The hookworm is a parasitic nematode 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. A. duodenale predominates in the Middle East, North Africa, India and (formerly) in southern Europe, while N. americanus predominates in the Americas, Sub-Saharan Africa, Southeast Asia, China, and Indonesia. Hookworms are thought to infect more than 600 million people worldwide. The A. braziliense and A. tubaeforme species infect cats, while A. caninum infects canines. Uncinaria stenocephala infects both dogs and cats. Ancylostoma caninum has infected humans, with 150 cases reported in Brisbane, Australia from 1988-1992.
Hookworms are much smaller than the giant 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 not visibly apparent.
Ancylostomiasis, also known by several other names, is the disease caused when A. duodenale hookworms, present in large numbers, produce an iron deficiency anemia by sucking blood from the host's intestinal walls.
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. In developed countries, hookworm infection is rarely fatal, but anemia can be significant in a heavily infected individual.
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