Preliminary investigation on the influencing factors and health impacts of hookworm infection in South Mountain area of Zhejiang Province

Abstract

Objective To understand the demographic characteristics and clinical features of hookworm infectors in high infection area in South Mountain area of Zhejiang Province, and to find the risk factors of infection, so as to provide the evidence for formulating prevention and control measures. Methods In 2018, according to the soil-borne nematode monitoring results of the previous year in Zhejiang Province, three villages with relatively more hookworm infections were selected from Qingtian County in South Mountain area of Zhejiang Province, and more than 10 cases of hookworm infection were selected from each survey site. A face to face questionnaire survey was conducted by all investigators using a questionnaire designed by the Center for Infectious Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, and information on the general condition, past diagnosis history, clinical symptoms and risk factors of infection of infected persons were collected. The stool samples were collected and tested for infection by modified Kato-Katz method to evaluate the drug deworming effect in the previous year. Results A total of 33 cases of hookworm infection were investigated, including 18 males and 15 females; the age ranged from 33 - 85 years old, mainly concentrated in 60 - 79 years old, a total of 23 cases (69.7%). Ten cases (30.3%) had been diagnosed with hookworm disease; 19 cases (57.6%) had similar symptoms of hooky dermatitis; and 12 cases (36.4%) had gastrointestinal symptoms in the past three years. There were 31 cases (93.9%) worked in the field for more than one month each year, 18 cases (54.5%) used fresh manure directly at home, 6 cases (18.2%) were used to working barefoot in the field, and 30 cases (90.9%) used to wearing slippers in the field. A total of 32 eligible stool samples were examined, and 4 case (12.5%) were still positive for hookworm eggs. Conclusions Among the infectors, fertilizing with fresh stool, working barefoot or wearing slippers in the field may serve as the risk factors. There is a certain failure proportion to eliminate the infection status when adopting only one round anthelminthic treatment. For prevention and control hookworm infections, comprehensive intervention measures including infection source management, harmless treatment of stools, individual behavior intervention and environment improvement are suggested. Key words: Hookworm; Soil-borne nematode; Risk factors; Health impacts; Intervention measures