Abstract
BackgroundHookworms (Necator americanus and Ancylostoma duodenale) remain a major public health problem worldwide. Infections with hookworms (e.g., A. caninum, A. ceylanicum and A. braziliense) are also prevalent in dogs, but the role of dogs as a reservoir for zoonotic hookworm infections in humans needs to be further explored.Methodology/Principal FindingsAs part of an open-label community based cluster-randomized trial in a tribal area in Tamil Nadu (India; 2013–2015), a total of 143 isolates of hookworm eggs from human stool were speciated based on a previously described PCR-RFLP methodology. The presence of hookworm DNA was confirmed in 119 of 143 human samples. N. americanus (100%) was the most prevalent species, followed by A. caninum (16.8%) and A. duodenale (8.4%). Because of the high prevalence of A. caninum in humans, dog samples were also collected to assess the prevalence of A. caninum in dogs. In 68 out of 77 canine stool samples the presence of hookworms was confirmed using PCR-RFLP. In dogs, both A. caninum (76.4%) and A. ceylanicum (27.9%) were identified. Additionally, to determine the contamination of soil with zoonotic hookworm larvae, topsoil was collected from defecating areas. Hookworm DNA was detected in 72 out of 78 soil samples that revealed presence of hookworm-like nematode larvae. In soil, different hookworm species were identified, with animal hookworms being more prevalent (A. ceylanicum: 60.2%, A. caninum: 29.4%, A. duodenale: 16.6%, N. americanus: 1.4%, A. braziliense: 1.4%).Conclusions/SignificanceIn our study we regularly detected the presence of A. caninum DNA in the stool of humans. Whether this is the result of infection is currently unknown but it does warrant a closer look at dogs as a potential reservoir.
Highlights
Infections with hookworms (Necator americanus and Ancylostoma duodenale) remain a major public health problem in several low and middle-income countries [1,2]
To control the disease burden attributable to hookworms, largescale deworming programs, in which drugs are administered to schoolchildren regardless of their infection status, are currently being implemented in endemic regions
Our results highlight the presence of DNA from animal-specific hookworms in both soil and human stool. These findings suggest that these animals could act as reservoir for zoonotic hookworm infections in humans, they should be interpreted with caution
Summary
Infections with hookworms (Necator americanus and Ancylostoma duodenale) remain a major public health problem in several low and middle-income countries [1,2]. The current strategy to control the morbidity caused by these intestinal worms are embedded in large-scale school-based deworming programs, in which benzimidazole drugs (albendazole and mebendazole) are administered to schoolchildren regardless of their infection status [6,7]. It remains unclear whether these school-based deworming programs are the most efficient approach [8]. Infections with hookworms (e.g., A. caninum, A. ceylanicum and A. braziliense) are prevalent in dogs, but the role of dogs as a reservoir for zoonotic hookworm infections in humans needs to be further explored
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