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An investigation of hookworm infection and reinfection following mass anthelmintic treatment in the South Indian fishing community of Vairavankuppam

Published online by Cambridge University Press:  06 April 2009

Melissa R. Haswell-Elkins ,
D. B. Elkins ,
K. Manjula ,
E. Michael  and
R. M. Anderson
Melissa R. Haswell-Elkins
Affiliation:
Department of Pure and Applied Biology, Imperial College, University of London, Prince Consort Road, London SW1 2BB
D. B. Elkins
Affiliation:
Department of Pure and Applied Biology, Imperial College, University of London, Prince Consort Road, London SW1 2BB
K. Manjula
Affiliation:
Department of Zoology, Madras Christian College, Tambaram, Madras 600 059, Tamil Nadu, India
E. Michael
Affiliation:
Department of Pure and Applied Biology, Imperial College, University of London, Prince Consort Road, London SW1 2BB
R. M. Anderson
Affiliation:
Department of Pure and Applied Biology, Imperial College, University of London, Prince Consort Road, London SW1 2BB
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Summary

Hookworm infections, as assessed by counting worms expelled following anthelmintic treatment and by egg output, were found to be of low prevalence and intensity in a South Indian fishing community. The initial overall prevalence of infection in the community was 43%, and the average burden was estimated at 2·2 hookworms per person. The age profiles of prevalence and intensity differed between males and females, with the latter harbouring significantly higher levels of infection. Children of both sexes under 10 years of age rarely harboured hookworms. Treatment with pyrantel pamoate was estimated to be 91% effective in clearing hookworm infections. Egg counts made on stools collected during an 11-month period of reinfection indicated that female patients became reinfected soon after treatment, while little hookworm egg excretion was observed in males during the observation period following treatment. Females acquired a significantly higher number of worms during the reinfection period compared with males, although the average burden in females reached only 28% of the initial, pre-treatment level. The hookworm population consisted of predominantly Necator americanus, and less than 10% of Ancylostoma duodenale. The parasites were highly aggregated within the host population with 10% of the community harbouring over 65% of the total hookworms. Low values of the negative binomial aggregation parameter, k, (indicating extreme over-dispersion) were recorded in groups stratified by age and sex. Highly significant positive correlations were observed between the initial (pre-treatment) and reinfection worm burdens of female (but not of male) patients. It is suggested that occupational practices related to walking through areas contaminated with hookworm larvae play an important role in generating the observed patterns of infection within this community.

Type
Research Article
Information
Parasitology , Volume 96 , Issue 3 , June 1988 , pp. 565 - 577
Copyright
Copyright © Cambridge University Press 1988

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