Hookworm anaemia and Intestinal Malabsorption Associated with Hookworm Infestation

Abstract

Anaemia in hookworm infestation due to iron deficiency has been firmly established [1,2]. Blood loss in these patients [3–8] is associated quantitatively with hookworm load. Protein loss in patients with severe hookworm infestation may lower the total serum protein [6, 9]. Haemopoietic nutrients other than these, namely vitamin B₁₂ and folic acid, however, need to be examined. A variable proportion of patients with hookworm disease have functional and structural changes of the small bowel leading to the clinical features of malabsorption [10–15]. Earlier studies have suggested that in humans, protein deficiency is related to abnormalities of small intestine function and structure [16, 17]. Reversal of malabsorption in cases with or without hookworm infestation on a high protein diet without any additional vitamin, antibiotic and without dewormification in the former has been demonstrated [17, 18]. It has also been postulated that vitamin B₁₂ deficiency may either induce or aggravate the intestinal malabsorption [19]. The present communication comments on anaemia, haemopoietic nutrient deficiency and protein deficiency in patients with hookworm infestation. It also discusses the role of vitamin B₁₂ and protein deficiency in the etiopathogenesis of intestinal malabsorption. Further, similar studies have been also carried out in patients without hookworm infestation and a comparison of the two has been made.