Hookworm

Notes
  • Hookworms include: Necator americanus, Anchylostoma duodenale, Anchylostoma braziliense and Anchylostoma caninum
  • The global prevalence of hookworm infections is 740 million people.
  • braziliense and A. caninum cause cutaneous larva migrans (they rarely complete their Life cycles in human but rather wander within the skin).
  1. Transmission
  • Life cycle

_Eggs in the stool

_Hatch into rhabditiform larvae (1-2 days)

_Rhabditiform larvae molt into filariform larvae (5 - 10 days).

_Filariform larvae penetrate human skin

_The larvae penetrate into pulmonary alveoli

_The larvae ascend the bronchial tree to the epiglottis

_The larvae are swallowed.

_The larvae develop into adults in the small intestine.

_They attach to the wall and feed on blood.

Symptoms
  • Mostly there are no symptoms
  • Rash at point of larval entry
  • Cutaneous larva migrans (mostly at the feet)
  • Abdominal pain
  • Nausea and vomiting
  • Worms in stool or vomit
  • Diarrhea or bloody stools
  • Fatigue
  • Anemia (major cause of anemia in endemic area)
  • Loeffler’s syndrome (caused by migration of numerous larvae through the lungs and characterized by:

_cough

_wheezing

_eosinophilia

_hemoptysis)

  • Weight loss or retarded growth in children
  • Malnutrition
  • Intestinal obstruction (in severe cases)
Diagnosis
  • Stool for ova
Management

Either,

Over 2 years: (children and adults): _Tabs/susp Albendazole 400mg stat

Or;

_Tabs Levamizole Adults: 120mg stat. Children 1-4 years: 40mg stat.  5-15 years: 80mg stat.

Or;

_Tabs Mebendazole 100mg BD x 3/7 or 500mg stat.

Or;

Tabs / susp Pyrantel pamoate 10mg/kg stat

Or;

Rarely:

   _Tabs Praziquantel 10mg/kg stat

Treatment of  anaemia

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