Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis

Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently feta...

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Published inThe American journal of tropical medicine and hygiene Vol. 103; no. 5; pp. 1958 - 1968
Main Authors Ness, Tara E, Agrawal, Vedika, Bedard, Kathryn, Ouellette, Lara, Erickson, Timothy A, Hotez, Peter, Weatherhead, Jill E
Format Journal Article
LanguageEnglish
Published United States Institute of Tropical Medicine 01.11.2020
The American Society of Tropical Medicine and Hygiene
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Summary:Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely to have anemia (combined odds ratio [cOR] 2.55 [2.20, 2.96], < 0.001). In addition, pregnant woman with hookworm were more likely to have malaria coinfection (cOR 1.60 [1.38, 1.86], < 0.001). Other effects on maternal and child health were investigated and summarized without systematic review or meta-analysis because of the limited study numbers. Despite current deworming recommendations in pregnant women, heavy hookworm burden, coinfection with malaria, and subsequent anemia persist. Although this is likely due, in part, to a lack of implementation of preventive chemotherapy, additional interventions such as health education, proper waste management, or linking malaria and soil-transmitted helminth treatment and prevention programs may also be needed. Further investigations on maternal-child outcomes as a result of hookworm infection during pregnancy will highlight public health interventional targets to reduce morbidity in pregnant women and children globally.
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Disclosure: P. H. is a patent holder and lead investigator on vaccines against hookworm both in clinical trials and in development.
Authors’ addresses: Tara E. Ness, Vedika Agrawal, Kathryn Bedard, and Jill E. Weatherhead, Department of Pediatrics, Baylor College of Medicine, Houston, TX, E-mails: tara.ness@bcm.edu, vedika.agrawal@bcm.edu, kathryn.bedard@bcm.edu, and weatherh@bcm.edu. Lara Ouellette, Texas Medical Center Library, Liaison, Houston, TX, E-mail: lara.ouellette@library.tmc.edu. Timothy A. Erickson, Department of Pediatrics, Baylor College of Medicine, Section of Pediatric Tropical Medicine, Houston, TX, E-mail: timothy.erickson@bcm.edu. Peter Hotez, Department of Pediatrics, Baylor College of Medicine, Houston, TX, and Department of Pediatrics, Texas Children’s Hospital, Houston, TX, E-mail: hotez@bcm.edu.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.20-0503