One Health Approach to Control Human and Zoonotic Hookworm Infections

Abstract

Human hookworm infection is linked to a variety of factors, such as poverty, inadequate living conditions, absence of adequate sanitary facilities, cultural habits, and ineffective prevention programs/health systems. Zoonotic hookworm infection, leading to cutaneous larva migrans in humans, is related to the presence of animals (dogs and cats) serving as reservoirs. Climate and soil structure are also important determinants for larval development in the environment, and consequently for both human and animal hookworm infections. Health systems usually focus on individual medicalization, leading eventually to antiparasitic overuse and development of drug resistances. Given the reduced sustainability and effectiveness of the community interventions observed over the last decades, there is a need for more comprehensive approaches. In this chapter, we discuss the One Health Approach as a multidisciplinary measure to control hookworm disease. Integrated control programs would reduce transmission sustainably, for example, by combining mass drug administration aiming at the entire population rather than only schoolchildren or other defined target groups, and expansion of sanitary improvement programs. Once available, widespread application of a hookworm vaccine will be an additional tool to further boost control efforts. Health professionals involved in specific control programs should integrate into an interdisciplinary manner differing disciplines and departments. Existing overlapping disease control programs should be integrated, to achieve sustainable and cost-effective control on the long run, of both human and animal hookworm infection, and hookworm-related cutaneous larva migrans, in addition to other neglected tropical diseases.