Background to the study

Hookworm infection is one of the most common diseases in Nigeria, infecting people at certain periods of lifetime with far reaching disabling and debilitating effects on the individual victims and on the socio-economic development of nations. The causative organisms of the common Hookworm infection are the strongylid nematodes Necator americanus and Ancylostoma duodenale (Udonsi, 1984).


WHO (1981) observed that the geographical distribution of the two main Hookworms, N. americanus and A. duodenale, used to be restricted and relatively distinct, the former being more prevalent in Europe and South Western Asia, and the latter in Tropical Africa and in the Americas. However, over the past decades, both parasites have become widely distributed throughout the tropics and rigid demarcations are no longer tenable. In Nigeria the presumed human Hookworms, N. americanus and A. duodenale, both occur (Agbolade et al, 2004; Odebunmi et al2007). Onubogu (1978) and Nwosu (1981) observed that these two diseases (Ancylostomiasis and Necatoriasis) are associated with poor hygienic practices and improper disposal of human wastes.

These features are typical of most rural and urban settlements in Nigeria where there is poor planning and inadequate public health facilities. Bundy et al. (1991) estimated that over 900 million people are infected with Hookworm disease worldwide. Hookworm infection in Nigeria is markedly seasonal because of the influence of climate on the free-living larval stages of the parasites. Nwosu and Anya (1980), suggested that this factor could be of serious economic consequences if the period of heavy infection or high incidence, coincides with busy period in the agricultural communities in the country.


Hookworm infection in humans is caused by helminth nematode parasites Necator americanus and Ancylostoma duodenale and is acquired through contact with contaminated soil (Hotez et al., 2004). Hookworm infection is widespread in tropical and subtropical parts of the world and is rampant particularly in impoverished countries. In the Philippines, the prevalence of hookworm infection nationwide ranged from 40% to 61%, varying only by province (Cabrera, 1998; Shaw et al., 2010).

Hookworm infection has many public health consequences but the major public health consequence is iron deficiency anemia (Awasthi et al., 2003; Bundy et al., 2004; Crompton and Nesheim, 2002; Farid et al., 1968; Hotez et al., 2004; Larocque et al., 2005; Stoltzfuz et al., 1996). Anemia caused by hookworm infection among pregnant women can cause adverse effects on the outcome of pregnancy (Allen, 2000; Bundy et al., 2004). Among infants and pre-school children, hookworm disease can result in growth stunting (Crompton and Nesheim, 2002) and behavioral deficits (Bundy et al., 2004; Farid et al., 1968; Hotez et al., 2004). Anemia caused by hookworm infection in school children may also adversely affect their intellectual and cognitive development (Ezeamama et al., 2005; Hotez et. al, 2004; Kvaslig et al., 1991; Pollitt et al., 1989; Soewondo et al., 1998; Stoltzfus et al., 2001). Indeed, a child with hookworm infection is often sick and absent from school, and frequent absences inevitably impede his learning ability. The cumulative effect of hookworm disease in the development of a child has far-reaching consequences. Growth and behavior deficits, low development quotients, cognitive impairments and underachievement in the prime of the child’s life will substantially affect his ability to be productive in his adult years.