Hookworm: a neglected resurgent infection

Albonico, Marco; Savioli, Lorenzo

doi:10.1136/bmj.j4813

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Treatment with benzimidazoles is the foremost approach for soil-transmitted helminth control; however, the indiscriminate use of these drugs in a target population selects naturally resistant parasites capable of surviving exposure to the drug and can produce resistant offspring [ 4 , 16 , 17 ]. This selective pressure has been associated with the occurrence of SNPs in codons 167, 198 and 200 of the beta-tubulin gene of several helminths [ 5 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…The standard approach for geohelminth control, including hookworms and A . lumbricoides , is large-scale preventive chemotherapy predominantly using benzimidazoles through mass drug administration (MDA), based on the drug’s performance in overall reductions in prevalence and reductions in the extent and severity of infection [ 4 ]. Nevertheless, this inexpensive and highly effective strategy can potentially select subpopulations of parasites that become resistant to treatment.…”

Section: Introductionmentioning

confidence: 99%

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PCR-RFLP screening of polymorphisms associated with benzimidazole resistance in Necator americanus and Ascaris lumbricoides from different geographical regions in Brazil

et al. 2018

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Ascaris lumbricoides and Necator americanus are soil-transmitted parasites with global geographic distribution, and they represent some of the most common and neglected infections in the world. Periodic treatment with mass drug administration (MDA) in endemic areas is the recommended action put forth by the World Health Organization. However, MDA can cause the selection of subpopulations that possess the genetic ability to overcome the mechanism of drug action. In fact, beta-tubulin gene mutations (codons 167, 198 and 200) are correlated with benzimidazole resistance in nematodes of veterinary importance. It is possible that these SNPs also have strong correlation with treatment resistance in the human geohelminths A. lumbricoides, Trichuris trichiura and hookworms. Here, we aimed to investigate the presence of some of these canonical molecular markers associated with parasite resistance to benzimidazole in N. americanus and A. lumbricoides collected from six Brazilian states. Nested-PCR and PCR-RFLP were used to detect mutations at codons 167 and 198 in 601 individual eggs of A. lumbricoides collected from 62 human stool samples; however, no mutations were found. Codons 198 and 200 were tested in 552 N. americanus eggs collected from 48 patients using the same methodology, which presented a relative frequency of 1.4% and 1.1%, respectively. The presence of these SNPs in N. americanus eggs is an important finding, indicating that with high benzimidazole drug pressure there is potential for benzimidazole resistance to be selected in this hookworm. However, at these low frequencies it does not indicate that there is at present any benzimidazole resistance problem. This is the first systematic study performed in South America, and the study yielded a landscape of the genetic variants in the beta-tubulin gene and anthelmintic resistance to soil-transmitted parasites detected by a simple, rapid and affordable genotyping assay of individual eggs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

PCR-RFLP screening of polymorphisms associated with benzimidazole resistance in Necator americanus and Ascaris lumbricoides from different geographical regions in Brazil

et al. 2018

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“…Hookworm infestation is usually asymptomatic and anemia is the major clinical finding of infection [3] being proportional to the number of adult worms in the gut [4]. Other symptoms are usually dermatological (erythema, itching), respiratory (cough, low fever, hoarsening, dyspnea) and digestive (abdominal pain, nausea, vomiting, diarrhea, asthenia, anorexia) depending on larvae location [3].…”

Section: Introductionmentioning

confidence: 99%

Hookworm Infection as a Rare Cause of Acute Pancreatitis

Laureano¹,

Nobre²,

Gonçalves³

et al. 2019

IJG

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The aim of this case report is to alert physicians to the possibility that hookworm disease can lead to acute pancreatitis. Method: We report a case of hookworm infestation associated with acute pancreatitis and food intolerance. Result: The patient presented on the emergency department complaining of anorexia, asthenia, nausea, vomiting, epigastric pain and fever. Blood test showed a amylase of 512U/L and a lipase of 1902, normal levels of hepatic aminotransferases, bilirubin and alkaline phosphatase and a slight elevation of the Creactive protein. An ultrasound showed no cholelithiasis, thickening of vesicular wall or dilation of the common bile duct and the computed tomography (CT) showed a normal pancreas with no evidence of cholecystitis or peripancreatic fluid. An upper digestive endoscopy was done because of food intolerance and revealed gastric stasis and duodenal mucosa congestive, friable, with loss of the usual pleating with biopsies revealing the presence of Ancylostoma duodenale. The patient was treated with albendazole and remains asymptomatic in a 3-year follow-up. Conclusion: Hookworm infestation is usually asymptomatic. Ampulla of Vater-migrating hookworms resulting in acute pancreatitis is a very rare event.

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