Hookworm cases of hookworm infections occur in Asia and

Hookworm infection is caused by intestinal worms which feed
on blood and has remained a global burden. Hookworm disease affects nearly one
billion people worldwide (1) with more than half of the cases prevalent in Asia
and the pacific regions (2). Hookworm infections lead to diseases like iron
deficiency anaemia and malnutrition in most developing countries (3). Hookworm
infections have also been reported to affect maternal and neonatal health,
causing low birth weight, physical and mental disorders and even death in
babies (4-7). With parasitological and molecular based studies, it has been
reported that about 500 million cases of hookworm infections occur in Asia and
the Pacific territories (2). For a long time it had been established that Necator americanus and Ancylostoma duodenale are the major
causes of this disease around the world (7). However, it has been recently
discovered that infections are caused by another species of hookworm called Ancylostoma ceylanicum, which was once
considered to be an uncommon zoonotic disease.

Ancylostoma
ceylanicum is a zoonotic parasitic hookworm species which affects mammals
including humans, dogs and cats. It is unique in the sense that it is the only
zoonotic hookworm species that has the ability to reach its adult stage in the
human intestine and manifest its symptoms. This disease affects over 20 million
people in areas where it is endemic with dogs and cats acting as reservoirs for
transmitting it to humans (6). It has been recently revealed from molecular
surveys to be the second most common hookworm species which affects humans (7).
It is prevalent in Southeast Asia but has also been reported to cause human
infections in South America, South Africa, Melanesia and Australia, although
its widespread presence in Melanesia is yet to be explored (8). Recent studies
have identified a much higher prevalence of A. ceylanicum in humans where it was once thought to be only a
rare infection in humans (6). Ancylostoma
spp has been known to cause anaemia in both malnourished and suitably
nourished individuals; although anaemia associated with A. ceylanicum have not been confirmed using specific molecular
detection methods (9). Clinical
symptoms associated with A. ceylanicum include
itching, pain, diarrhea and anaemia (10-14). Prior to this time, hookworm
species were identified using coprological studies since it was cheap and
simple to use. This has proven to be ineffective due to similar morphology of
soil-transmitted helminths (STH) (15) coupled with the fact that the method is
time consuming and labour intensive and require highly skilled personnel (15,
16). Furthermore, some hookworm species are may not be easily distinguished in
both egg and larva stages which make it difficult to culture them for
differentiation. PCR analysis tools have become a better alternative to more
accurately differentiate between hookworm species.

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