September 22, 2016
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Estimates show high global burden of human hookworm infection

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While hookworm infection is rarely deadly, even conservative estimates of its impact on human health and productivity show it deserves greater attention and investment, researchers said.

“Our study shows how the cumulative economic impact of a subacute chronic disease like hookworm can eventually exceed the impact of diseases that have higher mortality and more salient health effects,” Sarah M. Bartsch, MPH, research associate in the department of international health at the Johns Hopkins Bloomberg School of Public Health, and colleagues wrote in PLoS Neglected Tropical Diseases.

Bartsch and colleagues used a computer simulation model to estimate the economic and health burden of human hookworm infection. The results showed a global productivity loss of between $2.5 billion and $138.9 billion, depending on the probability of anemia and the calculation method used.

“At first glance, it may be easy to underestimate the impact of hookworm since it does not tend to result in death,” Bartsch said in a news release. “However, the blood loss and potential disturbances to growth and cognition caused by hookworm impairs peoples’ ability to contribute to society and these productivity losses add up over time.”

The head of Necator americanus

The head of Necator americanus, a species of hookworm, including its mouth and cutting plates.

Source: CDC/Mae Melvin

When using gross national income per capita as a proxy for annual wages, Bartsch and colleagues estimated a total productivity loss of $7.5 billion to $138.9 billion annually. Using minimum wage as a proxy, it was $2.5 billion to $43.9 billion.

The study also showed a total global burden of 2,126,280 disability-adjusted life years (DALYs) based on 2004 disability weight estimates, and 4,087,803 DALYs using 2010 estimates.

“Our results provide important information for decision-makers,” Bartsch and colleagues wrote. Without a better understanding of the economic and health burden of hookworm worldwide and in different countries, it is difficult for decision-makers such as funders, policymakers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control.

“Our results can also help decision-makers know where hookworm should fall on their priority lists and allocate limited resources.” – by Gerard Gallagher

Disclosure: The researchers report no relevant financial disclosures.