Objectives: To determine the prevalence and trends of human hookworm infection (HWI) in the Northern Territory over the past 10 years, and to assess the influence of the community children’s deworming program (CCDP).
Design, patients and setting: A retrospective observational analysis of consecutive microbiologically confirmed cases of HWI in patients diagnosed at NT government health care facilities and the main private laboratory servicing the NT between January 2002 and July 2012.
Main outcome measures: Annual prevalence of HWI (2002–2011); age, sex, Indigenous status, residence, haemoglobin level and eosinophil count of patients with HWI; and proportion of patients within the CCDP target population (children aged 6 months to 16 years, who should receive 6-monthly albendazole).
Results: From 64 691 faecal samples examined during the study period, hookworm was detected in 112 patients. There was a downward trend in the annual prevalence of HWI, falling from 14.0 cases per 100 000 population (95% CI, 8.8–19.2) in 2002 to 2.2 per 100 000 population (95% CI, 0.3–4.1) in 2011. Only 16 patients (14.3%) fell within the CCDP target population. Seventy-one patients (63.4%) were living in remote communities, and 94 (84.7%) were recorded as Indigenous Australians.
Conclusions: The prevalence of HWI in the NT reduced over the 10-year period. HWI predominantly occurs in individuals outside the CCDP target population. Our data support continuation of the CCDP in conjunction with improvements in housing, health hardware and health promotion. Continued use of albendazole in individuals beyond the CCDP may facilitate the eventual eradication of HWI from the NT.
- 1. World Health Organization. Soil-transmitted helminthiases: eliminating soil-transmitted helminthiases as a public health problem in children. Progress report 2001–2010 and strategic plan 2011–2020. Geneva: WHO, 2012.
- 2. Prociv P, Luke RA. The changing epidemiology of human hookworm infection in Australia. Med J Aust 1995; 162: 150-154.
- 3. Brooker S, Bethony J, Hotez PJ. Human hookworm infection in the 21st century. Adv Parasitol 2004; 58: 197-288.
- 4. Harhay MO, Horton J, Olliaro PL. Epidemiology and control of human gastrointestinal parasites in children. Expert Rev Anti Infect Ther 2010; 8: 219-234.
- 5. Taylor-Robinson DC, Maayan N, Soares-Weiser K, et al. Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin and school performance. Cochrane Database Syst Rev 2012; (7): CD000371.
- 6. Currie B. Why does Australia have no national drug policy [letter]? Med J Aust 1992; 157: 210.
- 7. Victorian Medical Postgraduate Foundation. Antibiotic guidelines. 8th ed. Melbourne: Interprin, 1994.
- 8. Central Australian Rural Practitioners Association. CARPA standard treatment manual. 5th ed. Alice Springs: CARPA, 2009.
- 9. Holt DC, McCarthy JS, Carapetis JR. Parasitic diseases of remote Indigenous communities in Australia. Int J Parasitol 2010; 40: 1119-1126.
- 10. Australian Bureau of Statistics. Australian demographic statistics, Jun 2012. Canberra: ABS, 2012. (ABS Cat. No. 3101.0.) http://www.abs.gov. au/Ausstats/abs@.nsf/mf/3101.0 (accessed Jan 2013).
- 11. Garcia LS, Bruckner D. Diagnostic medical parasitology. 3rd ed. Washington, DC: ASM Press, 1997: 615-618.
- 12. Australian Bureau of Statistics. Australian Standard Geographical Classification (ASGC), July 2011. Canberra: ABS, 2011. (ABS Cat. No. 1216.0.) http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/E4A3564F8B855E26 CA25791F000EEC45?opendocument (accessed Jan 2013).
- 13. Hotez PJ, Brooker S, Bethony JM, et al. Hookworm infection. N Engl J Med 2004; 351: 799-807.
- 14. Hopkins RM, Gracey MS, Hobbs RP, et al. The prevalence of hookworm infection, iron deficiency and anaemia in an Aboriginal community in north-west Australia. Med J Aust 1997; 166: 241-244.
- 15. Thompson RCA, Reynoldson JA, Garrow SC, et al. Towards the eradication of hookworm in an isolated Australian community. Lancet 2001; 357: 770-771.
- 16. Aratchige PE, Markey P, Webby R, Krause V. Hepatitis B in the Northern Territory – an analysis of hepatitis B notifications. NT Dis Control Bull 2012; 19 (2): 1-12.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.