High Prevalence of Ancylostoma ceylanicum Hookworm Infections in Humans, Cambodia, 2012

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Abstract

Preventative chemotherapy without community hygiene and animal health programs may be leading to emergence of this zoonosis.

Abstract

Ancylostoma ceylanicum, a hookworm of canids and felids in Asia, is becoming the second most common hookworm infecting humans. In 2012, we investigated the prevalence and infection dynamics of and risk factors for hookworm infections in humans and dogs in a rural Cambodian village. Over 57% of the population was infected with hookworms; of those, 52% harbored A. ceylanicum hookworms. The greatest intensities of A. ceylanicum eggs were in persons 21-30 years of age. Over 90% of dogs also harbored A. ceylanicum hookworms. Characterization of the cytochrome oxidase-1 gene divided isolates of A. ceylanicum hookworms into 2 groups, 1 containing isolates from humans only and the other a mix of isolates from humans and animals. We hypothesize that preventative chemotherapy in the absence of concurrent hygiene and animal health programs may be a factor leading to emergence of A. ceylanicum infections; thus, we advocate for a One Health approach to control this zoonosis.

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Ancylostoma ceylanicum, a re-emerging but neglected parasitic zoonosis.

Rebecca J Traub (2013)

Although Ancylostoma ceylanicum is known to be an endemic and widely distributed hookworm of dogs and cats in Asia, its contribution to human morbidity as a potentially zoonotic hookworm remains largely unexplored. Since its discovery by Lane (1913) as a 'new parasite' of humans a century ago, the hookworm has been regarded as a 'rare' and 'abnormal' parasite and largely overlooked in surveys of human parasites. Recent molecular-based surveys in Asia, however, have demonstrated that A. ceylanicum is the second most common hookworm species infecting humans, comprising between 6% and 23% of total patent hookworm infections. In experimentally induced infections, A. ceylanicum mimics the clinical picture produced by the anthroponotic hookworms of 'ground itch' and moderate to severe abdominal pain in the acute phase. Natural infections with A. ceylanicum in humans have been reported in almost all geographical areas in which the hookworm is known to be endemic in dogs and cats, however for the majority of reports, no clinical data are available. Much like the anthroponotic hookworm species, patent A. ceylanicum adults can isolate within the jejunum to produce chronic infections that on occasion, may occur in high enough burdens to produce anaemia. In addition, the hookworm can act much like Ancylostoma caninum and be found lower in the gastrointestinal tract leading to abdominal distension and pain, diarrhoea and occult blood in the faeces accompanied by peripheral eosinophilia. Whether A. ceylanicum is capable of producing both classical hookworm disease and evoking morbidity through an uncontrolled allergic response in some individuals remains unascertained. Future investigations combining the use of molecular diagnostic tools with clinical and pathological data will shed further light on its role as a human pathogen. The control of this zoonosis necessitates an integrated and inter-sectorial "One Health" approach be adopted in communities where large numbers of dogs share a close relationship with humans. Copyright © 2013. Published by Elsevier Ltd.

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PCR-based coprodiagnostic tools reveal dogs as reservoirs of zoonotic ancylostomiasis caused by Ancylostoma ceylanicum in temple communities in Bangkok.

Rebecca J Traub, Tawin Inpankaew, Chantira Sutthikornchai … (2008)

A survey of gastrointestinal parasites of dogs and humans from temple communities in Bangkok revealed that 58% of dogs and 3.4% of humans, among those sampled, were infected with hookworms utilising faecal flotation techniques and microscopy. A previously established polymerase chain reaction (PCR)-RFLP approach was utilised to determine the species of hookworms infecting dogs found positive for hookworm eggs. Single infections with Ancylostoma ceylanicum and Ancylostoma caninum were recorded in 77% and 9% of hookworm positive dogs, respectively and mixed infections with both species of Ancylostoma were recorded in 14% of dogs. A single-step PCR for the multiplex detection of Ancylostoma species and Necator americanus DNA in human faeces was developed and applied to characterise the species of hookworms in microscopy positive individuals. Single infection with N. americanus was recorded in five and A.ceylanicum infection in two, out of seven individuals positive for hookworm. This study demonstrates that humans are at risk of acquiring infection with A. ceylanicum in communities where this species of hookworm is endemic in dogs.

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Incidence and risk factors of hookworm infection in a rural community of central Thailand.

Vittaya Jiraanankul, Saovanee Leelayoova, Tawee Naaglor … (2011)

A cohort study to identify incidence and risk factors of hookworm infection was conducted in a rural community, central Thailand from November 2005 to February 2007. Stool specimens were examined for hookworm eggs using wet preparation, Kato thick smear, and water-ethyl acetate sedimentation technique. The incidence rate of hookworm infection was 7.5/100 person-years. The independent risk factors for acquiring hookworm infection were barefoot walking (incidence rate ratio [IRR] = 4.2, 95% confidence interval [CI] = 1.2-14.5) and raising buffaloes around the house (IRR = 4.8, 95% CI = 1.9-11.8). Sequencing of internal transcribed spacer 1 (ITS1)-5.8S-ITS2 region of the ribosomal RNA gene were performed for identifying species of hookworm. Necator americanus was the most common hookworm identified in this population. Ancylostoma duodenale and A. ceylanicum were also detected. Our data suggest transmission of both human and animal hookworms in this community. Thus, prevention and control strategies of hookworm infection should cover both human and animal infection.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): June 2014

Volume: 20

Issue: 6

Pages: 976-982

Affiliations

[1]University of Copenhagen, Copenhagen, Denmark (T. Inpankaew, A. Dalsgaard); Kasetsart University, Bangkok, Thailand (T. Inpankaew, W. Chimnoi);

[2]Swiss Tropical and Public Health Institute, Basel, Switzerland (F. Schär, V. Khieu, H. Marti, P. Odermatt);

[3]University of Basel, Basel (F. Schär, V. Khieu, H. Marti, P. Odermatt);

[4]National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia (V. Khieu, S. Muth);

[5]Fisheries Administration, Phnom Penh (C. Chhoun, D. Sok);

[6]The University of Queensland, Gatton, Queensland, Australia (R.J. Traub);

[7]University of Melbourne, Parkville, Victoria, Australia (R.J. Traub)

Author notes

Address for correspondence: Tawin Inpankaew, Department of Parasitology, Faculty of Veterinary Medicine, Kasetrsart University, 50 Phahonyothin Rd, Chatuchak, Bangkok, Thailand 10900; email: fvettwi@ 123456gmail.com

Article

Publisher ID: 13-1770

DOI: 10.3201/eid2006.131770

PMC ID: 4036766

PubMed ID: 24865815

SO-VID: 76d6816c-ab96-4232-aebd-6968ad848b02

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High Prevalence of Ancylostoma ceylanicum Hookworm Infections in Humans, Cambodia, 2012

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Most cited references 30

Ancylostoma ceylanicum, a re-emerging but neglected parasitic zoonosis.

PCR-based coprodiagnostic tools reveal dogs as reservoirs of zoonotic ancylostomiasis caused by Ancylostoma ceylanicum in temple communities in Bangkok.

Incidence and risk factors of hookworm infection in a rural community of central Thailand.

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Cited by 62

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