Ancylostoma duodenale is a species of the roundworm genus Ancylostoma. It is a parasitic nematode worm and commonly known as the Old World hookworm. It lives in the small intestine of hosts such as humans, cats and dogs, where it is able to mate and mature. Ancylostoma duodenale and Necator americanus are the two human hookworms that are normally discussed together as the cause of hookworm infection. They are dioecious. Ancylostoma duodenale is abundant throughout the world, including in the following areas: southern Europe, north Africa, India, China, southeast Asia, some areas in the United States, the Caribbean, and South America.
Ancylostoma duodenale is small cylindrical worm, greyish-white in color. It has two ventral plates on the anterior margin of the buccal capsule. Each of them has two large teeth that are fused at their bases. A pair of small teeth can be found in the depths of the buccal capsule. Males are 8 mm 11 mm small with a copulatory bursa at the posterior end. Females are 10 mm to 13 mm long, with the vulva located at the posterior end; females can lay 10,000 to 30,000 eggs per day. The average lifespan of Ancylostoma duodenale is one year.
After a rhabditiform "infective" larva penetrates the intact skin – most commonly through the feet – the larva enters the blood circulation. It is then carried to the lungs, breaks into alveoli, ascends the bronchi and trachea and is coughed up and swallowed back into the small intestine where it matures. The larva later matures into an adult in the small intestine ("the adult worm live in the jejunum mainly"), where they attach to the villi and female worms can lay 25,000 eggs per day. The eggs are released into the feces and reside on soil, when deposited on warm, moist soil a larva rapidly develops in the egg and hatches after 1 to 2 days. This rhabditiform larva moults twice in the soil and become a skin penetrating 3rd stage infective larva within 5–10 days. The infective rhabditiform larvae are able to sense vibrations in the soil from heat or carbon dioxide, and are able to use dendritic processes similar to cilia. They use these processes as thermosensory, chemosensory, and mechanosensory receptors in order to migrate towards a host for infection. The rhabditiform larvae can then penetrate the exposed skin of another organism and begin a new cycle of infection.
Ancylostoma duodenale is prevalent in southern Europe, northern Africa, India, China, and southeast Asia, small areas of United States, the Caribbean islands, and South America. This hookworm is well known in mines because of the consistency in temperature and humidity that provide an ideal habitat for egg and juvenile development. It is estimated 1 billion people are infected with hookworms. Transmission of Ancylostoma duodenale is by contact of skin with soil contaminated with larvae. The way Ancylostoma duodenale enters the human body was understood in the 1880s, after an epidemic of ancylostomiasis among miners working in the hot and humid Gotthard Tunnel (Switzerland).
A light infection causes abdominal pain, loss of appetite and geophagy. Heavy infection causes severe protein deficiency or iron deficiency anemia. Protein deficiency may lead to dry skin, edema and potbelly, while iron deficiency anemia might result in mental dullness and heart failure. Women who are pregnant and infected should be aware that this parasite is able to infect the fetus and can cause complications such as low birth weight, maternal anemia, and infant mortality.
The eggs of Ancylostoma duodenale and Necator americanus cannot be distinguished. Larvae cannot be found in stool specimen unless they are left at ambient temperature for a day or more.
Education, improved sanitation and controlled disposal of human feces are important. Wearing shoes in endemic areas can reduce the prevalence of infection as well.
Ancylostoma duodenale can be treated with albendazole, mebendazole and benzimidazoles. Pyrantel pamoate is an alternative. In severe cases of anemia, blood transfusion may be necessary.
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