Hookworm

Hookworm can be contracted from eating contaminated food, or may penetrate the skin, e.g. soles of feet. They pass to the lungs and are coughed up and swallowed. The adult worm lives in the upper small intestine and releases eggs that pass out in the faeces.

Hookworms inhabit the small bowel and suck blood from their point of attachment. An iron deficiency anaemia often exists and this merits treatment along with the hookworms.

There are an estimated 900 million cases worldwide.

The most widely used drugs recommended by WHO are albendazole and mebendazole:

• a systematic review revealed that the highest observed cure rate for hookworm was 80% from albendazole (1)
• a study has shown superiority of emodepside (30mg) compared with albendazole (400mg), with observed cure rate of 96.6% vs 81.2% (2)

Reference:

1. Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis. BMJ. 2017 Sep 25;358:j4307.
2. Taylor L et al. Efficacy and safety of emodepside compared with albendazole in adolescents and adults with hookworm infection in Pemba Island, Tanzania: a double-blind, superiority, phase 2b, randomised controlled trial. Lancet August 17th 2024.