A Case of Severe Anemia by Necator americanus Infection in Korea

This report describes clinical and parasitological findings of an 82-yr-old female patient who lived in a local rural village and suffered from severe chronic anemia for several years. She was transferred to the National Police Hospital in Seoul for management of severe dyspnea and dizziness. At admission, she showed symptoms or signs of severe anemia. Gastroduodenoscopy observed hyperemic mucosa of the duodenum and discovered numerous moving roundworms on the mucosa. Endoscopy isolated seven of them, which were identified as Necator americanus by characteristic morphology of cutting plates in the buccal cavity. The patient was treated with albendazole and supportive measures for anemia, and her physical condition much improved. This case suggests the possibility that hookworm N. americanus is still transmitted in a remote local mountainous area in Korea.

Hookworm infection and anemia in adult women in rural Chiapas, Mexico

OBJECTIVE: To describe associations between anemia and hookworm (Necator americanus) infection in hospitalized women in rural Chiapas, Mexico. MATERIAL AND METHODS: We retrospectively reviewed the hospital records of 68 anemic women (defined as having a hemoglobin level <10mg/dl) or with intestinal parasitism, identified through hospital discharge and transfusion records for the calendar year 1999. The medical charts of 86 cases were located, 18 of which were not confirmed as anemia cases. The hospital is located in Altamirano, Chiapas. Characteristics of subjects were compared using Student's t-test (for continuous variables) and the chi2 test (for categorical variables). A p-value <0.01 was used for statistical significance. Chart review and data analysis took place during the year 2000. RESULTS: Fifty percent of women who had stool examinations were infected with N. americanus. Necator often coexisted with other potential causes of anemia, such as pregnancy and hemorrhage. Hemoglobin levels in hookworm-infected women (mean 4.1 g/dl) were significantly lower than in uninfected women (mean 7.0 gm/dl), and Necator prevalence was significantly higher in the anemic women (50 percent) than in the overall hospital population (1.9 percent). CONCLUSIONS: Anemic women should be offered stool testing where Necator is present, and should be considered for antihelminthic treatment even if pregnant. Further investigation is recommended among women in Chiapas, and probably elsewhere in Mexico

Relaciones entre las prevalencias de las geohelmintiasis humanas en Venezuela / Relationship between prevalences of geohelminthic infections in human, Venezuela

By means of Kato-Katz technique 113,254 coprological samples of the human population belonging to 100 counties from Venezuela were analyzed. It was determined the following prevalences: ascaris lumbricoides 26,8 percent, trichuris trichiura 32,7 percent and hookworm 5,6 percent. It was found a strong correlation between a. lumbricoides and t. trichiura infection (p<0,001), a significant correlation between t. trichiura and hookworn (p<0,5) and no correlation between a. lumbricoides and hookworm

Epidemiology of human intestinal nematode infections in Wujiang and Pizhou counties, Jiangsu Province, China.

Intestinal nematode infections are considered highly endemic in the Chinese province of Jiangsu. In May 1997, the prevalence of intestinal nematodes infections was determined among all of the inhabitants aged 5 to 65 of the southern Jiangsu village of Yaojiakon (Wujiang County) and the northern Jiangsu village of Jianmiao (Pizhou County). It was determined that the prevalence of ascariasis, trichuriasis and hook worm infection was greatly reduced compared to when it was last measured in 1990. The reduction was noted to be particularly impressive in Yaojiakon village where the prevalence of ascariasis and trichiuriasis fell to 2% and 1.5% respectively. Much of this reduction was attributed to improvements in economic development which have occurred in southern Jiangsu Province at a rapid pace. In contrast, the reduction in nematode infections among villagers living in northern Jiangsu was more modest. The most striking reduction in both villages was in school-aged children who since 1988 have received yearly treatments with anthelminthic drugs. The intensity of nematode infections was investigated for hookworm where 70% of hookworm-infected Yaojiakon villagers were found to harbor light infections (< 400 eggs per gram) compared to 83% of hookworm-infected Jianmiao villagers. Necator americanus was the predominant hookworm in Yaojiakon village (South), whereas Ancylostoma duodenale predominated in Jianmiao village (North). The majority (76%) of hookworm-infected patients developed IgG antibodies against N. americanus antigen, although 20% of uninfected patients living in the village also had circulating antibodies. Intestinal nematode infections continue to be a significant public health problem in Jiangsu Province although their prevalence has decreased since 1990.

Intestinal parasitic infections in Likupang, North Sulawesi, Indonesia.

A parasitological survey was conducted on the inhabitants of 6 villages of Likupang, Minahasa Peninsula, North Sulawesi, Indonesia, in August 1991. A total of 419 fecal samples were examined by using direct smear, flotation, formalin ether concentration, Harada-Mori culture and agar-plate culture techniques. Five nematode and 7 protozoan parasites were detected, while trematode and cestode infection was not observed. Soil-transmitted nematode infections were predominant. Among the younger inhabitants aged less than 15, positive rates of Ascaris, Trichuris and hookworm infections were almost same, namely 45.7, 45.3 and 47.7%, respectively. Among the elder people aged 15 or more, positive rate of hookworm infection (89.4%) was much higher than Ascaris and Trichuris infections (19.3 and 26.1%, respectively). Village to village differences in parasite prevalence, probably due to socio-economic and sanitary-environmental differences were observed. Both Necator americanus and Ancylostoma duodenale were detected. The agar-plate culture was proved to be an efficient method for detection of hookworm as well as Strongyloides stercoralis.

Comparacion de varias tecnicas coproparasitologicas para el diagnostico de geohelmintiasis intestinales / Comparison of several coproparasitological techniques for diagnosis of soil-transmitted intestinal helminthiasis

Se procesan "a ciegas" 511 muestras de heces por las tecnicas de Kato-Katz, Willis, Ritchie y directo. Al comparar los resultados obtenidos en el diagnostico de Trichuris trichiura, Necator americanus y Ascaris lumbricoides, vimos que la de Kato-Katz fue mas sensible, revelando el mayor numero de casos, siguiendole en orden sucesivo, el Willis, el Ritchie, y el examen directo. Si se tiene en cuenta que el metodo de Kato-Katz es ademas cuantitativo, podemos recomendar-lo como tecnica de eleccion para el diagnostico de las geohelmintiasis intestinales.