the lungs, they break into the alveoli, ascend the bronchial tree, and are swallowed.
4. **Intestinal Phase:** They reach the small intestine, attach to the mucosa, mature into adult worms, and feed on blood, causing anemia and nutritional deficiencies.
**Molecular Mechanisms:**
1. **Skin Penetration:**
- Larvae secrete proteolytic enzymes, including metalloproteases and serine proteases, which break down skin barriers.
2. **Immune Modulation:**
- Excretory/secretory products from larvae and adult worms modulate host immune responses. For instance, hookworms release anti-inflammatory molecules like Ac-TMP-1 which inhibit chemokines that aid in neutrophil recruitment.
3. **Iron Acquisition:**
- Adult worms utilize mechanisms like hemoglobin digestion and the production of aspartic proteases to break down hemoglobin, facilitating iron acquisition and feeding.
4. **Anticoagulation:**
- Hookworms secrete anticoagulant proteins (e.g., AcAP5) that prevent blood clotting at the attachment site, ensuring continuous blood flow for feeding.
5. **Intestinal Attachment:**
- Adult hookworms produce proteins like Ancylostoma secreted proteins (ASPs) that help them attach to the intestinal mucosa and evade host defenses.
Understanding these mechanisms unveils potential targets for interventions, including vaccines and therapies aimed at disrupting the parasite's lifecycle and mitigating its effects on the host. - Treatment
-
The drug of choice for the treatment of hookworm disease is mebendazole which is effective against both species, and in addition, will remove the intestinal worm Ascaris also, if present. The drug is very efficient, requiring only a single dose and is inexpensive. However, treatment requires
more than giving the anthelmintic, the patient should also receive dietary supplements to improve their general level of health, in particular iron supplementation is very important. Iron is an important constituent of a multitude of enzyme systems involved in energy metabolism, DNA synthesis and
drug detoxification.An infection of N. americanus parasites can be treated by using benzimidazoles, albendazole, and mebendazole. A blood transfusion may be necessary in severe cases of anemia. Light infections are usually left untreated in areas where reinfection is common. Iron supplements and a diet high in protein will speed the recovery process. In a case study involving 56–60 men with Trichuris trichiura and/or N. americanus infections, both albendazole and mebendazole were 90% effective in curing T. trichiura. However, albendazole had a 95% cure rate for N. americanus, while mebendazole only had a 21% cure rate. This suggests albendazole is most effective for treating both T. trichiura and N. americanus.During the 1910s, common treatments for hookworm included thymol, 2-naphthol, chloroform, gasoline, and eucalyptus oil. By the 1940s, the treatment of choice was tetrachloroethylene, given as 3 to 4 cc in the fasting state, followed by 30 to 45 g of sodium sulfate. Tetrachloroethylene was reported to have a cure rate of 80 percent for Necator infections, but 25 percent in Ancylostoma infections, requiring re-treatment. - Compassionate Use Treatment
- Ancylostomiasis, caused by hookworms, primarily requires anthelmintic treatments such as albendazole or mebendazole. Compassionate use or off-label treatments are not commonly associated with these infections since the standard treatments are generally effective. However, in cases where standard treatments fail or specific patient needs arise, ivermectin might be considered as an alternative due to its broad-spectrum antiparasitic effects. Experimental treatments may include newer formulations or combinations of existing drugs under clinical investigation, but these are typically within a research context rather than routine practice.
- Lifestyle Recommendations
-
For ancylostomiasis (hookworm infection), lifestyle recommendations include:
1. **Proper Sanitation:** Ensure access to clean and safe sanitation facilities to prevent soil contamination with human feces, which is the primary source of hookworm larvae.
2. **Good Hygiene Practices:** Regular hand washing with soap, especially before eating and after using the toilet, can minimize the risk of infection.
3. **Wear Footwear:** Always wear shoes or sandals, especially in endemic areas, to prevent larvae from penetrating the skin.
4. **Safe Waste Disposal:** Dispose of human waste hygienically to avoid contaminating the soil. Use latrines or other sanitary methods.
5. **Community Health Education:** Educate communities about the transmission and prevention of hookworm infection to promote behavioral changes that reduce risk.
6. **Water Safety:** Use treated or boiled water for drinking and washing to avoid contamination.
7. **Regular Deworming Programs:** Participate in community deworming programs, especially in high-risk areas, to reduce the prevalence of infection.
Implementing these lifestyle changes can help prevent and control the spread of ancylostomiasis. - Medication
- Ancylostomiasis, commonly known as hookworm infection, is treated with antiparasitic medications. The most commonly prescribed medications include albendazole and mebendazole. These drugs are usually effective in eradicating the infection. Treatment may also include iron supplements if the infection has caused significant blood loss and anemia.
- Repurposable Drugs
-
Ancylostomiasis, also known as hookworm infection, is primarily treated with antiparasitic medications. Some repurposable drugs for treating hookworm infections include:
1. **Albendazole** – Commonly used for its broad-spectrum antiparasitic activity.
2. **Mebendazole** – Another effective option for treating various helminth infections, including hookworm.
3. **Pyrantel pamoate** – Works by paralyzing the worms, making them easier to expel from the body.
These medications have been proven effective in managing and treating ancylostomiasis. - Metabolites
-
Ancylostomiasis, also known as hookworm infection, is primarily caused by the parasitic nematodes Ancylostoma duodenale and Necator americanus. The key metabolites involved in the infection process include:
1. Hemoglobin breakdown products - Hookworms feed on blood, leading to the breakdown of hemoglobin and the release of metabolites such as bilirubin and hemosiderin.
2. Iron and Protein Metabolites - Infection often results in iron deficiency and hypoproteinemia due to blood loss.
3. Eosinophil-derived Metabolites - The host’s immune response produces metabolites such as eosinophil cationic protein and major basic protein.
Hookworm infections do not typically involve nanoparticles (nan). The conventional treatment focuses on antiparasitic medications. - Nutraceuticals
- For ancylostomiasis, the primary treatment involves antiparasitic medications such as albendazole or mebendazole. There is limited evidence to support the use of nutraceuticals specifically for treating ancylostomiasis. However, maintaining adequate nutritional status, particularly iron and protein intake, can help manage symptoms such as anemia and malnutrition commonly associated with the disease.
- Peptides
- Ancylostomiasis, also known as hookworm infection, is caused by the parasitic nematodes Ancylostoma duodenale and Necator americanus. Peptidases are enzymes secreted by these parasites to degrade host tissues and facilitate nutrient absorption. Research into nanotechnology for ancylostomiasis is ongoing, exploring nanoparticle-based drug delivery systems to improve treatment efficacy and reduce side effects.