Necator americanus, Ancylostoma duodenale
Hookworm species infect 740 million people. N americanus is the predominant hookworm worldwide, whereas A. duodenale is focally endemic in Egypt, India, and China. Hookworm larvae live in the soil and penetrate exposed skin. After reaching the lungs, larvae migrate to the oral cavity and are swallowed. After attaching to the jejunal mucosa, the adult worms feed on host blood. There is a direct correlation between the hookworm burden and fecal blood loss. Unlike heavy Ascaris and Trichuris infections, which occur mostly in children, heavy hookworm infections also occur in adults.
The major treatment goal is to remove blood-feeding adult hookworms from the intestines. Albendazole and mebendazole are preferred agents against both A. duodenale and N. americanus.
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