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Abstract
More than two billion people globally are estimated to be infected with intestinal parasites, with over 900 million of these estimated to be infected with hookworm. When measured in disability-adjusted life years, the global disease burden from hookworm alone exceeds all other major tropical infectious diseases (with the exception of malaria, leishmaniasis, and lymphatic filariasis), and includes an estimated blood loss of 7 million liters per day. 65,000 persons are estimated to die from hookworm infection each year. A 2010 study of the global prevalence and burden of soil-transmitted helminths (STH) estimated that, of the 4.98 million years lived with disability (YLDs) attributable to STH, 65% were attributable to hookworm alone. Children and child-bearing women are particularly vulnerable to serious morbidities and outcomes associated with intestinal parasitic infections, especially hookworm. In children, chronic heavy-intensity infections are associated with growth retardation, iron-deficiency anemia, as well as intellectual and cognitive impairments. Due to the relatively high prevalence among the poor—particularly persons who live on less than US $2/day—soil-transmitted helminth infections have received relatively little global attention—despite annual morbidities and mortalities in the hundreds and tens of millions, respectively.