Ancylostoma duodenale

Ancylostoma duodenale is a species of the worm genus Ancylostoma. It is a parasitic nematode worm and commonly known as Old World hookworm. It lives in the small intestine of host such as humans, cats and dogs. Ancylostoma duodenale and Necator americanus are the two human hookworms that are normally discussed together as the cause of hookworm infection. 90% asymptomatic can lead to iron deficiency anemia. They are dioecious.[1] Ancylostoma duodenale , a member of the Ancylostomidae, is also commonly referred to as a "hookworm". As such, hookworms have the ability to mate and mature in the small intestine of their host. Ancylostoma duodenale is abundant throughout the world, including the following countries: southern Europe, north Africa, India, China, Southeast Asia, some areas in the United States, Caribbean, and South America.

Morphology
Ancylostoma duodenale is small cylindrical worm,greyish white in color.it has two ventral plates at 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 to 11 mm long with a copulatory bursa at the posterior end. It also has needlelike spicules which are not fused and have simple tips. Females are 10 mm to 13 mm long with the vulva located at the posterior end and can lay 10,000 to 30,000 eggs per day. Their life span is one year.

Life cycle
When a filariform larva (infective stage) penetrates the intact skin, the larva enters the blood circulation. Then it is carried to the lungs, coughed up and swallowed back to the small intestine. The larva later matures into adult in the small intestine and female worms can lay 25,000 eggs per day. The eggs are released into the feces and resided on soil. Embryonated egg on soil will hatch into juvenile 1 stage (rhabditiform or noninfective stage) and mature into filariform larvae. The filariform larvae can then penetrate another exposed skin and begin a new cycle of human infection.

Epidemiology
Ancylostoma duodenale is the first hookworm in which a life cycle was illuminated. It is prevalent in southern Europe, northern Africa, India, China, and Southeast Asia, small areas of United States, 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.

Symptoms
Light infection causes abdominal pain, loss of appetite and geophagy. Heavy infection causes severe protein deficiency or iron deficiency anemia. Protein deficiency might have dry skin, edema and potbelly, while iron deficiency anemia might have mental dullness and heart failure.

Laboratory Diagnosis
The eggs of Ancylostoma duodenale and Necator americanus cannot be distinguished. Larvae cannot be found in the stool specimens unless it is left at ambient temperature for a day or more.

Prevention and Control

Education, improved sanitation and controlled disposal of human feces are important. Wearing shoes in endemic areas can reduce the prevalence of infection as well.

Treatment
Ancylostoma duodenale can be treated with albendazole, mebendazole and benzimidazoles. Pyrantel pamoate is an alternative. In severe cases of anemia, blood transfusion might be necessary.