Hookworm disease

The mechanism of action by which pyrantel pamoate is effective lor the treatment of Necator americanu.% (hookworm) disease is... 

Leach CN. 1922. Carbon tetrachloride in the treatment of hookworm disease. J Am Med Assoc 78 1789-1790. 

The hookworm disease is caused by the blood sucking nematodes, Anajlos-toma duodenale, A. ceylanicum and Necator americanus, commonly known as hookworms, in the intestine of human. The infection normally takes place when farmers working in coffee, banana, sugarcane, sweet potato, rice and maize fields expose their bare feet to the soil fertilized with human excreta where the infective larvae penetrate the skin and enter the blood circulation. These larvae eventually grow into adult hookworms and live in the intestine where they engulf the intestinal villi into their buccal cavities and survive on direct blood feed from the host. 

KendrickJF. 1929. The treatment of hookworm disease with tetrachloroethylene. AmJTropMed 483-488. 

Although more people are being fed than ever before, there are also more malnourished humans than ever before. Thus, more than 1.6 billion of the 5.3 billion people living today are malnourished and do not have access to adequate supplies of food (3), Clearly, a malnourished person cannot lead a fully productive life. The plight of these people is more serious than just a lack of adequate food, for many are ill with disease and/or carry heavy loads of parasites. For example, a survey of school children in Kwale District, Kenya showed that 96% were infected with hookworms, 50% with roundworms, 95% with whipworms, and 40% with schistosomiasis... 

In a state of desperation, I went to see all kinds of different doctors, healers and alternative practitioners. Based on the symptoms I reported, one doctor told me I must have intestinal parasites. I was willing to go along with any glimmer of hope. I thought If I have parasites, that can be treated, then my symptoms will go away—fantastic However, I wanted a second opinion. I went to a doctor in Albuquerque who took urine, stool and saliva samples and sent them to a doctor in New York. The lab report said there were eggs from two kinds of parasites found, hookworm and whipworm. The doctor gave me herbal potions made from God-knows-what he had gathered in the rain forest. These remedies made me worse, so I decided to go to the Tropical Disease Hospital in Tondon. It wasn t easy. 

Exploiting the knowledge that has recently developed on the induction of regulatory immune pathways by helminths, clinical trials were and are being initiated to study the effect of these parasites on inflammatory diseases. Currently, Trichuris suis is being used to treat patients with ulcerative colitis and Crohn s disease, with promising initial results [44]. Future studies are planned to examine the effect of hookworms on allergic airway diseases [45] and of T. suis on MS [11]. 

Albendazole has an even broader spectrum of activity than mebendazole. Its indications include pin-worm infection, ascariasis, trichuriasis, strongyloidiasis and hookworm infections. It is the preferred agent for inoperable cases of hydatid disease. 

Stwngyloides stercoralis infection is acquired, like hookworm, from filariform larvae in contaminated soil that penetrate the skin. This parasite maintains itself for many decades in the small intestine asymptomatically. Persons treated with immunosuppressive drugs or who are debilitated by chronic illness may be at risk for widespread tissue invasion or hyperinfection syndrome. Prompt treatment may be life saving in disseminated disease. 

Mebendazole is used primarily for the treatment of A. lumbricoides, T. trichiura, E. vermicularis, and hookworm infections, in which it produces high cure rates. It is an alternative agent for the treatment of trichinosis and visceral larva migrans. Owing to its broad-spectrum anthelmintic effect, mixed infections (ascariasis, hookworm infestation, or enterobiasis in association with trichuriasis) frequently respond to therapy. High doses have been used to treat hydatid disease, but albendazole is now thought to be superior. 

Anti -acne. Preventing the inflammatory disease of the pilosebaceous unit. Anti-amoebic. Destroying or suppressing the growth of amoebae. Anti-ancylostomiasis. Preventing the infection with hookworms of the genus Ancyclostoma. 

Ascarlasis, ankylostomiasis and trichuriasis 400 mg single dose Taenlasis strongyloldosis 400 mg x 3 days Neurocysticercosis 15 mg/kg/dally x 1 month Hydatid disease 400 mg BD X 1 month (If required repeat after 2 wks). Trichinosis and strongyloldosis 25 mg/kg/day In two divided doses X 2 days after meal (If required repeat after 2 days) Ascarlasis and hookworm Infestation 50-150 mg single dose. Taenlasis 0.5-2 g (After breakfast 1 g to be chewed and swallowed with water followed by 1 g after 1 hr) For H. nana Infestation 2 g dose Is repeated dally for 5 days. 

Albendazole, a broad-spectrum oral antihelminthic, is the drug of choice and is approved in the USA for treatment of hydatid disease and cysticercosis. It is also used in the treatment of pinworm and hookworm infections, ascariasis, trichuriasis, and strongyloidiasis. 

Benzimidazoles are thought to act against nematodes by inhibiting microtubule synthesis. Albendazole also has larvicidal effects in hydatid disease, cysticercosis, ascariasis, and hookworm infection and ovicidal effects in ascariasis, ancylostomiasis, and trichuriasis. 

Chadderdon, R.C. and Cappello, M. (1999) The hookworm platelet inhibitor functional blockade of integrins GPIIb/llla (alphallbbeta3) and GPIa/lla (alpha2beta1) inhibits platelet aggregation and adhesion in vitro. Journal of Infectious Diseases 179, 1235-1241. 

Albendazole (Albenza) is primarily used to treat infections caused by the larval form of certain cestodes (tapeworms). These infections often cause cysts (hydatid disease) in the liver, lungs, and other tissues albendazole is used as an adjunct to the surgical removal of these cysts or as the primary treatment if these cysts are inoperable. This drug is also effective against many gastrointestinal roundworms and hookworms, and is typically used as a secondary agent if other anthelmintics are not effective in treating these infections. 

Levamisole hydrochloride is used in the treatment of helminth infections and as an adjuvant in malignant disease. It is active against intestinal nematode worms and appears to act by paralyzing and eliminating susceptible worms. It has proven valuable in the treatment of ascariasis and hookworm infections. The use of levamisole should be avoided in patients with preexisting blood disorders. 

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