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...

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.
  2. Bethony J, , 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367: 15211532.[Crossref]
  3. Hotez P, , 2008. Neglected infections of poverty in the United States of America. PLoS Negl Trop Dis 2: e256.[Crossref]
  4. Warren KS, , 1974. Helminthic diseases endemic in the United States. Am J Trop Med Hyg 23: 723730.
  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.
  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]
  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]
  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]
  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]
  10. Headlee WH, Cable RM, , 1942. Intestinal parasitism among students of Berea College, Kentucky. Am J Trop Med Hyg 22: 351360.
  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]
  12. Atchley FO, Hemphill EC, Hunt DW, , 1956. Current status of intestinal parasitism of man in eastern Kentucky. J Parasitol 42: 505509.[Crossref]
  13. Fulmer HS, Huemphner HR, , 1965. Intestinal helminths in eastern Kentucky: a survey in three rural counties. Am J Trop Med Hyg 14: 269275.
  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]
  15. Gloor RF, Breyley ER, Martinez IG, , 1970. Hookworm infection in a rural Kentucky county. Am J Trop Med Hyg 19: 10071009.
  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.
  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.
  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.
  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]
  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]
  21. Farhadian H, Schneider EA, , 1975. Trichuriasis in Calcasieu Parish, southwest Louisiana. J La State Med Soc 127: 337340.
  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.
  23. Farmer HF, , 1986. Hookworm eradication program of Florida in the early 20th century. JFMA 73: 300304.
  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.
  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]
  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.
  27. US Department of Housing and Urban Development, 2000. Washington, DC: Government Printing Office. US Housing Market Conditions, First Quarter 2000.
  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.
  29. Mirdha B, , 2009. Human strongyloidiasis: often brushed under the carpet. Trop Gastroenterol 30: 14.[Crossref]
  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]

Data & Media loading...

Supplementary Data

Supplemental appendix A and B

  • Received : 08 Apr 2011
  • Accepted : 24 Jun 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