Susana Londoo

Francisco Guzman
Alyssa Silva
Biomedical Engineering A3/A4
September !" #$4
%oo&'orm (n)ections in Sub*Sa+aran A)rica
%oo&'orm" Necator americanus or Ancylostoma duodenale" is a soil*transmitted
+elmint+ parasite capable o) in)ecting and p+ysiologically impairing its +ost, -+e ./. estimates
t+at bet'een 01! to 14$ million people are in)ected 'it+ t+e parasite 'orld'ide, (n
underdeveloped nations t+e incidence o) in)ection o) t+e parasite is substantially +ig+er t+an in
more developed nations as a result o) t+e disparity in economic and +ealt+care in)rastructure2 t+is
paper 'ill e3clusively deal 'it+ Sub*Sa+aran A)rica4s endemic o) +oo&'orm in)ections,
E3acerbating t+is situation" %oo&'orm parasitic in)ections are considered a 5eglected -ropical
/isease" one prevalent in less developed nations 'it+ tropical climates t+an in more developed
nations 'it+ more moderate climates" t+us deemed unpro)itable 'it+ no economic incentive )or
more developed nations to eradicate it in ot+er nations, 6ut o) t+e 'orld 'ide estimate" Sub*
Sa+aran A)rica accounts )or appro3imately 78 million in)ected individuals * over #09 o) t+e
'orld4s total a))ected population * and appro3imately #79 o) t+e total Sub*Sa+aran population,
(t is readily apparent t+at treatment and" most importantly" prevention o) in)ection o) %oo&'orm
is :uintessential to t+e development o) standard o) living in Sub*Sa+aran A)rica, Anybody near
contaminated )ecal matter is at ris& o) contracting +oo&'orm" but c+ildren and )armers are t+e
ones in most ris& )or t+eir considerably longer duration o) being in contact 'it+ soil and t+us
possibly ac:uiring t+e parasite,
-+e parasite +as related +elmint+ic variants t+at a))ect bot+ +uman and non+uman +osts,
6nly t'o variations o) +oo&'orm are dedicated in +uman in)ection, ;+en +umans come in
direct p+ysical contact or ingest soil contaminated 'it+ t+e larvae o) eit+er Americanus necator
or Ancylostoma duodenale" t+e parasite 'ill eit+er remain on t+e person4s s&in until it matures
and can penetrate it or 'ill directly in)ect t+e +ost due to ingestion, -+e li)e*cycle o) bot+
variations o) +oo&'orm begins 'it+ t+e eggs '+ic+ are predominantly )ound in soil
contaminated 'it+ )ecal matter o) an in)ected +ost2 'it+in #4 to 48 +ours a)ter e3cretion" t+ese
+atc+ into r+abditi)orm larvae, -+ey t+en gro' into )ili)orm larvae 0 to $ days later '+ile in t+e
soil or coming into contact 'it+ an individual2 t+ey remain in in)ected soil )or up to 4 'ee&s and
are capable o) directly penetrating an individual4s tissues, -+e )ili)orm larvae may eit+er burro'
t+roug+ t+e s&in or t+roug+ t+e alveoli o) t+e +ost until t+ey reac+ t+e small intestine o) t+e +ost
'+ere t+ey absorb nutrients )rom t+e +ost4s lumen eventually causing anemia" malnutrition" and
developmental constrictions in c+ildren, () untreated" t+ey may remain t+ere )or many years
creating adverse pat+op+ysiological e))ects to t+e +ost as 'ell as propagating eggs t+roug+ t+e
+ost4s )ecal matter t+us restarting t+e li)e*cycle,
6ne met+od used to prevent +oo&'orms is s+oes, (n t+e <,S an average pair o) s+oes
costs around =$ * #$" '+ic+ )or a developed nation is not muc+, -+e average income o) an
American +ouse+old is =!$"$$$ per year '+ile in Sub*Sa+aran A)rica" it is less t+an =1!$, -+is
means t+at people in A)rica are only capable o) buying vital products" suc+ as )ood and paying
)or s+elter ma&ing s+oes not a priority,
S+oes protect against parasites by preventing t+em )rom penetrating t+e s&in since a
persons )oot is covered by t+e s+oes material and t+ere is no training re:uired needed, A pair o)
s+oes can last about 3*! mont+s depending on t+eir use,
Anot+er met+od )or treating a +oo&'orm in)ection is t+e use o) cryot+erapy, -+is t+erapy
is one t+at utilizes cold temperatures )or local or general use on t+e s&in, .arbon dio3ide at *18
degrees .elsius" 'it+ a pressure o) 0$ bars and a )re:uency o) 4$$ %z is applied to t+e s&in )or
s+ort periods o) time" and sessions can be repeated at 'ill, Alt+oug+ t+is treatment modality +as
been proven e))ective in some cases by &illing t+e +oo&'orm larvae" cryot+erapy re:uires
localization o) t+e larvae )or e))ect" '+ic+ is usually not al'ays possible, -+e possibility o) a
person" particularly a c+ild >c+ildren are t+e ones most a))ected by t+e +oo&'orm parasite?" to
&no' '+ere t+ey 'ere bitten is +ig+ly improbable, Also" t+is 'ay o) treatment doesn4t prevent
)urt+er +oo&'orm contractions, 5ot @ust anyone can administer cryot+erapy" a medical
pro)essional 'ould +ave to relay t+is sort o) treatment" ma&ing it not very cost e))icient )or
people in impoveris+ed areas,
-+e most practiced use o) treating +oo&'orm in)ection is t+e administration o) counter
parasitic medication" speci)ically Albendazole and Aebendazole, -+ese medications are e))ective
in &illing t+e +elmint+es 'it+in a s+ort period o) time >*3 days?" but a )ollo' up administration
# 'ee&s later may be need to )ully eradicate any remaining +oo&'orms, Alt+oug+ it appears to
be cost e))ective" its bene)it is usually s+ort*lived due to t+e )act t+at it provides a temporary
cure" t+ose previously a))licted can and typically are in)ected 'it+ t+e parasite again t+us needing
o) t+e treatment once more, Great and repeated usage o) t+e medication results in increasing cost
to provide it to t+ose '+o need it t+e most" speci)ically t+ose '+o cannot a))ord it as 'ell as
'orry t+at t+e parasites may develop natural resistance to t+e active agents t+us 'orsening t+e
endemic condition in Sub*Sa+aran A)rica, /espite t+is" t+e drugs4 e))ectivity proves to be use)ul
in curing t+e people" albeit o)ten s+ortly" o) +oo&'orms and ot+er +elmint+es,
-able o) Assessments o) .urrent Aedical -ec+nologies
S+oes .ryot+erapy Aedicine
.ost =$*#$ =$$*=0$$ per person"
depending on area size
and location
=$,$0/#$$mg tablet o)
Albendazole
=$,3!/$$mg o)
Aebendazole
>Aay re:uire multiple
doses over s+ort time?
/uration 3*! mont+s <ntil ne3t +oo&'orm
parasitic in)ection
<ntil ne3t +oo&'orm
in)ection
E))ectiveness E))ectively prevents
+oo&'orm to in)ect
via t+e sole o) t+e
)oot only
E))ective i) able to
pinpoint site o)
in)ection
%ig+ly e))ective in
removing current
in)ection in *3 day
treatment and )ollo'
up use2 concern o)
parasitic resistance
Administration /oes not apply 6nly medical
pro)essionals can
administer t+is
treatment
Little to no medical
&no'ledge but
administration is best
le)t to educated
personnel
Accessibility Lo'2 many cannot
a))ord s+oes
E3tremely lo'2 its cost
render t+is treatment
t+e most impractical
Lo'" most people +ave
no access to obtaining
eit+er drug due to
economic or ot+er
constraints
;or&s .ited
BA)ricaCs Economy,B BBC News, BB." n,d, ;eb, 8 Sept, #$4,
B%oo&'orm (n)ections,B : Causes, Symptoms & Treatments, 5,p," n,d, ;eb, 8 Sept, #$4,
%otez" Deter E," and Aruna Famat+, B5eglected -ropical /iseases in Sub*Sa+aran A)ricaG
Hevie' o) -+eir Drevalence" /istribution" and /isease Burden,B Ed, Aic+ael .appello,
PLoS Neglected Tropical Diseases 3,8 >#$$7?G E4#, ;eb, 8 Sept, #$4,
BDarasites * %oo&'orm,B Centers for Disease Control and Preention, .enters )or /isease
.ontrol and Drevention" $ Ean, #$3, ;eb, 8 Sept, #$4,
B<nited States .ensus Bureau,B !ncome "ain# People and $ouse%olds, 5,p," n,d, ;eb, 8 Sept,
#$4,
B<SA(/Cs 5-/ Drogram,B &SA!D's Neglected Tropical Disease Program: Target Diseases,
Soil#Transmitted $elmint%iasis, $oo(worm, 5,p," n,d, ;eb, 8 Sept, #$4,
;als+" Aic+ael, B(n)ection Landscapes,B $oo(worm, 5,p," n,d, ;eb, 8 Sept, #$4,
B;+y S+oesIB Soles)Souls L $elp &s ST*P &p: S%oes to *liminate Poerty+, Soles4soulsls"
#$4, ;eb, 8 Sept, #$4,