Hookworm is a parasite that typically leads to diarrhea or stomach cramps. Severe infestations can pose serious risks for infants, young children, pregnant women, and those suffering from malnutrition. These infections are primarily found in tropical and subtropical regions, impacting about a billion people worldwide, which is roughly one-fifth of the global population. Ancylostoma duodenale, one of the prevalent hookworm species, is present in southern Europe, northern Africa, northern Asia, and parts of South America. Another species, Necator americanus, was once common in the southeastern United States during the early 1900s.The lifecycle of hookworms is intricate, beginning and concluding in the intestine. Their eggs need warm, moist, and shaded soil to hatch into larvae. These tiny larvae can penetrate human skin, often through bare feet, travel to the bloodstream, move through the respiratory system to the mouth, and are swallowed to reach the small intestine. This process takes about a week. In the small intestine, they mature into worms about half an inch long, attaching to the intestinal lining to feed on blood. These adult worms produce thousands of eggs, which are excreted with feces. If the eggs reach suitable soil conditions, they hatch and develop into infective larvae within 5 to 10 days.Hookworm infection is acquired through contact with soil tainted by hookworms, such as walking barefoot or accidentally ingesting contaminated soil. Children are particularly susceptible due to their tendency to play in dirt and walk barefoot. Since the larvae must develop in soil, hookworm cannot be transmitted directly from one person to another.Chronic severe hookworm infections can impair children's growth and development. The resulting loss of iron and protein can hinder growth and mental development, sometimes permanently. Initial symptoms of infection include itching and a rash where the larvae entered the skin, followed by stomach pain, diarrhea, reduced appetite, and weight loss. The infection can also lead to breathing difficulties, heart enlargement, and irregular heartbeat. In extreme cases, particularly among infants, hookworm infections can be fatal.Diagnosis involves detecting hookworm eggs in a stool sample. In regions where hookworm is prevalent and reinfection is likely, mild cases are often not treated. In the United States, treatment usually spans 1-3 days, with effective drugs that have minimal side effects. A follow-up stool test is conducted 1 to 2 weeks post-treatment, and if the infection persists, treatment is repeated. Anemia may require iron supplements.Those with hookworm infections are half as likely to suffer from asthma compared to those without, supporting the hygiene hypothesis. This theory suggests that modern hygiene reduces exposure to infections, increasing susceptibility to allergies like asthma.To prevent hookworm infection, avoid walking barefoot or touching soil with bare hands in areas where hookworms are common, or where soil or sand may be contaminated with feces.
