Volume 85, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The epidemiology of soil-transmitted helminth infections (hookworm, , , and ) in the United States is poorly understood. To gain understanding of the status of disease, a systematic review was performed to assess the prevalence of soil-transmitted helminth infections in the United States. Of all studies reviewed, 14 were designated as high-quality. High-quality studies were published from 1942 to 1982 and showed that infection was prevalent throughout the southern United States and Appalachia as recently as 1982, finding that hookworm (19.6%), (55.2%), (49.4%), and (3.8%) affected significant percentages of the population. However, because the most recent high-quality studies were published over 25 years ago, the literature does not provide sufficient data to assess current endemic transmission. Because the status of disease remains unclear, there is a need for additional studies to determine if soil-transmitted helminths remain endemic in the United States.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Blumenthal DS, Schultz MG, , 1975. Incidence of intestinal obstruction in children infected with Ascaris lumbricoides . Am J Trop Med Hyg 24: 801805. [Google Scholar]
  2. Bethony J, , 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367: 15211532.[Crossref] [Google Scholar]
  3. Hotez P, , 2008. Neglected infections of poverty in the United States of America. PLoS Negl Trop Dis 2: e256.[Crossref] [Google Scholar]
  4. Warren KS, , 1974. Helminthic diseases endemic in the United States. Am J Trop Med Hyg 23: 723730. [Google Scholar]
  5. Milder JE, Walzer PD, Kilgore G, Rutherford I, Klein M, , 1981. Clinical features of Strongyloides stercoralis infection in an endemic area of the United States. Gastroenterology 80: 14811488. [Google Scholar]
  6. Moher D, Liberati A, Tetzlaff J, Altman D, , 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151: 264269.[Crossref] [Google Scholar]
  7. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, , 2007. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Epidemiology 18: 800804.[Crossref] [Google Scholar]
  8. Mallen C, Peat G, Croft P, , 2005. Quality assessment of observational studies is not commonplace in systematic reviews. J Clin Epidemiol 59: 765769.[Crossref] [Google Scholar]
  9. Lohr K, Carey T, , 1999. Assessing best evidence: issues in grading the quality of studies for systematic reviews. Jt Comm J Qual Improv 25: 470479.[Crossref] [Google Scholar]
  10. Headlee WH, Cable RM, , 1942. Intestinal parasitism among students of Berea College, Kentucky. Am J Trop Med Hyg 22: 351360. [Google Scholar]
  11. Young MM, , 1955. Report of a survey for intestinal parasites in school children in a rural mountain county in Tennessee. South Med J 48: 4653.[Crossref] [Google Scholar]
  12. Atchley FO, Hemphill EC, Hunt DW, , 1956. Current status of intestinal parasitism of man in eastern Kentucky. J Parasitol 42: 505509.[Crossref] [Google Scholar]
  13. Fulmer HS, Huemphner HR, , 1965. Intestinal helminths in eastern Kentucky: a survey in three rural counties. Am J Trop Med Hyg 14: 269275. [Google Scholar]
  14. Healy GR, Gleason NN, Bokat R, Pond H, Roper M, , 1969. Prevalence of ascariasis and amebiasis in Cherokee Indian school children. Public Health Rep 84: 907914.[Crossref] [Google Scholar]
  15. Gloor RF, Breyley ER, Martinez IG, , 1970. Hookworm infection in a rural Kentucky county. Am J Trop Med Hyg 19: 10071009. [Google Scholar]
  16. Martin LK, , 1972. Hookworm in Georgia. I. Survey of intestinal helminth infections and anemia in rural school children. Am J Trop Med Hyg 21: 919929. [Google Scholar]
  17. Martin LK, , 1972. Hookworm in Georgia. II. Survey of intestinal helminth infections in members of rural households of southeast Georgia. Am J Trop Med Hyg 21: 930943. [Google Scholar]
  18. Morgan PM, Hubbard DW, Willis RA, Unglaub WG, Langham RA, Hedmeg AW, Muldrey JE, , 1972. Intestinal parasitism and nutritional status in Louisiana. J La State Med Soc 124: 197203. [Google Scholar]
  19. Sargent RG, Dudley BW, Fox AS, Lease EJ, , 1972. Intestinal helminths in children in coastal South Carolina: a problem in southeastern United States. South Med J 65: 294298.[Crossref] [Google Scholar]
  20. Hubbard DW, Morgan PM, Yaeger RG, Unglaub WG, Hood MW, Willis RA, , 1974. Intestinal parasite survey of kindergarten children in New Orleans. Pediatr Res 8: 652658.[Crossref] [Google Scholar]
  21. Farhadian H, Schneider EA, , 1975. Trichuriasis in Calcasieu Parish, southwest Louisiana. J La State Med Soc 127: 337340. [Google Scholar]
  22. Walzer PD, Milder JE, Banwell JG, Kilgore G, Klein M, Parker R, , 1982. Epidemiologic features of Strongyloides stercoralis infection in an endemic area of the United States. Am J Trop Med Hyg 31: 313319. [Google Scholar]
  23. Farmer HF, , 1986. Hookworm eradication program of Florida in the early 20th century. JFMA 73: 300304. [Google Scholar]
  24. Teague RE, , 1945. The common intestinal parasites in Kentucky. Frankfort, KY: Department of Public Health of Kentucky. Bulletin of the State Department of Health of Kentucky, 431439. [Google Scholar]
  25. Crocker C, Reporter R, Redelings M, Mascola L, , 2010. Strongylodiasis-related deaths in the United States, 1991–2006. Am J Trop Med Hyg 83: 422426.[Crossref] [Google Scholar]
  26. US Bureau of the Census, 2003. Income, Poverty, and Health Care Insurance in the United States. Available at: http://pubdb3.census/gov/macro/032004/pov/new41_100_01.htm. Accessed June 10, 2011. [Google Scholar]
  27. US Department of Housing and Urban Development, 2000. Washington, DC: Government Printing Office. US Housing Market Conditions, First Quarter 2000. [Google Scholar]
  28. Glasmeier AK, , 2006. An Atlas of Poverty in America: One Nation, Pulling Apart, 1960–2003. Distressed Regions Section. New York, NY: Routledge Taylor & Francis Group, 5180. [Google Scholar]
  29. Mirdha B, , 2009. Human strongyloidiasis: often brushed under the carpet. Trop Gastroenterol 30: 14.[Crossref] [Google Scholar]
  30. Tarafder MR, Carabin H, Joseph L, Balolong E, Olveda R, McGarvey ST, , 2010. Estimating the sensitivity and specificity of Kato-Katz stool examination technique for detection of hookworms, Ascaris lumbriocides and Trichuris trichiura infections in humans in the absence of a ‘gold standard.' Int J Parasitol 40: 399404.[Crossref] [Google Scholar]

Data & Media loading...

Supplemental appendix A and B

  • Received : 08 Apr 2011
  • Accepted : 24 Jun 2011
  • Published online : 01 Oct 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error