The problem of hookworm infection amongst adults and children in impoverished areas is not a new one. The parasitic worms invest themselves in the small intestine of the human body, burrowing in the lumen and generating sufficient blood loss to cause anemia in their human host. Unlike its soil-transmitted helminthiasis fellows, however (namely roundworm and whipworm), which inflict primarily school age children, hookworm causes high-intensity infections predominantly amongst populations of pregnant women. The resulting anemia in these cases has dramatic consequences for both mother and her child: the Neglected Tropical Diseases Program cites the hookworm as the culprit for low birth weight, impaired milk production, and elevated risk and vulnerability for both the mother host and her child. Further, the hookworm has lasting effects on the development of children as they grow, having "been shown to impair physical and intellectual development, reduce school performance and attendance, and adversely affect future productivity and wage-earning potential."
The transmission of hookworm infection presents a challenge to researchers looking to solve the problem with a single solution. Since hookworms are transmitted primarily through unsanitary disposal of human waste, and reinfection can occur in both children and adults within mere months after parasites are removed, the solution to eradicating this threat lies in a three-part approach. Social education, sanitary disposal of waste, and the development of a possible hookworm vaccine have been collectively targeted as the most effective means of reducing the rate of highly-preventable hookworm infection amongst mothers and children.
Initiatives to educate rural communities on safe sanitation practices have existed in this country for almost a century—the International Health Board even released a silent film, “Unhooking the Hookworm” in 1920—and efforts to extend the same message are currently underway across the globe, through organizations like the Neglected Tropical Disease Program and the World Health Organization.
The Human Hookworm Vaccine Initiative (HHVI) is currently investigating a clinical approach to fighting hookworm infections. Researchers are in the process of developing a vaccine that employs two antigens (Na-GST-1 and Na-APR-1(M74)) that work conjointly to prevent the offending parasite from infecting children in high-risk regions.
Here’s to ‘Unhooking the Hookworm’ in moms and babies around the globe!
The photo is a drawing done by a child describing hookworm in his/her context.
Jean M. Bouquet, DO, is an Assistant Professor of Family Medicine and Co-Director of the Urban Underserved Track at the Rocky Vista University College of Osteopathic Medicine. He is the founder of the Bouquet Speculum, an innovative and FDA-cleared medical device that helps to screen women for cervical cancer. Dr. Bouquet also started the Cure Cervical Cancer nonprofit. The following blog post was written by Dr. Bouquet about his journey to creating the Bouquet Speculum.
Dr. Daniel Kimani is a trained and licensed medical officer in Kenya, holding a Bachelor of Medicine & Surgery, and a post-graduate certificate on basic oncology training. Dr. Kimani is the founder of the Global Cancer Care and Research Institute, and is an expert in clinical colposcopy — a procedure to examine the cervix, vagina, and vulva.