ANCLYNOSTOMA DUODENALE

Ancylostoma duodenale is a species of the roundworm genus Ancylostoma. It is a parasitic nematode worm

and commonly known as the Old World hookworm. It lives in the small intestine of hosts such as humans, cats and
dogs, where it is able to mate and mature. Ancylostoma duodenale and Necator americanus are the two
human hookworm species that are normally discussed together as the cause of hookworm infection. They
are dioecious. Ancylostoma duodenale is abundant throughout the world, including Southern Europe, North Africa,
India, China, Southeast Asia, some areas in the United States, the Caribbean, and South America.
Characteristics:
A. duodenale is small, cylindrical worm, greyish-white in color. It has two ventral plates on the anterior
margin of the buccal capsule. Each of them has two large teeth that are fused at their bases. A pair of small teeth can
be found in the depths of the buccal capsule. Males are 8–11 mm long with a copulatory bursa at the posterior end.
Females are 10–13 mm long, with the vulva located at the posterior end; females can lay 10,000 to 30,000 eggs per
day. The average lifespan of A. duodenale is one year.
Lifecycle:
After a filariform "infective" larva penetrates the intact skin – most commonly through the feet – the larva
enters the blood circulation. It is then carried to the lungs, breaks into alveoli, ascends the bronchi and trachea, and
is coughed up and swallowed back into the small intestine, where it matures. The larva later matures into an adult in
the small intestine (jejunum mainly), where they attach to the villi and female worms can lay 25,000 eggs per day.
The eggs are released into the feces and reside on soil; when deposited on warm, moist soil, a larva rapidly develops
in the egg and hatches after 1 to 2 days. This rhabditiform larva moults twice in the soil and becomes a skin-
penetrating third-stage infective larva within 5–10 days. The infective rhabditiform larvae are able to sense vibrations
in the soil, heat, or carbon dioxide, and are able to use dendritic processes similar to cilia. They use these processes
as thermosensory, chemosensory, and mechanosensory receptors to migrate towards a host for infection. The
rhabditiform larvae can then penetrate the exposed skin of another organism and begin a new cycle of infection.

Epidemiology:
A. duodenale is prevalent in Southern Europe, North Africa, India, China, Southeast Asia, small areas of
United States, the Caribbean islands, and South America. This hookworm is well known in mines because of the
consistency in temperature and humidity that provides an ideal habitat for egg and juvenile development. An
estimated 1 billion people are infected with hookworms. Transmission of A. duodenale is by contact of skin with soil
contaminated with larvae. The way it enters the human body was understood in the 1880s, after an epidemic
of ancylostomiasis among miners working in the hot and humid Gotthard Tunnel (Switzerland).
Infection:
A light hookworm infection causes abdominal pain, loss of appetite, and geophagy. Heavy infection causes
severe protein deficiency or iron-deficiency anemia. Protein deficiency may lead to dry skin, edema, and abdominal
extension from edema (potbelly), while iron-deficiency anemia might result in mental dullness and heart failure.
Women who are pregnant and infected should be aware that this parasite is able to infect the fetus and can cause
complications such as low birth weight, maternal anemia, and infant mortality.
 The eggs of A. duodenale and Necator americanus cannot be distinguished. Larvae cannot be found in
stool specimens unless they are left at ambient temperature for a day or more.

Symptoms:
Symptoms generally start with itchiness and a small rash caused by an allergic reaction in the area that the
larvae entered your skin. This is generally followed by diarrhea as the hookworms grow in your intestine. Other
symptoms include:
 abdominal pain
 colic, or cramping and excessive crying in infants
 intestinal cramps
 nausea
 a fever
 blood in your stool
 a loss of appetite
 itchy rash

Diagnosis:
The standard method for diagnosing the presence of hookworm is by identifying hookworm eggs in a stool
sample using a microscope. Because eggs may be difficult to find in light infections, a concentration procedure is
recommended.
Prevention:
Education, improved sanitation, and controlled disposal of human feces are important. Wearing shoes in
endemic areas can reduce the prevalence of infection, as well.
Treatment:
Anthelminthic medications (drugs that rid the body of parasitic worms), such as albendazole and
mebendazole, are the drugs of choice for treatment of hookworm infections. Albendazole: 400 mg orally once.
Mebendazole: 100 mg orally twice a day for 3 days or 500 mg orally once. Pyrantel pamoate: 11 mg/kg (up to a
maximum of 1 g) orally daily for 3 days. The WHO recommends deworming treatment during the second or third
trimester for pregnant women with heavy hookworm infections. Infections are generally treated for 1-3 days. The
recommended medications are effective and appear to have few side effects. Iron supplements may also be
prescribed if the infected person has anemia.

References:
"Ancylostoma duodenale". Animal Diversity Web.
 Bugnion, E. (1881). "On the epidemic caused by Ankylostomum among the eorkmen in the St. Gothard
Tunnel". British Medical Journal. 1 (1054): 382. doi:10.1136/bmj.1.1054.382. PMC 2263460. PMID 20749811.
 Peduzzi, R.; Piffaretti, J.-C. (1983). "Ancylostoma duodenale and the Saint Gothard anaemia". British Medical
Journal. 287 (6409): 1942–5. doi:10.1136/bmj.287.6409.1942. PMC 1550193. PMID 6418279.
 "Soil-Transmitted Helminths | USAID's Neglected Tropical Disease Program". www.neglecteddiseases.gov.
https://www.cdc.gov/parasites/hookworm/treatment.html
https://www.cdc.gov/parasites/hookworm/health_professionals/index.html
 University of the Philippines Manila
SCHOOL OF HEALTH SCIENCE
Palo, Leyte

PUBLIC HEALTH PARASITOLOGY

Ancylostoma
Duodenale

Submitted by:
MARWIN JOYCE ODITA DM 40TH