Hookworms
PRESENTER M.K BEZA
Hookworms
The hookworms cause hookworm disease,
which is one of the five major parasitic disease
in China(malaria, shistosomiasis, filariasis, kala-
azar and hookworm disease). At least two
species of hookworms infect man, Necator
americanus and Ancylostoma duodenale.
They live in small intestine.
I. Morphology
1. Adults: They look like an odd
piece thread and are about 1cm
long. They are white or light
pinkish when living. Female is
slightly larger than a male. The
male’s posterior end is expanded
to form a copulatory bursa.
2. Eggs: 60×40 µm in size, oval in
shape, shell is thin and colorless.
Content is 2-8cells.
Differences between two hookworms
Adults of A. duodenale Adults of N. americanus
Scanning electron micrograph of the mouth
capsule of Ancylostoma duodenale, note the
presence of four "teeth," two on each side.
Scanning electron micrograph of the mouth
capsule of Necator americanus, another
species of human hookworm. Note the
presence of two cutting "teeth“.
Ancylostoma duodenale -
copulatory bursa and spines
of male(a side view)
Copulatory bursa of N.
americanus(a side view)
Left picture: Copulatory bursa and spines of N.
americanus(a side view);
Right picture: copulatory bursa of A. duodenale(a
top view)
Morphologically it is
not possible to
differentiate
between A.
duodenale and N.
americanus.
Interference
contrast. ×400.
Enlarged by 5.4.
3.The Morphological Differences between
Two species of Hookworms
_____________________________________________________
A. duodenale N. americanus
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Size larger smaller
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Shape single curve, looks like C double curves, looks like S
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Mouth 2 pairs of ventral teeth 1peir of ventral cutting plates
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Copulatory circle in shape oval in shape
Bursa (a top view) (a top view)
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Copulatory 1pair with separate 1pair of which unite to form
spicule endings a terminal hooklet
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caudal spine present no
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vulva position post-equatorial pre-equatorial
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II. Life Cycle
1. Final host: man
2. Inf. Stage: Larva 3 or filariform
larva
3. Inf. Route: by skin
4. Food: blood and tissue fluid
5. Site of inhabitation: small intestine
6. Life span: Ad 15years, Na 3-7years
7. Blood-lung migration:
skin, right heart, lungs
Life cycle of hookworm
III. Pathogenesis and Clinical
Manifestations
1. Larval migration
(1) Dermatitis, known as "ground itch" or
"stool poison".The larvae penetrating the skin
cause allergic reaction, petechiae 0r papule
with itching and burning sensation. Scratching
leads to secondary infection.
(2) pneumonitis (allergic reaction), Loeffier's
syndrome: cough, asthma, low fever, biood-
tinged sputum or hemoptysis, chest-pain,
inflammation shadows in lungs under X-ray.
These manifestations go on about 2 weeks.
2. Adults in small intestine
(1) Epigastric pain as that of a duodenal ulcer.
(2) A large worm burden results in microcytic
hypochromatic anemia (character manifestation).
The symptoms are edema, palpitation of the
heart. In severe case, death may result from
cardiac failure or physical exhaustion.
(3) Allotriophagy (or pica) is due to the lack of
trace element iron .
(4) Amenorrhea, sterility, abortion may take
place in women.
(5) Gastrointestinal bleeding
(6) Infantile hookworm disease
Adults in intestinal mucosa
Iv. Diagnosis
Criterion: 1. hemoglobin is lower than 120g/L in man, 110g/L in
woman. 2. find hookworm egg
Method:
1. saturated brine flotation technique
2. direct fecal smear
3. culture of larvae
V. Treatment
1. Albendazole 2. Mebendazole
VI. Epidemiology
worldwide distribution. 22-26℃ is the optimal temperature for
Ancylostoma duodenale development, Ancylostoma duodenale
mainly prevalent in north of China. 31-35℃ is suitable for
Necator americanus, it is mainly prevalent in south of China
VII. Prevention
Unified measures: 1. sanitary disposal of night soil, 2. individual
protection, 3. health education, 4. cultivate hygienic habits,
5. treat the patients and carriers.
PREVENTION
Wear shoes and other protective
wear to avoid skin contact with soil
Use mats in beaches to avoid
direct contact with sand
Routine veterinary care of dogs
and cats
Regular deworming
PREVENTION CONT……..
Prompt disposal of animal feces
prevents eggs from hatching and
contaminating soil
Avoid eating soil especially
pregnant women
Avoid defecating outdoors and
effective sewage disposal
SIYABONGA KAKHURU…………..
