Pawlowski Z.S., Schad G.A., Stott G.J. Hookworm Infection and Anaemia

World Health Organization, 1991. — 103 p.
A detailed guide to the many simple, effective, and inexpensive measures that can be used to reduce the prevalence and severity of anaemia caused by hookworm infection. The main aim is to help practitioners, working in the field, know how to detect infection and associated anaemia, and then implement appropriate measures, whether for individual cases or entire communities. In view of the widespread tendency to underestimate the importance of hookworm infection and accord it low priority, the book also performs a persuasive function, documenting the major public health consequences of hookworm anaemia, illustrating the striking results of control measures, and encouraging scientists to take a greater interest in this challenging disease. To this end, descriptions of the simple measures available for control are placed within the context of the many complex factors that guide their selection and determine their effectiveness. The book opens with basic information about the life cycles of Ancylostoma duodenale and Necator americanus, their distinctive features at different stages, and geographical distribution. Subsequent chapters describe the clinical pathology of infection and explain how infection causes anaemia. Particular attention is given to the factors that determine iron balance in a given population, including factors that can precipitate severe anaemia even when hookworm loads are low. A chapter devoted to epidemiology explains the behaviours, climatic conditions, and agricultural practices that encourage the maintenance and spread of infection, and identifies three main epidemiological patterns of transmission. These patterns form the framework for subsequent advice on prevention and control. Because confirmation of infection is so simple, chapters on prevention and control concentrate on information that can help health workers know when to suspect infection and then carry out the relevant detective work. Different control strategies described include standard case management, targeted treatment, mass treatment, and supplementary iron distribution. For standard case management, readers are given detailed advice on the best drugs and doses for iron therapy and anthelminthic treatment, which are presented as the foundation for hookworm anaemia control. The final chapter, devoted to practical aspects of prevention and control, outlines programme approaches for each of the three main patterns of hookworm anaemia. The book concludes with a series of three annexes, which describe and illustrate laboratory and other techniques for use in hookworm and anaemia surveys, and explain how to determine the best sampling frame, sample size, and sampling procedures for use in household or group surveys.