Author:
- Introduction
- Methods
- Ethical approval.
- Participant enrollment.
- Sample collection and processing.
- Egg hatch assay: analysis of in vitro anthelminthic activity of albendazole.
- Speciation of hookworm isolates using polymerase chain reaction.
- Blood and serum analysis.
- Household questionnaire.
- Determination of anthropometric status.
- Dietary diversity, household food insecurity, and consumption of animal source foods.
- Statistical analysis.
- Results
- Intestinal parasite assessment of study population.
- Socioeconomic status and risk of hookworm infection.
- Anthropometric and nutritional indicators.
- Nutritional status, dietary intake, and risk of hookworm infection.
- Malaria infection.
- Hookworm antibody levels.
- Response to treatment with albendazole.
- In vitro susceptibility of hookworm isolates.
- Speciation of hookworm isolates using PCR.
- Discussion
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Hookworm Infection among School Age Children in Kintampo North Municipality, Ghana: Nutritional Risk Factors and Response to Albendazole Treatment
Debbie Humphries
Debbie Humphries
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Benjamin T. Simms
Benjamin T. Simms
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Dylan Davey
Dylan Davey
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Joseph Otchere
Joseph Otchere
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Josephine Quagraine
Josephine Quagraine
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Shawn Terryah
Shawn Terryah
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Samuel Newton
Samuel Newton
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Elyssa Berg
Elyssa Berg
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Lisa M. Harrison
Lisa M. Harrison
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Daniel Boakye
Daniel Boakye
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Michael Wilson
Michael Wilson
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Michael Cappello
Michael Cappello
Program in International Child Health, Department of Pediatrics and School of Public Health, Yale School of Medicine, New Haven, Connecticut; Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Children (n = 812) 6–11 years of age attending 16 schools in the Kintampo North Municipality of Ghana were screened for participation in a study on hookworm infection, nutrition, and response to albendazole. The prevalence of Necator americanus hookworm infection (n = 286) was 39.1%, and significant predictors of infection included age, malaria parasitemia, lack of health care, school area, levels of antibodies against hookworm, and low consumption of animal foods. The cure rate after a single dose (400 mg) albendazole was 43%, and the mean fecal egg count reduction rate was 87.3%. Data for an in vitro egg hatch assay showed a trend toward reduced albendazole susceptibility in post-treatment hookworm isolates (P = 0.06). In summary, hookworm infection is prevalent among school age children in the Kintampo North Municipality and animal food intake inversely correlates with infection status. Modest cure rates and fecal egg count reduction rates reinforce the need for further investigation of potential benzimidazole resistance in Ghana.
Author Notes
Financial support: This study was supported by National Institutes of Health grant RO1AI099623 (Michael Wilson), a Wilbur Downs International Health Fellowship from the Yale School of Public Health (Benjamin T. Simms), a Benjamin H. Kean Traveling Fellowship in Tropical Medicine from the American Society of Tropical Medicine and Hygiene (Dylan Davey), and a Medical Scholars Program Award from the Infectious Diseases Society of America (Dylan Davey).
Authors' addresses: Debbie Humphries, Yale School of Public Health, New Haven, CT, E-mail: debbie.humphries@yale.edu. Benjamin T. Simms and Shawn Terryah, Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, E-mails: simmsb@gmail.com and shawn.terryah@gmail.com. Dylan Davey, Josephine Quagraine, Elyssa Berg, Lisa M. Harrison, and Michael Cappello, Department of Pediatrics, Yale School of Medicine, New Haven, CT, E-mails: dylan.davey@yale.edu, josephine.quagraine@yale.edu, elyssa.berg@yale.edu, lisa.harrison@yale.edu, and michael.cappello@yale.edu. Joseph Otchere, Daniel Boakye, and Michael Wilson, Department of Parasitology, Noguchi Memorial Institute for Medical Research, Accra, Ghana, E-mails: jotchere@noguchi.mimcom.org, dboakye@noguchi.mimcom.org and mwilson@noguchi.mimcom.net. Samuel Newton, Department of Epidemiology, Kintampo Health Research Centre, Kintampo, Ghana, E-mail: samkofinewton@yahoo.com.
- Introduction
- Methods
- Ethical approval.
- Participant enrollment.
- Sample collection and processing.
- Egg hatch assay: analysis of in vitro anthelminthic activity of albendazole.
- Speciation of hookworm isolates using polymerase chain reaction.
- Blood and serum analysis.
- Household questionnaire.
- Determination of anthropometric status.
- Dietary diversity, household food insecurity, and consumption of animal source foods.
- Statistical analysis.
- Results
- Intestinal parasite assessment of study population.
- Socioeconomic status and risk of hookworm infection.
- Anthropometric and nutritional indicators.
- Nutritional status, dietary intake, and risk of hookworm infection.
- Malaria infection.
- Hookworm antibody levels.
- Response to treatment with albendazole.
- In vitro susceptibility of hookworm isolates.
- Speciation of hookworm isolates using PCR.
- Discussion
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-
1.
Bungiro R, Cappello M, 2011. Twenty-first century progress toward the global control of human hookworm infection. Curr Infect Dis Rep 13: 210–217.
-
2.
de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L, 2003. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol 19: 547–551.
-
3.
Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ, 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367: 1521–1532.
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