Ancylostomiasis (Hookworm Infection)

Ancylostomiasis is the medical name for hookworm infection in humans. Tiny worm larvae living in contaminated soil can enter your body (usually through bare feet). They travel through the blood to the lungs, get coughed up and swallowed, and then mature into adult worms in the small intestine. Adult worms attach to the gut lining and steal blood and protein, which can cause iron-deficiency anemia, low albumin (blood protein), and tiredness—especially when there are many worms. CDC+1

Ancylostomiasis is a parasitic infection of the small intestine caused mainly by Necator americanus and Ancylostoma duodenale. Infective larvae in contaminated soil penetrate bare skin (often the feet), travel through the bloodstream to the lungs, are coughed up and swallowed, then mature in the small bowel. Adult hookworms attach to the gut lining and feed on blood, which can cause iron-deficiency anemia, protein loss, abdominal pain, diarrhea, and fatigue. Illness severity depends on worm burden, diet (iron intake), and host factors like pregnancy or child growth. Diagnosis is usually by finding eggs in stool; treatment is with anthelmintic (anti-worm) medicines and iron repletion when needed. Preventing reinfection requires sanitation, footwear, and regular deworming programs in endemic areas. NCBI+2Nature+2

Another names

Hookworm infection; Hookworm disease; Ancylostoma duodenale infection; Necator americanus infection; Soil-transmitted helminth (STH) infection (hookworm type); Geohelminth infection; Uncinariasis; Necatoriasis; Human hookworm; Intestinal hookworm disease. (When the infecting species comes from dogs/cats, people may read “zoonotic hookworm” or “cutaneous larva migrans,” which is a skin-only form from animal hookworms.) CDC+1

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Types

You can think about “types” in three simple ways:

1. By species (most common way)

   • Necator americanus — now the most common human hookworm worldwide. It usually infects by skin penetration. CDC

   • Ancylostoma duodenale — also a major human hookworm. It can infect through the skin and, less often, by swallowing larvae on contaminated food/water. Latent tissue larvae may “wake up” later (e.g., during pregnancy) and cause new intestinal infection. Medscape

   • Ancylostoma ceylanicum — a zoonotic hookworm of dogs/cats that now infects people in parts of Asia and, recently, the Americas. It behaves clinically much like the two human species. Am J Trop Med Hyg+1

2. By where it affects you

   • Skin phase (“ground itch” where larvae entered): itchy red bump(s) on the feet or exposed skin.

   • Lung phase: brief dry cough or wheeze when larvae pass through the lungs (sometimes called Löffler syndrome, a short-lived cough with fleeting lung shadows and high eosinophils).

   • Intestinal phase: adult worms in the small intestine causing blood loss and symptoms of iron-deficiency anemia. NCBI+1

3. By intensity (how heavy the infection is)

   • Light: few or no symptoms.

   • Moderate

   • Heavy: fatigue, pallor, shortness of breath on exertion, swelling from low protein, and growth or learning problems in children due to chronic anemia and protein loss. Nature

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Causes

Here “cause” mainly means how and why people get exposed to infective larvae.

1. Walking barefoot on contaminated, moist soil. Hookworm larvae actively penetrate the skin. World Health Organization

2. Poor sanitation (no safe toilets; open defecation), which seeds soil with eggs that hatch into larvae. World Health Organization

3. Warm, humid climates where larvae survive well (tropics and subtropics). World Health Organization

4. Soil that remains damp (after rain, irrigation, or flooding), which helps larvae live longer. World Health Organization

5. Living or working on bare, earthen floors where contaminated dust/soil contacts skin. World Health Organization

6. Agricultural work (e.g., planting, harvesting, irrigation) with bare feet or hands in contaminated soil. World Health Organization

7. Children playing in soil without shoes—kids have more frequent soil contact. World Health Organization

8. Use of untreated human feces (“night soil”) as fertilizer on crops. World Health Organization

9. Sleeping outdoors or on the ground in endemic areas, exposing skin to soil. World Health Organization

10. Crowded housing and poverty, which limit access to toilets and shoes. World Health Organization

11. Travel to or migration from endemic regions without protective footwear. NCBI

12. Mining or tunnel work with damp, contaminated ground (the old term “miners’ anemia” came from this). Medscape

13. Lack of health education about how hookworm spreads and how to prevent it. World Health Organization

14. Limited access to deworming programs (public health mass drug administration). NCBI

15. Barefoot farming of kitchen gardens fertilized with contaminated compost/soil. World Health Organization

16. Handling contaminated soil with bare hands (e.g., building with mud). World Health Organization

17. Poor handwashing after soil contact before eating (ingestion is uncommon but possible, especially for A. duodenale). Medscape

18. Keeping dogs/cats that roam outdoors in areas where A. ceylanicum circulates (a zoonotic risk). Am J Trop Med Hyg+1

19. Post-disaster displacement (temporary camps may lack sanitation and shoes). World Health Organization

20. Working barefoot in irrigation channels or rice paddies with contaminated sediments. World Health Organization

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Symptoms

Not everyone feels sick. Symptoms depend on the stage and on how many worms are in the gut.

1. Itchy entry spot (“ground itch”) where larvae penetrated—small, red, very itchy bump(s), usually on feet. It may last days to a week. NCBI

2. Mild rash on the feet or legs from the skin phase. It settles as larvae move on. NCBI

3. Dry cough or throat tickle for a few days when larvae pass through the lungs. NCBI

4. Wheezing or short breath for a short time (sometimes Löffler syndrome). Chest X-ray may show temporary patchy shadows that move around. PMC

5. Belly pain (crampy around the navel) once worms attach in the small intestine. NCBI

6. Nausea or reduced appetite, especially in heavier infections. NCBI

7. Diarrhea or loose stools, sometimes alternating with normal stools. NCBI

8. Tiredness and low energy from iron loss over time. This is one of the commonest complaints. NCBI

9. Pale skin and inner eyelids (pallor) due to iron-deficiency anemia. NCBI

10. Dizziness or fast heartbeat on exertion in moderate-to-heavy anemia. NCBI

11. Pica (craving clay/soil/ice) sometimes occurs with iron deficiency. NCBI

12. Swelling of feet/ankles (edema) if protein loss is significant (low albumin). Nature

13. Weight loss with long-standing, heavy infection. NCBI

14. Poor growth and learning problems in children if anemia and protein loss are not corrected. Nature

15. Eosinophilia (a high count of a specific white blood cell). This is a lab sign but sometimes links to itch and cough during migration. PMC

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Diagnostic tests

Big picture: The main test is stool examination for hookworm eggs, often using a method called Kato-Katz to count egg numbers (eggs per gram, EPG). Multiple stool samples on different days improve detection, especially when infection is light. Other tests check anemia, iron status, and protein levels, or look for short-lived lung changes during the migration phase. CDC+2PMC+2

A) Physical exam

1. General exam for pallor
   Your clinician looks at the inner eyelids, tongue, and palms for paleness, suggesting iron-deficiency anemia from blood loss to worms. This finding guides urgent lab testing. NCBI

2. Vital signs and effort tolerance
   Pulse and breathing rate at rest and with mild exertion can uncover the strain of anemia (fast heart rate, short breath with activity), which helps grade severity and decide how fast to treat. NCBI

3. Skin check for entry marks
   A focused exam of the feet and lower legs can show itchy red papules (“ground itch”) where larvae entered. This supports exposure in the right setting. NCBI

4. Nutrition screening (weight, height, mid-upper arm circumference)
   Simple bedside measurements help detect under-nutrition or growth faltering in children, which can be worsened by chronic hookworm. Nature

5. Cardiac and edema exam
   Listening for a flow murmur (from anemia) and checking for ankle swelling (from low albumin) show systemic impact and guide urgency of care. Nature

B) Manual tests (microscopy-based stool methods done by hand)

6. Direct wet mount stool microscopy
   A drop of stool is examined under a microscope to look for hookworm eggs. It is quick and cheap but less sensitive when egg numbers are low. CDC

7. Kato-Katz thick smear (quantitative)
   A measured amount of stool is pressed under a glycerol-soaked cellophane strip and read by a microscopist. It counts eggs per gram (EPG) and helps grade infection intensity and program impact. It must be read within 30–60 minutes because hookworm eggs clear with glycerol over time. Multiple smears or days improve sensitivity in light infections. PMC+2PLOS+2

8. Formalin-ethyl acetate concentration
   The stool is mixed, spun, and concentrated so eggs are easier to find on a slide. This boosts detection when egg output is low. CDC

9. Harada–Mori filter paper culture (larval culture)
   Stool on filter paper is incubated so larvae hatch and develop to identifiable stages, which helps confirm hookworm and can aid species identification in some labs. It is more sensitive than simple wet mounts in some settings. Cabinet Digital Library+1

C) Laboratory & pathological tests

10. Complete blood count (CBC) with differential
    Looks for anemia (low hemoglobin) and eosinophilia (often high during migration). It quantifies disease impact and tracks recovery after treatment. NCBI

11. Iron studies (serum ferritin, transferrin saturation, serum iron, TIBC)
    Distinguish iron-deficiency anemia from other anemias and guide iron replacement. Low ferritin and low transferrin saturation point to iron loss from intestinal blood-feeding. NCBI

12. Serum albumin and total protein
    Heavy infections can cause protein loss leading to hypoalbuminemia and edema; low albumin supports severity. Nature

13. Repeat stool exams on different days
    Egg output can vary day to day; examining 2–3 separate samples raises sensitivity for light infections and avoids under-diagnosis. PLOS

14. FLOTAC / Mini-FLOTAC quantitative egg counts
    Flotation-based methods that can be more sensitive than Kato-Katz in some settings and useful for monitoring control programs. PMC

15. McMaster egg counting
    Another quantitative flotation method originally used in veterinary parasitology but applied in human surveys to estimate intensity. (It helps compare before/after treatment.) PMC

16. PCR / qPCR on stool for species identification
    Molecular assays can distinguish Necator vs Ancylostoma and detect A. ceylanicum in areas with animal reservoirs—useful in research and some reference labs. Am J Trop Med Hyg

17. Copro-antigen (ELISA) tests (where available)
    Experimental or specialized assays that look for worm proteins in stool; they may improve detection where microscopy is limited, though availability varies. Nature

18. Duodenal aspiration/biopsy (rarely needed)
    In unusual cases with negative stools but strong suspicion, endoscopy can sample the upper small intestine to visualize worms or eggs. This is invasive and not routine. NCBI

D) Imaging tests

19. Chest X-ray during the lung phase
    If cough and eosinophilia occur, a chest film may show fleeting, patchy opacities that migrate (Löffler syndrome). These resolve as larvae move on. Medscape+1

20. Upper endoscopy (duodenoscopy) or capsule endoscopy
    Very occasionally, clinicians may see adult hookworms attached to the duodenal mucosa. This is not first-line but can explain unexplained GI bleeding or severe anemia when stool tests are unclear. NCBI

Non-pharmacological treatments (therapies & other measures)

(Each item includes Purpose and Mechanism in simple terms.)

1. Wearing closed footwear outdoors
   Purpose: Stop larvae in soil from penetrating skin.
   Mechanism: A physical barrier between skin and contaminated ground—especially on farms, building sites, and moist soil—prevents the first step of infection. Consistent shoe use reduces exposure, particularly in children. Nature

2. Household latrines and safe feces disposal
   Purpose: Cut transmission at the source.
   Mechanism: Hookworm eggs leave the body in feces and hatch in warm, moist soil. Toilets/latrines and safe sludge management keep human feces out of the environment, interrupting the life cycle so fewer larvae can mature in soil. WHO Apps

3. Hand hygiene after soil contact and before meals
   Purpose: Reduce accidental ingestion of larvae/eggs and other pathogens.
   Mechanism: Soap and water remove soil and organic material from hands and under nails, lowering the chance of oral exposure and co-infections that worsen anemia. WHO Apps

4. Keep children’s play areas off bare soil
   Purpose: Protect toddlers and school-age children, who play close to the ground.
   Mechanism: Sandboxes with clean, covered sand or play on concrete/grass decreases skin contact with contaminated earth and lowers infection risk in high-transmission settings. WHO Apps

5. Health education (community and school)
   Purpose: Build habits that prevent reinfection.
   Mechanism: Teaching about shoe use, latrines, handwashing, and regular deworming helps entire communities sustain behaviors that keep transmission low, especially after mass drug administration (MDA). WHO Apps

6. Mass drug administration (MDA) campaigns
   Purpose: Rapidly reduce worm burden in at-risk groups.
   Mechanism: Periodic single-dose albendazole or mebendazole to preschoolers, school-age children, and other high-risk groups lowers community egg output; pairing MDA with WASH (water, sanitation, hygiene) gives the longest benefit. WHO Apps

7. Water, sanitation, and hygiene (WASH) packages
   Purpose: Durable transmission control.
   Mechanism: Combining improved water access, latrines, handwashing stations, and behavior change creates multiple “barriers” against exposure, complementing deworming medicines. WHO Apps

8. Nutritional counseling for iron and protein intake
   Purpose: Correct or prevent iron-deficiency anemia and low albumin.
   Mechanism: Encouraging heme-iron foods (meat, fish), iron-rich plant foods with vitamin C, and adequate protein helps rebuild blood and protein stores while medicines clear worms. New England Journal of Medicine

9. Safe agriculture practices (gloves, boots, covered wounds)
   Purpose: Protect farmers and laborers.
   Mechanism: PPE (boots/gloves) lowers skin exposure; covering cuts prevents direct entry of larvae. Community uptake is highest when gear is affordable and comfortable in hot climates. Nature

10. Pregnancy-specific counseling
    Purpose: Protect maternal and fetal health.
    Mechanism: Screening and deworming after the first trimester in high-burden regions, plus iron and folate, reduces maternal anemia and its complications. World Health Organization+1

11. School-based deworming schedules
    Purpose: Keep kids learning and growing.
    Mechanism: Regular, supervised dosing at school reaches most children efficiently and is a WHO-endorsed delivery channel in endemic areas. WHO Apps

12. Community mapping & targeted interventions
    Purpose: Use resources where they matter most.
    Mechanism: Mapping stool-positivity “hotspots” guides frequency of deworming and WASH investments, preventing rebound in high-intensity zones. WHO Apps

13. Discouraging geophagy (soil eating) and pica
    Purpose: Reduce ingestion of pathogens and soil-bound inhibitors of iron absorption.
    Mechanism: Counseling and nutrition support reduce pica behaviors linked with iron deficiency and exposure to contaminated soil. New England Journal of Medicine

14. Household cleaning (mud floors → sealed surfaces)
    Purpose: Minimize larval survival indoors.
    Mechanism: Smoother, washable floor surfaces lower moist micro-environments where larvae persist, complementing sanitation. WHO Apps

15. Community monitoring & follow-up after MDA
    Purpose: Sustain gains.
    Mechanism: Post-MDA stool surveys and coverage reviews decide when to repeat rounds and where to intensify WASH measures. WHO Apps

16. Occupational health programs for miners, brick-kiln and construction workers
    Purpose: Reduce workplace exposure.
    Mechanism: PPE, onsite latrines, and clean rest areas reduce skin contact with damp soil and shared defecation sites. Nature

17. Community savings/financing for latrines and shoes
    Purpose: Overcome cost barriers.
    Mechanism: Micro-grants or co-ops help households afford durable footwear and toilets, amplifying health education impact. WHO Apps

18. Safe childcare practices (diaper disposal, yard fencing)
    Purpose: Limit soil contamination near homes.
    Mechanism: Proper infant feces disposal and separating play areas from livestock and drainage ditches lower environmental egg deposition. WHO Apps

19. Rapid treatment of symptomatic cases
    Purpose: Cut egg shedding and community transmission.
    Mechanism: Prompt diagnosis and deworming of individuals with anemia or GI symptoms stops ongoing contamination and helps patients recover faster. CDC

20. Integration with anemia control programs
    Purpose: Address the main harm of hookworm.
    Mechanism: Bundling deworming with iron/folate supplementation, diet counseling, and malaria control reduces anemia more than any single measure alone. New England Journal of Medicine

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Drug treatments

Important context: For hookworm, only a small number of anthelmintic drugs are truly effective and recommended. The rest of the medications below are adjuncts to correct iron-deficiency anemia or manage special situations. I’ll label these clearly.

Core anthelmintics

1. Albendazole (first-line)
   Class: Benzimidazole anthelmintic.
   Dose/Time: Adults & children ≥24 months: 400 mg single dose; some settings use 400 mg daily for 3 days to improve cure; emerging data suggest 800 mg single dose in adults can increase efficacy.
   Purpose & Mechanism: Kills adult worms by binding parasite β-tubulin, blocking microtubules and glucose uptake → worm death and expulsion.
   Side effects: Usually mild—abdominal pain, nausea; rare liver enzyme rise. Avoid in first trimester unless benefits outweigh risks. Medscape+2PMC+2

2. Mebendazole
   Class: Benzimidazole.
   Dose/Time: 500 mg once, or 100 mg twice daily for 3 days; cure rates for hookworm are modest vs albendazole but still useful.
   Purpose & Mechanism: Same class mechanism (microtubule disruption).
   Side effects: GI upset, rare hypersensitivity; avoid in first trimester if possible. Medscape+1

3. Pyrantel pamoate (alternative when benzimidazoles unavailable)
   Class: Depolarizing neuromuscular blocker for nematodes.
   Dose/Time: 11 mg/kg orally (max 1 g) once; some programs repeat after 2–3 weeks depending on species mix.
   Purpose & Mechanism: Paralyzes worms so they detach and are expelled.
   Side effects: Nausea, cramps, headache; generally safe. Medscape

4. Levamisole (used in some endemic countries)
   Class: Imidazothiazole anthelmintic.
   Dose/Time: Often 2.5 mg/kg single dose; local guidance varies.
   Purpose & Mechanism: Nicotinic acetylcholine receptor agonist → spastic paralysis of worms.
   Side effects: Nausea, metallic taste; rare agranulocytosis; not widely used in many countries today. Frontiers

5. Tribendimidine (emerging/region-specific)
   Class: Broad-spectrum anthelmintic (derivative of amidantel).
   Dose/Time: Trials suggest 400 mg single dose effective and well tolerated; availability limited.
   Purpose & Mechanism: Nicotinic acetylcholine receptor agonism leading to worm paralysis/expulsion.
   Side effects: Usually mild GI symptoms in trials. PubMed+2Oxford Academic+2

6. Albendazole, extended regimen
   Class: Benzimidazole.
   Dose/Time: 400 mg daily for 3 days when single-dose cure rates are suboptimal or intensity is heavy.
   Purpose & Mechanism: Increases exposure time to improve worm kill.
   Side effects: As above. Medscape

7. Albendazole + oxantel pamoate (combo used mainly for Trichuris; limited hookworm benefit)
   Class: Benzimidazole + tetrahydropyrimidine.
   Dose/Time: Single-dose combos in trials; consult local protocols.
   Purpose & Mechanism: Broader spectrum for mixed infections; hookworm benefit is variable.
   Side effects: GI upset; follow local guidance. PubMed

8. Albendazole + ivermectin (not standard for hookworm alone)
   Class: Benzimidazole + macrocyclic lactone.
   Dose/Time: Used in integrated NTD campaigns for multiple parasites.
   Purpose & Mechanism: Addresses co-endemic parasites; hookworm effect mainly via albendazole.
   Side effects: Usually mild; adhere to program protocols. Frontiers

Adjuncts for anemia and recovery (treat the main harm of hookworm)

9. Ferrous sulfate (oral iron)
   Class: Iron salt.
   Dose/Time: Typical 60–120 mg elemental iron/day for adults; pediatric weight-based.
   Purpose & Mechanism: Replete iron lost to chronic intestinal bleeding; restores hemoglobin.
   Side effects: Nausea, constipation; take with vitamin C or on empty stomach for better absorption when tolerated. New England Journal of Medicine

10. Ferrous fumarate / ferrous gluconate (oral iron alternatives)
    Class: Iron salts.
    Dose/Time: Dose by elemental iron equivalent (e.g., 65–106 mg elemental once daily).
    Purpose & Mechanism: Same as ferrous sulfate; alternative tolerability profiles.
    Side effects: GI upset; stool darkening. New England Journal of Medicine

11. Iron polymaltose complex (oral)
    Class: Non-ionic iron complex.
    Dose/Time: Elemental iron equivalent dosing; often once daily.
    Purpose & Mechanism: Gentler GI profile for patients who cannot tolerate iron salts.
    Side effects: Less GI irritation; cost can be higher. New England Journal of Medicine

12. Intravenous iron (e.g., ferric carboxymaltose or iron sucrose)
    Class: Parenteral iron preparations.
    Dose/Time: Single or divided IV doses based on hemoglobin deficit; used when oral iron fails or is intolerable, or when rapid repletion is needed.
    Purpose & Mechanism: Bypasses gut; quickly replenishes iron stores.
    Side effects: Infusion reactions are uncommon; monitor during administration. New England Journal of Medicine

13. Folic acid
    Class: Vitamin (B9).
    Dose/Time: 0.4–1 mg daily; higher in pregnancy as recommended.
    Purpose & Mechanism: Supports erythropoiesis during recovery from anemia; corrects concomitant folate deficiency.
    Side effects: Very well tolerated. New England Journal of Medicine

14. Vitamin B12 (cobalamin) when deficient
    Class: Vitamin.
    Dose/Time: Oral or intramuscular per deficiency protocol.
    Purpose & Mechanism: Restores normal red blood cell production if mixed deficiency is present.
    Side effects: Very safe. New England Journal of Medicine

15. Vitamin C (ascorbic acid) with iron
    Class: Vitamin/absorption enhancer.
    Dose/Time: 100–200 mg with iron doses.
    Purpose & Mechanism: Increases non-heme iron absorption in the gut.
    Side effects: Mild GI upset at high doses. New England Journal of Medicine

16. Antiemetics for iron intolerance (e.g., ondansetron PRN)
    Class: 5-HT3 antagonist (example).
    Dose/Time: As needed per label to help patients keep iron down.
    Purpose & Mechanism: Improves adherence to iron therapy when nausea is significant.
    Side effects: Headache, constipation. New England Journal of Medicine

17. Proton-pump inhibitors are not indicated to treat hookworm
    Class: Acid-suppressing agents.
    Note: Do not treat hookworm; may actually reduce iron absorption if overused.
    Purpose/Mechanism: Only use for true acid-related disease; avoid routine use during iron repletion. New England Journal of Medicine

18. Paracetamol/acetaminophen for symptomatic relief
    Class: Analgesic/antipyretic.
    Dose/Time: Standard dosing.
    Purpose & Mechanism: Eases abdominal discomfort or fever associated with concurrent infections; does not treat worms.
    Side effects: Hepatotoxicity if overdosed—follow label. NCBI

19. Blood transfusion (packed red cells) in severe, symptomatic anemia
    Class: Blood component therapy (procedure with medication order).
    Dose/Time: Per transfusion thresholds and clinical instability.
    Purpose & Mechanism: Rapidly raises hemoglobin when patients are hemodynamically compromised while definitive therapy (anthelmintic + iron) works.
    Side effects: Transfusion reactions; monitor carefully. New England Journal of Medicine

20. Pregnancy deworming after first trimester (programmatic single-dose albendazole 400 mg or mebendazole 500 mg)
    Class: Benzimidazoles under public-health protocols.
    Dose/Time: One dose after 1st trimester in eligible high-burden areas.
    Purpose & Mechanism: Reduces maternal worm burden and anemia; WHO supports use after first trimester where anemia burden is high.
    Side effects: As above; growing safety data show no increased adverse outcomes with inadvertent early exposure, but routine first-trimester use is avoided. World Health Organization+2NCBI+2

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Dietary molecular supplements

1. Elemental iron (any oral form) — 60–120 mg/day adults; pediatric weight-based. Function/Mechanism: Replaces iron lost to chronic blood feeding, restoring hemoglobin and ferritin. Take with water or vitamin C; avoid tea/coffee around dosing. New England Journal of Medicine

2. Heme iron polypeptide — Product-specific dosing (often 12–24 mg elemental per capsule). Function: Better absorption, fewer GI effects for some patients. Mechanism: Uses heme carrier pathways independent of gastric pH. New England Journal of Medicine

3. Folate (vitamin B9) — 0.4–1 mg daily. Function: Supports DNA synthesis in red cell precursors. Mechanism: Repletes folate when dietary intake is low, speeding anemia recovery. New England Journal of Medicine

4. Vitamin B12 — Oral (e.g., 1,000 µg/day) if deficient. Function: Corrects megaloblastic component if present. Mechanism: Restores methionine synthase activity for effective erythropoiesis. New England Journal of Medicine

5. Vitamin C — 100–200 mg with iron. Function: Enhances non-heme iron uptake. Mechanism: Reduces ferric to ferrous iron and forms absorbable complexes. New England Journal of Medicine

6. Protein supplement (e.g., milk powder/legume blends) — As per nutrition plan. Function: Corrects hypoalbuminemia/protein loss in heavy infections. Mechanism: Provides amino acids to rebuild albumin and tissue proteins. New England Journal of Medicine

7. Multiple micronutrient (MMN) with vitamin A & zinc — Daily per label. Function: Addresses co-existing deficiencies that worsen anemia and immunity. Mechanism: Supports hematopoiesis and mucosal immunity during recovery. New England Journal of Medicine

8. Intravenous iron (ferric carboxymaltose/iron sucrose) — Dosed to deficit. Function: Rapid repletion when oral iron fails or is intolerable. Mechanism: Delivers bioavailable iron directly to transferrin/ferritin pools. New England Journal of Medicine

9. Iodized salt (programmatic) — Routine dietary use. Function: Supports thyroid function and growth; often bundled in public-health nutrition where helminths are endemic. Mechanism: Ensures adequate iodine to complement child development goals alongside deworming. WHO Apps

10. Calcium-rich foods timing (a “negative supplement” tip) — Avoid with iron doses. Function: Prevents reduced iron absorption. Mechanism: Calcium competes at intestinal transporters; take iron separately by a few hours. New England Journal of Medicine

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Immunity booster / regenerative / stem-cell” drugs

Bottom line: There are no approved immune-booster, regenerative, or stem-cell drugs to treat ancylostomiasis. Treatment is anthelmintics + iron, plus prevention. Below are clarifications so readers don’t spend money on ineffective therapies.

1. “Immune boosters” (over-the-counter tonics) — Not indicated; no evidence they clear worms or correct anemia beyond standard care. Focus on deworming + iron. NCBI

2. Erythropoiesis-stimulating agents — Not routine for hookworm anemia; iron therapy is preferred and effective. Consider only for other specific indications. New England Journal of Medicine

3. Stem-cell therapies — No role in hookworm infection or its anemia. NCBI

4. Biologic immunomodulators — No role; do not eradicate helminths. NCBI

5. Probiotics as “deworming” — May support gut health but do not kill hookworms; not a treatment substitute. NCBI

6. Experimental “helminth therapy” — Involves deliberate exposure to worms for immune diseases, not for treating hookworm and should not be used; it causes infection and anemia. Nature

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Surgeries

Hookworm almost never requires surgery. Rarely, procedures are used to diagnose bleeding or stabilize severe anemia; these are exceptions, not standard care.

1. Upper endoscopy (EGD) for GI bleeding — Used to look for bleeding mucosa; occasionally visualizes attached worms in the duodenum. Helps confirm cause when anemia is severe or melena occurs. NCBI

2. Endoscopic hemostasis — If a focal bleeding site is identified, endoscopic therapy can control it while definitive deworming and iron repletion proceed. NCBI

3. Blood transfusion (procedure) — For hemodynamically significant anemia; stabilizes the patient before/alongside deworming. New England Journal of Medicine

4. IV iron infusion (procedure) — Rapid iron store replacement when oral therapy fails; not surgery but sometimes done in day-care infusion units. New England Journal of Medicine

5. Exploratory surgery — Very rarely for suspected complications unrelated to simple hookworm infection; stat texts emphasize surgical complications are unlikely. NCBI

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Preventions

1. Wear shoes outdoors, especially on farms or damp soil. Nature

2. Use latrines; never defecate in fields. WHO Apps

3. Wash hands with soap after soil contact and before eating. WHO Apps

4. Keep children off bare soil; provide clean play spaces. WHO Apps

5. Join school/community deworming when offered. WHO Apps

6. Improve floors (sealed, washable) and household hygiene. WHO Apps

7. Use gloves/boots for farm or construction work. Nature

8. Treat anemia early and complete iron therapy. New England Journal of Medicine

9. In pregnancy, follow antenatal guidance and deworm after first trimester in eligible regions. World Health Organization

10. Community WASH: safe water points, handwashing stations, and latrines. WHO Apps

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When to see a doctor (red flags)

Seek care urgently for black, tarry stools; fainting, chest pain, shortness of breath; severe fatigue with very pale skin; rapid heartbeat; or if a child is listless and not growing or eating. Pregnant patients with suspected infection or anemia should be assessed promptly to plan safe deworming (after the first trimester) and iron therapy. Anyone with persistent abdominal pain, diarrhea, or unexplained anemia should be tested (stool exam) and treated according to local guidelines. Follow-up is important to confirm cure and to arrange family or school deworming to prevent reinfection. CDC+1

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What to eat & what to avoid

1. Eat: heme-iron foods (beef, chicken, fish, liver) several times a week. Why: best-absorbed iron; fastest way to rebuild blood. New England Journal of Medicine

2. Eat: iron-rich plants (lentils, beans, spinach) with vitamin-C foods (lemon, guava). Why: vitamin C boosts absorption. New England Journal of Medicine

3. Eat: adequate protein (eggs, dairy, soy) daily. Why: supports albumin and tissue repair. New England Journal of Medicine

4. Avoid with iron pills: tea/coffee within 1–2 hours. Why: polyphenols reduce iron absorption. New England Journal of Medicine

5. Avoid: taking calcium supplements simultaneously with iron. Why: calcium competes with iron uptake. New England Journal of Medicine

6. Eat: fortified staples (iron-fortified flour/rice) when available. Why: convenient iron source. WHO Apps

7. Avoid: raw, unwashed produce from fields fertilized with human waste. Why: contamination risk. WHO Apps

8. Eat: small, frequent meals if iron pills upset your stomach. Why: better tolerance. New England Journal of Medicine

9. Avoid: self-medicating with “deworming herbs.” Why: no reliable efficacy; may delay proven care. NCBI

10. Eat: balanced meals during recovery; keep hydrated. Why: supports healing and tolerance of medicines. New England Journal of Medicine

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Frequently asked questions (FAQ)

1. How do people get hookworm?
   By walking barefoot or skin contact with contaminated soil containing larvae from human feces; larvae penetrate skin and mature in the gut. Nature

2. Is it contagious person-to-person?
   No. Transmission requires soil contamination with feces; it’s environmental, not direct contact. Nature

3. What’s the biggest health problem it causes?
   Iron-deficiency anemia from intestinal blood loss; protein loss can also occur in heavy infections. New England Journal of Medicine

4. How is it diagnosed?
   Stool microscopy for eggs; sometimes antigen or molecular tests in studies; endoscopy is rarely needed. NCBI

5. What’s the best medicine?
   Albendazole 400 mg single dose is widely recommended; some cases use 3-day regimens or higher adult single doses to improve cure rates. Medscape+1

6. Is mebendazole effective?
   Yes, but cure rates for hookworm are generally lower than albendazole; still used in many programs. BMJ

7. Do I need iron tablets?
   If you have anemia or low ferritin, yes—iron therapy speeds recovery while deworming clears the worms. New England Journal of Medicine

8. Can pregnant women be treated?
   WHO supports single-dose albendazole or mebendazole after the first trimester in high-burden areas to reduce maternal anemia. World Health Organization

9. What about side effects of albendazole?
   Usually mild (nausea, abdominal pain). Serious effects are rare. Follow dosing and local guidance. Medscape

10. If I’m treated once, am I cured forever?
    No. You can be re-infected if you walk barefoot or sanitation is poor; combine medicine with prevention. WHO Apps

11. Why do we deworm whole schools or communities?
    Mass treatment reduces the overall number of worms shedding eggs, protecting everyone and lowering reinfection rates. WHO Apps

12. Are stronger or repeated doses ever used?
    Yes—3-day albendazole or higher single adult dose (800 mg) has shown higher efficacy in some studies; protocols vary by country. Medscape+1

13. Do PPIs help stomach symptoms from worms?
    No—they don’t treat hookworm and may hinder iron absorption. Use only if you have a true acid disorder. New England Journal of Medicine

14. Is tribendimidine available to me?
    It has promising trial data but limited availability; follow local formularies and guidelines. PubMed

15. What’s the long-term plan for my family?
    Take medicines as directed, finish iron therapy, wear shoes, use latrines, join school/community deworming, and improve home hygiene to keep worms away. WHO Apps

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: September 16, 2025.

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