Hookworms (Ancylostoma)

· Larvae which are the infective form are found in warm damp soil and infect the human by penetrating the skin or by drinking contaminated water or by soil pica.

· Larvae migrate from the dermis or intestinal wall to the venous circulation and are carried to the lungs where they break into the alveolar spaces, migrate upwards and are then swallowed  to reach the upper small intestine.

Treatment

· In severe anemia (hemoglobin concentration less than 5 gm/dL), iron therapy should be given before anthelmintic drugs in a dose of 6 mg/kg /day until anemia is corrected.

· In cases of anemia with heart failure, diuretics and slow transfusion of packed red cells are indicated.

· Albendazole: 400mg orally once for all ages, or

· Mebendazole:  100mg orally twice daily for 3 days or 500 mg as a single dose, or

· Pyrantel pamoate in a dose of 11mg/kg up to 1gm as a single dose.