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Necatoriasis

Disease Details

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Description: Necatoriasis is an infection caused by the hookworm Necator americanus, leading to gastrointestinal and nutritional symptoms due to the parasite's consumption of the host's blood.
Type: Necatoriasis is a parasitic infection caused by the hookworm Necator americanus. It is not a genetic disease and therefore does not have a type of genetic transmission.
Signs And Symptoms: When adult worms attach to the villi of the small intestine, they suck on the host's blood, which may cause abdominal pain, diarrhea, cramps, and weight loss that can lead to anorexia. Heavy infections can lead to the development of iron deficiency and hypochromic microcytic anemia. This form of anemia in children can give rise to physical and mental retardation. Infection caused by cutaneous larvae migrans, a skin disease in humans, is characterized by skin ruptures and severe itching.
Prognosis: Necatoriasis, caused by the hookworm Necator americanus, generally has a favorable prognosis if treated promptly. Anthelmintic medications effectively eradicate the infection. However, chronic or severe infections can lead to complications such as significant anemia and malnutrition, particularly in vulnerable populations such as children and pregnant women. Appropriate medical intervention and supportive care typically result in a good outcome.
Onset: The onset of necatoriasis, an infection caused by the hookworm Necator americanus, usually involves asymptomatic incubation while the larvae penetrate skin and migrate through the body. Symptoms might start appearing 1-2 weeks after initial exposure when the larvae reach the small intestine, where they mature and start feeding. Early symptoms can include itching and rash at the site of entry, followed by respiratory symptoms (if larvae travel through the lungs), and gastrointestinal issues such as abdominal pain, diarrhea, and anemia as the adult worms feed on blood in the intestines.
Prevalence: Necatoriasis, also known as hookworm infection, is caused by Necator americanus. Its prevalence varies significantly around the world, particularly in regions with poor sanitation. It is common in tropical and subtropical areas, especially in sub-Saharan Africa, Southeast Asia, and parts of South America. Precise prevalence data can vary, but globally, it is estimated that hundreds of millions of people are infected with hookworms, including Necator americanus.
Epidemiology: Necator americanus was first discovered in Brazil and then was found in Texas. Later, it was found to be indigenous in Africa, China, southwest Pacific islands, India, and Southeast Asia. This parasite is a tropical parasite and is the most common species in humans. Roughly 95% of hookworms found in the southern region of the United States are N. americanus. This parasite is found in humans, but can also be found in pigs and dogs.Transmission of N. americanus infection requires the deposition of egg-containing feces on shady, well-drained soil and is favored by warm, humid (tropical) conditions. Therefore, infections worldwide are usually reported in places where direct contact with contaminated soil occurs.
Intractability: Necatoriasis, caused by the hookworm Necator americanus, is not generally considered intractable. It can be effectively treated with antiparasitic medications such as albendazole or mebendazole. Improved sanitation and public health measures can also help prevent infection and reinfection. However, eradication efforts can be challenging in regions with poor access to healthcare and inadequate sanitation infrastructure.
Disease Severity: Necatoriasis, caused by the hookworm Necator americanus, can vary in severity. Infection severity depends on the worm burden:

1. **Mild Infection**: Often asymptomatic or may cause minor gastrointestinal symptoms.
2. **Moderate Infection**: Can lead to intermittent abdominal pain, diarrhea, loss of appetite, and weight loss.
3. **Severe Infection**: Results in significant blood loss, leading to iron-deficiency anemia, protein malnutrition, fatigue, and in children, impaired physical and cognitive development.

Severity tends to be higher in those with heavy worm infestations, and the disease can become chronic without treatment.
Healthcare Professionals: Disease Ontology ID - DOID:2790
Pathophysiology: Necatoriasis, also known as hookworm infection, is primarily caused by the parasitic worm *Necator americanus*. The pathophysiology involves the following stages:

1. **Larval Penetration**: Infective larvae penetrate the skin, often through bare feet.
2. **Migration**: Larvae enter the bloodstream, travel to the lungs, ascend the bronchial tree, and are swallowed.
3. **Intestinal Attachment**: Once in the intestines, larvae mature into adult worms and attach to the intestinal wall.
4. **Blood Loss**: Adult worms feed on blood, leading to intestinal blood loss.
5. **Nutrient Absorption**: The worms can impair nutrient absorption, leading to deficiencies.

The resulting blood loss and nutrient depletion can cause anemia and protein malnutrition, major clinical features of the disease.
Carrier Status: Necatoriasis is caused by the hookworm Necator americanus. It is not associated with a carrier status akin to bacterial or viral infections. The disease results from direct infection by larvae in soil contaminated by human feces, which penetrate the skin. There is no asymptomatic carrier state; individuals are either infected or not. Nanotoxicity does not apply to this context.
Mechanism: Necatoriasis, also known as hookworm infection, is primarily caused by the parasitic nematode *Necator americanus*.

**Mechanism:**
1. **Transmission:** It typically begins when infective larvae in contaminated soil penetrate human skin, often through the feet.
2. **Migration:** The larvae travel through the bloodstream to the lungs, ascend the bronchial tree to the trachea, and are then swallowed.
3. **Intestinal Phase:** After reaching the small intestine, the larvae mature into adult worms. The adult worms attach to the intestinal wall using their cutting plates, causing damage and blood loss.

**Molecular Mechanisms:**
1. **Anticoagulants and Proteolytic Enzymes:** *Necator americanus* secretes anticoagulants and a variety of proteolytic enzymes to facilitate blood-feeding and prevent clot formation, which ensures a stable blood supply for the parasite.
2. **Immune Evasion:** The hookworm excretes molecules that modulate the host immune response, including protease inhibitors and molecules mimicking host proteins, which helps the parasite evade immune detection.
3. **Nutrient Acquisition:** The parasite expresses specialized receptors and transporters on its surface to absorb nutrients, particularly hemoglobin from the digested blood of the host.
4. **Hypoxia Adaptation:** *Necator americanus* has developed mechanisms to survive in the low-oxygen environment of the intestines, including upregulation of genes involved in anaerobic metabolism.
5. **Signaling Pathways:** The worm employs a complex array of signaling pathways to regulate development and differentiation within the host, including pathways mediated by insulin-like peptides.

Understanding these mechanisms is crucial for developing targeted therapies and effective control measures against necatoriasis.
Treatment: An infection of N. americanus parasites can be treated by using benzimidazoles: albendazole or 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.Cryotherapy by application of liquid nitrogen to the skin has been used to kill cutaneous larvae migrans, but the procedure has a low cure rate and a high incidence of pain and severe skin damage, so it now is passed over in favor of suitable pharmaceuticals. Topical application of some pharmaceuticals has merit, but requires repeated, persistent applications and is less effective than some systemic treatments.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, and often produced mild intoxication in the patient.
Compassionate Use Treatment: Necatoriasis, caused by the hookworm Necator americanus, primarily requires antiparasitic treatment. As of now:

1. **Compassionate Use Treatment**: Albendazole and mebendazole are the mainstays and are readily available treatments for necatoriasis. These drugs might be offered under compassionate use in regions where they are not easily accessible.

2. **Off-Label or Experimental Treatments**: Tribendimidine and Nitroimidazole derivatives (like Oxantel pamoate) have shown promise in experimental or off-label use. Research is ongoing to determine their efficacy and safety in treating necatoriasis. Additionally, controlled trials are exploring the potential of combining existing antiparasitic medications for increased effectiveness.
Lifestyle Recommendations: Necatoriasis, caused by the parasitic hookworm Necator americanus, primarily affects the intestines and can lead to anemia and malnutrition. Lifestyle recommendations for preventing and managing necatoriasis include:

1. **Avoid Barefoot Walking:** Avoid walking barefoot in areas where the soil may be contaminated with human feces, as hookworm larvae can penetrate the skin.
2. **Sanitation Practices:** Improve sanitation by using proper toilet facilities and avoiding open defecation to reduce soil contamination.
3. **Personal Hygiene:** Wash hands thoroughly with soap and water after handling soil or coming into contact with potentially contaminated surfaces.
4. **Water Safety:** Drink clean, treated water to avoid ingesting hookworm larvae.
5. **Diet and Nutrition:** Eat a balanced diet rich in iron to combat anemia associated with hookworm infection. Foods like leafy greens, meats, and fortified cereals can help.
6. **Regular Screening:** In endemic areas, periodic screening and deworming programs can help reduce the prevalence of infection.

Ensuring these practices can significantly reduce the risk of contracting necatoriasis and help manage its impact on health.
Medication: Necatoriasis, an infection caused by hookworms (primarily *Necator americanus*), is typically treated with antiparasitic medications. Commonly used medications include:

1. **Albendazole**: Usually administered at a dose of 400 mg once for several days, depending on the severity of the infection.
2. **Mebendazole**: Typically given as 100 mg twice daily for three days.

Both medications work by disrupting the metabolism of the parasites, leading to their eventual death. It is essential to follow a healthcare provider's prescription guidelines for effective treatment.
Repurposable Drugs: Currently, there are no well-established repurposable drugs specifically identified for necatoriasis, which is primarily caused by the hookworm Necator americanus. The standard treatment generally involves antiparasitic medications such as albendazole or mebendazole. Research into repurposable drugs for parasitic infections is ongoing, so it is advisable to consult recent studies for potential new developments.
Metabolites: Necatoriasis, commonly caused by the hookworm Necator americanus, primarily results in anemia and protein loss. Metabolites involved include hemoglobin breakdown products in the host and metabolic byproducts of the hookworm itself, such as anticoagulant proteins and various enzymes. Understanding these metabolites can help develop targeted therapies and diagnostic tools.
Nutraceuticals: Nutraceuticals, which are products derived from food sources with extra health benefits beyond basic nutritional value, have limited evidence supporting their use specifically for necatoriasis. This parasitic infection, caused by the hookworm Necator americanus, primarily requires anthelmintic medication such as albendazole or mebendazole for treatment. While nutraceuticals might support general immune function or nutritional status, they are not a substitute for the necessary pharmacological treatment for necatoriasis.
Peptides: Necatoriasis, also known as hookworm infection, primarily caused by Necator americanus, involves hookworms attaching to the intestinal wall and feeding on blood. Treatment commonly involves anthelmintic medications rather than peptides or nanotechnology (nan). Currently, there are no peptide-based treatments or nanotechnology solutions that are standard for the treatment or management of necatoriasis.