A hookworm

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Health authorities should step up efforts to treat pregnant women for hookworm to reduce the risk of anaemia, a major cause of maternal deaths, researchers say.

Their study, published in PLoS Neglected Tropical Diseases this month (17 September), shows a distinct link between intestinal blood loss from hookworm infection and low levels of iron in pregnant women from countries across Africa, Asia and Latin America.

The analysis of 19 studies and randomised trials in the developing world found just three countries regularly offer mothers-to-be medication against the intestinal worms.

Madagascar, Nepal and Sri Lanka have a policy of routinely deworming pregnant women, which offers significant and relatively inexpensive long-term health benefits for both the mother and her unborn child.

"We hope this will prompt the WHO, international agencies and national governments to further consider deworming in maternal health packages," says Simon Brooker, lead author on the paper from the KEMRI-Wellcome Trust Collaborative Programme in Nairobi, Kenya.

Anaemia contributes to the low birth weight of newborn babies and has been blamed for the high death rates of infants.

The researchers call for "effective lobbying" to include anti-worm treatments as part of maternal health packages.

They also recommend that hookworm medication be combined with iron supplements and intermittent treatment for malaria, which also causes anaemia, in order to gain maximum benefits for mother and child.

Between a quarter and a third of all pregnant women in sub-Saharan Africa are infected with hookworm, which increases the risk of easily preventable anaemia to them and their unborn children.

Vera Adams, a researcher from South Africa's Medical Research Council (MRC) who monitors patients infected with both HIV and intestinal parasites, says infections also negatively affect children's ability to learn and stunts their physical growth.

Nearly 100 schools in Cape Town, South Africa, successfully run their own twice-a-year deworming programmes. The MRC is now considering drafting policy guidelines to make the pilot project national.

Research published last month (6 August) in PLoS ONE by researchers from the College of Medicine in Blantyre, Malawi, also suggests that severe anaemia has been overlooked in childhood public health strategies.

Link to full paper in PLoS Neglected Tropical Diseases

Link to full paper in PLoS ONE