Ancylostomiasis overview: Difference between revisions

	Ancylostomiasis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Ancylostomiasis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
Endoscopy
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Ancylostomiasis overview On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Ancylostomiasis overview All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Ancylostomiasis overview
CDC on Ancylostomiasis overview
Ancylostomiasis overview in the news
Blogs on Ancylostomiasis overview
Directions to Hospitals Treating Ancylostomiasis
Risk calculators and risk factors for Ancylostomiasis overview

VisualWikitext

Latest revision as of 22:39, 3 September 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalpana Giri, MBBS [2]

Overview

Ancylostomiasis is a hookworm infection, soil-transmitted helminths (STH) occurs predominantly in countries with low socioeconomic status located in tropical and subtropical areas of the world. Common symptoms of ancylostomiasis include: anorexia, flatulence, diarrhea, weight loss, pallor, dyspnea, weakness, generalized edema, melena, hematemesis, dizziness, syncope, cough, sneezing, hemoptysis, nausea, vomiting, pharyngeal irritation, itchy, erythematous, serpiginous skin lesions. The mainstay of treatment for ancylostomiasis is anti-helminthic therapies are recommended among patients with ancylostomiasis.

Historical Perspective

Ancylostomiasis was first discovered by Dubini, an Italian physician, in 1838.

Classification

Ancylostomiasis may be classified according to the species into two groups: Human hookworm: Ancylostoma and Necator Americanus and Zoonotic hookworm: Ancylostoma braziliense, Ancylostoma caninum, Ancylostoma ceylanicum and Uncinaria stenocephala.

Pathophysiology

Ancylostomiasis is a hookworm infection, soil-transmitted helminths (STH) occurs predominantly in countries with low socioeconomic status located in tropical and subtropical areas of the world. The life cycle of hookworm include: human hookworm and zoonotic hookworm. Mature females released eggs in the host’s small intestine and these eggs are passed in the feces. Under appropriate conditions, each eggs hatch in soil, and develops into an infective filariform (L3) stage larva. It enter the body either through a skin or oral ingestion then enters the bloodstream, and reach the lungs and migrate across the alveoli. Then they ascend from the bronchial tree to the pharynx and reach the small intestine where they mount into fourth-stage larvae and mature into blood-feeding adults male or female.

Causes

Common causes of ancylostomiasis include: Ancylostoma duodenale, Necator americanus, Ancylostoma ceylanicum, and less common organisms include: Ancylostoma braziliense, Ancylostoma caninum, Ancylostoma ceylanicum, and Uncinaria stenocephala.

Differentiating ancylostomiasis from Other Diseases

Ancylostomiasis must be differentiated from contact dermatitis, scabies infection, migratory myiasis, and cercarial dermatitis for cutaneous manifestations, and portal hypertension, meckel’s diverticulum, inflammatory bowel disease and nonsteroidal anti-inflammatory drug-induced small bowel disease, angiectasias, adenocarcinoma, leiomyoma, and lymphoma for GI bleeding.

Epidemiology and Demographics

The incidence rate of hookworm infection was 7.5/100 person-years. Prevalence of ancylostomiasis is approximately 1 billion people worldwide. People of all ages are susceptible to ancylostomiasis, commonly affects children and women of childbearing age. Mortality rate of hookworms in the tropics is approximately 50-60,000 deaths per year. Men are more commonly affected by ancylostomiasis than women.

Risk Factors

Common risk factors of ancylostomiasis include: exposure to soil where filariform larvae, the infective stage, live in and penetrate human skin, poor sanitation, low socioeconomic status, low educational attainment.

Natural History, Complications, and Prognosis

The majority of the infected patients remain asymptomatic. The symptoms of ancylostomiasis typically develop by direct contact of the skin with contaminated soil and the fecal-oral route. The most common complications include: iron deficiency anemia, in child: intellectual and cognitive development, in pregnant women: severe anemia, impaired growth, severe anemia, premature birth, neonatal anemia. Prognosis is generally excellent with proper treatment.

Diagnosis

X Ray

There are no x-ray findings associated with ancylostomiasis.

CT

There are no CT findings associated with ancylostomiasis.

Other Diagnostic Studies

Other diagnostic studies for ancylostomiasis include upper gastrointestinal endoscopy, which demonstrates live and motile worms in GI tract.

Treatment

Medical Therapy

Anti-helminthic therapies are recommended among patients with ancylostomiasis. Efficacy of treatment varies according to the severity of infection, geographical distribution, and age groups. Multiple blood transfusion, iron supplements are also be given in severe cases.

Surgery

Surgical intervention is not recommended for the management of ancylostomiasis.

Primary Prevention

Effective measures for the primary prevention of ancylostomiasis include periodic mass anthelminthic treatment of at-risk populations, avoid gardening barefooted, patient education on proper hygiene and sanitation.

References

Template:WH Template:WS

@@ Line 4: / Line 4: @@
 {{CMG}} {{AE}} {{Kalpana Giri}}
 ==Overview==
-[[Ancylostomiasis]] was first [[discovered]] by [[Dubini]], an [[Italian physician]], in 1838 who provided the first detailed description of [[hookworms]] during an [[autopsy]] on a woman who had died in Milan. [[Ancylostomiasis]] may be classified according to the species into two groups: Human hookworm: [[Ancylostoma]] and [[Necator Americanus]] and Zoonotic hookworm: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]] and [[Uncinaria stenocephala]]. [[Ancylostomiasis]] is a [[hookworm infection]], [[soil-transmitted]] [[helminths]] (STH) occurs predominantly in [[countries]] with [[low socioeconomic]] [[status]] located in [[tropical]] and [[subtropical]] areas of the [[world]]. The [[external]] [[surface]] of [[helminth]] comprises key [[molecules]] [[excretory/secretory]] (ES) products which contain a large range of [[structurally]] and [[functionally]] distinct [[molecules]], mostly [[proteins]], and also [[lipids]], and [[carbohydrates]]. These [[molecules]] help the [[parasite]] to [[survive]] and evade the [[host]] [[immunological]] [[response]]. The [[biological]] [[role]] and [[molecular]] [[nature]] of [[hookworm]] ES products are still [[unclear]]. The life cycle of hookworm include: human hookworm and zoonotic hookworm. [[Mature females]] released eggs in the host’s [[small intestine]] and these eggs are passed in the feces, where they hatch [[first stage]] [[rhabditiform]] [[larva]] (L1) within several days. The L1 feeds on soil [[microbes]] and [[molts]] to the L2 stage, and under appropriate conditions, each eggs hatch in warm, moist, sandy soil, or in feces and develops into an [[infective]] [[filariform]] (L3) stage larva. The [[infective-stage]] [[larvae]] (L3) enter the body either through a [[cutaneous route]] or by [[direct]] [[oral ingestion]]. [[Human]] [[hookworm]] such as Ancylostoma and Necator americanus enter the body by [[skin penetration]] which may cause a [[local pruritic]] [[dermatitis]], at the site of [[penetration]] whereas the [[ancylostoma species]] can also [[enter the body orally]]. The [[infective larvae]] (L3) [[migrate]] through the [[dermis]], enters the [[bloodstream]], and reach the [[lungs]] and [[migrate]] across the [[alveoli]]. Then they [[ascend]] from the [[bronchial tree]] to the [[pharynx]] and reach the [[small intestine]] where they [[mount]] into [[fourth-stage]] [[larvae]] and [[mature]] into [[blood-feeding]] [[adults]] [[male]] or [[female]]. These [[adult worms]] degrades the [[intestinal mucosa]] and [[erosion]] of [[blood vessels]] which results in [[blood]] [[extravasation]]. [[Hookworms]] also [[secrete]] [[Ancylostoma ceylanicum]] [[anticoagulant]] [[peptide-1]], which inhibits the [[blood]] [[coagulation]] in the [[attachment site]] and leads to [[blood loss]] from the [[intestine]]. [[Zoonotic]] [[hookworm]] (i.e., cat and dog hookworms) include: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]] and [[Uncinaria stenocephala]]. Among these most commonly [[encountered]] [[hookworm]]is [[Ancylostoma braziliense]]. It causes [[cutaneous larva migrans]] ([[creeping eruption]]). [[Ancylostoma ceylanicum]] is the only species that develops to [[adult]] in [[humans]], and causes [[enteric]] [[hookworm infection]]. [[Ancylostoma caninum]] occasionally reaches [[adulthood]] in [[humans]], and causes [[eosinophilic enteritis]].Common causes of [[Ancylostomiasis]] include: [[Ancylostoma duodenale]], [[Necator americanus]], [[Ancylostoma ceylanicum]], and less common organisms include: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]], and [[Uncinaria stenocephala]]. [[Ancylostomiasis]] differentiated from [[ascariasis]], [[trichuriasis]], and [[Strongyloides species]]. The [[incidence rate]] of [[hookworm]] infection was 7.5/100 person-years, prevalence is approximately 1 billion people worldwide, and mortality rate in the [[tropics]] is approximately 50-60,000 deaths per year. It commonly affects [[children]] and [[women]] of [[childbearing]] age. Common risk factors of ancylostomiasis include: [[exposure]] to [[soil]] where [[filariform larvae]], the [[infective stage]], live in and [[penetrate]] human [[skin]], [[Poor sanitation]], [[low socioeconomic status]], [[low educational attainment]]. The majority of the [[infected]] [[patients]] remain [[asymptomatic]]. The symptoms of [[ancylostomiasis]] typically develop by [[direct contact]] of the [[skin]] with [[contaminated soil]] and the [[fecal-oral route]]. The most common complications include: [[Iron deficiency anemia]], in child: [[intellectual]] and [[cognitive]] [[development]], in pregnant women: [[severe anemia]], [[impaired growth]], [[severe anemia]], [[premature birth]], [[neonatal anemia]].Prognosis is generally [[excellent]] with [[proper treatment]]. The diagnostic test of [[ancylostomiasis]] is the [[microscopic]] [[detection]] of [[hookworms eggs]] in stool. The majority of [[patients]] with [[ancylostomiasis]] are [[asymptomatic]]. Common symptoms of ancylostomiasis include: [[anorexia]], [[flatulence]], [[diarrhea]], [[weight loss]], [[pallor]], [[dyspnea]], [[weakness]], [[generalized edema]], [[melena]], [[hematemesis]], [[dizziness]], [[syncope]], [[cough]], [[sneezing]], [[hemoptysis]], [[nausea]], [[vomiting]], [[pharyngeal irritation]], [[itchy]], [[erythematous]], [[serpiginous]] [[skin lesions]]. Physical examination include: [[pallor]], [[fatigue]], [[dizziness]], [[serpiginous]], [[erythematous]], and [[palpable plaque]], [[abdominal distension]]. Lab findings include: decreased [[hemoglobin]], [[eosinophilia]], presence of several [[live and motile]] [[worms]] in [[upper gastrointestinal]] [[endoscopy]]. For treatment [[anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]]. [[Efficacy]] of [[treatment]] varies according to the [[severity]] of [[infection]], [[geographical]] [[distribution]], and [[age groups]]. [[Multiple blood transfusion]], [[iron supplements]] are also be given in severe cases. Effective measures for the primary prevention of ancylostomiasis include periodic mass anthelminthic treatment of at-risk populations, avoid Gardening barefooted, Patient Education on [[proper hygiene]] and [[sanitation]].
+[[Ancylostomiasis]] is a [[hookworm infection]], [[soil-transmitted]] [[helminths]] (STH) occurs predominantly in [[countries]] with [[low socioeconomic]] [[status]] located in [[tropical]] and [[subtropical]] areas of the [[world]]. Common symptoms of ancylostomiasis include: [[anorexia]], [[flatulence]], [[diarrhea]], [[weight loss]], [[pallor]], [[dyspnea]], [[weakness]], [[generalized edema]], [[melena]], [[hematemesis]], [[dizziness]], [[syncope]], [[cough]], [[sneezing]], [[hemoptysis]], [[nausea]], [[vomiting]], [[pharyngeal irritation]], [[itchy]], [[erythematous]], [[serpiginous]] [[skin lesions]]. The mainstay of treatment for ancylostomiasis is [[anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]].
 ==Historical Perspective==
-[[Ancylostomiasis]] was first [[discovered]] by [[Dubini]], an [[Italian physician]], in 1838 who provided the first detailed description of [[hookworms]] during an [[autopsy]] on a woman who had died in Milan. [[Necator americanus]] and [[Ancylostoma duodenale]] were responsible for all [[human]] [[hookworm]] [[infections]] mentioned by Bethony et al ( 2006), de Silva et al.(2003), however Bradbury & Traub (2016) and Traub et al. (2008) mentioned [[Ancylostoma ceylanicum]] is also an [[important]] [[hookworm]] of humans, especially in South East Asia.
+[[Ancylostomiasis]] was first [[discovered]] by [[Dubini]], an [[Italian physician]], in 1838.
 ==Classification==
 [[Ancylostomiasis]] may be classified according to the species into two groups: Human hookworm: [[Ancylostoma]] and [[Necator Americanus]] and Zoonotic hookworm: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]] and [[Uncinaria stenocephala]].
-==pathophysiology==
+==Pathophysiology==
-[[Ancylostomiasis]] is a [[hookworm infection]], [[soil-transmitted]] [[helminths]] (STH) occurs predominantly in [[countries]] with [[low socioeconomic]] [[status]] located in [[tropical]] and [[subtropical]] areas of the [[world]]. The [[external]] [[surface]] of [[helminth]] comprises key [[molecules]] [[excretory/secretory]] (ES) products which contain distinct [[molecules]], mostly [[proteins]], and also [[lipids]], and [[carbohydrates]]. These [[molecules]] help the [[parasite]] to [[survive]] and evade the [[host]] [[immunological]] [[response]]. The life cycle of hookworm include: human hookworm and zoonotic hookworm. [[Mature females]] released eggs in the host’s [[small intestine]] and these eggs are passed in the feces, where they hatch [[first stage]] [[rhabditiform]] [[larva]] (L1). L1 feeds on soil [[microbes]] and [[molts]] to the L2 stage, and under appropriate conditions, develops into an [[infective]] [[filariform]] (L3) stage larva. The [[infective-stage]] [[larvae]] (L3) enter the body either through a [[cutaneous route]] or by [[direct]] [[oral ingestion]]. The [[infective larvae]] (L3) [[penetrate]] the [[skin]] and through the [[dermis]], enters the [[bloodstream]], and reach the [[lungs]] and [[ascend]] to the [[pharynx]] and reach the [[small intestine]] where they [[mount]] into [[fourth-stage]] [[larvae]] and [[mature]] into [[blood-feeding]] [[adults]] [[male]] or [[female]]. These [[adult worms]] degrades the [[intestinal mucosa]] and [[erosion]] of [[blood vessels]] which results in [[blood]] [[extravasation]]
+[[Ancylostomiasis]] is a [[hookworm infection]], [[soil-transmitted]] [[helminths]] (STH) occurs predominantly in [[countries]] with [[low socioeconomic]] [[status]] located in [[tropical]] and [[subtropical]] areas of the [[world]]. The life cycle of hookworm include: human hookworm and zoonotic hookworm. [[Mature females]] released eggs in the host’s [[small intestine]] and these eggs are passed in the feces. Under appropriate conditions, each eggs hatch in soil, and develops into an [[infective]] [[filariform]] (L3) stage larva. It enter the body either through a [[skin]] or [[oral ingestion]] then enters the [[bloodstream]], and reach the [[lungs]] and [[migrate]] across the [[alveoli]]. Then they [[ascend]] from the [[bronchial tree]] to the [[pharynx]] and reach the [[small intestine]] where they [[mount]] into [[fourth-stage]] [[larvae]] and [[mature]] into [[blood-feeding]] [[adults]] [[male]] or [[female]].
 ==Causes==
-Common causes of [[Ancylostomiasis]] include: [[Ancylostoma duodenale]], [[Necator americanus]], [[Ancylostoma ceylanicum]], and less common organisms include: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]], and [[Uncinaria stenocephala]].
+Common causes of [[ancylostomiasis]] include: [[Ancylostoma duodenale]], [[Necator americanus]], [[Ancylostoma ceylanicum]], and less common organisms include: [[Ancylostoma braziliense]], [[Ancylostoma caninum]], [[Ancylostoma ceylanicum]], and [[Uncinaria stenocephala]].
 ==Differentiating ancylostomiasis from Other Diseases==
-[[Ancylostomiasis]] manifests in a variety of clinical forms, [[differentiation]] must be established in accordance with the particular sign and symptoms. Such as [[abdominal symptoms]] differentiated from [[ascariasis]] and [[trichuriasis]], and [[parasites]] associated with [[pneumonitis]] and [[peripheral eosinophilia]] are [[Aascaris]] and [[Strongyloides species]]. [[Cutaneous]] [[manifestations]] are [[differentiated]] from [[contact dermatitis]], [[scabies infection]], [[migratory myiasis]], and [[cercarial dermatitis]]. In infants [[gastrointestinal]] [[bleeding]]  must be [[differentiated]] from other diseases that cause [[melena]], [[pallor]], [[anorexia]], [[listlessness]], and [[edema]] such as [[portal hypertension]], [[Meckel’s diverticulum]], or [[AV malformation]]. In adults [[gastrointestinal bleeding]] must be differentiated from other [[diseases]] such as [[meckel’s diverticulum]] and [[Dieulafoy’s lesions]], [[inflammatory bowel disease]] and [[nonsteroidal]] [[anti-inflammatory]] [[drug-induced]] [[small bowel disease]]. In older patient (>50 years old) are prone to [[gastrointestinal bleeding]] from [[angiectasias]], [[adenocarcinoma]], [[leiomyoma]], and [[lymphoma]].
+[[Ancylostomiasis]] must be differentiated from [[contact dermatitis]], [[scabies infection]], [[migratory myiasis]], and [[cercarial dermatitis]] for [[cutaneous]] [[manifestations]], and [[portal hypertension]], [[meckel’s diverticulum]], [[inflammatory bowel disease]] and [[nonsteroidal]] [[anti-inflammatory]] [[drug-induced]] [[small bowel disease]], [[angiectasias]], [[adenocarcinoma]], [[leiomyoma]], and [[lymphoma]] for GI bleeding.
 ==Epidemiology and Demographics==
-The [[incidence rate]] of [[hookworm]] infection was 7.5/100 person-years. Prevalence of [[Ancylostomiasis]] is approximately 1 billion people worldwide. People of all ages are susceptible to [[Ancylostomiasis]], commonly affects [[children]] and [[women]] of [[childbearing]] age. Mortality rate of [[Hookworms]] in the [[tropics]] is approximately 50-60,000 deaths per year. Men are more [[commonly]] affected by [[Ancylostomiasis]] than women. [[Ancylostomiasis]] is a [[common]] disease that tends to affect [[cooler]], [[drier regions]].
+The [[incidence rate]] of [[hookworm]] infection was 7.5/100 person-years. Prevalence of [[ancylostomiasis]] is approximately 1 billion people worldwide. People of all ages are susceptible to [[ancylostomiasis]], commonly affects [[children]] and [[women]] of [[childbearing]] age. Mortality rate of [[hookworms]] in the [[tropics]] is approximately 50-60,000 deaths per year. Men are more [[commonly]] affected by [[ancylostomiasis]] than women.
 == Risk Factors==
-Common risk factors of ancylostomiasis include: [[exposure]] to [[soil]] where [[filariform larvae]], the [[infective stage]], live in and [[penetrate]] human [[skin]], [[Poor sanitation]], [[low socioeconomic status]], [[low educational attainment]].
+Common risk factors of ancylostomiasis include: [[exposure]] to [[soil]] where [[filariform larvae]], the [[infective stage]], live in and [[penetrate]] human [[skin]], [[poor sanitation]], [[low socioeconomic status]], [[low educational attainment]].
 ==Natural History, Complications, and Prognosis==
-The majority of the [[infected]] [[patients]] remain [[asymptomatic]]. The symptoms of [[ancylostomiasis]] typically develop by [[direct contact]] of the [[skin]] with [[contaminated soil]] and the [[fecal-oral route]]. The most common complications include: [[Iron deficiency anemia]], in child: [[intellectual]] and [[cognitive]] [[development]], in pregnant women: [[severe anemia]], [[impaired growth]], [[severe anemia]], [[premature birth]], [[neonatal anemia]]. Prognosis is generally [[excellent]] with [[proper treatment]].
+The majority of the [[infected]] [[patients]] remain [[asymptomatic]]. The symptoms of [[ancylostomiasis]] typically develop by [[direct contact]] of the [[skin]] with [[contaminated soil]] and the [[fecal-oral route]]. The most common complications include: [[iron deficiency anemia]], in child: [[intellectual]] and [[cognitive]] [[development]], in pregnant women: [[severe anemia]], [[impaired growth]], [[severe anemia]], [[premature birth]], [[neonatal anemia]]. Prognosis is generally [[excellent]] with [[proper treatment]].
 ==Diagnosis==
@@ Line 33: / Line 35: @@
 ===History and Symptoms===
-The majority of [[patients]] with [[ancylostomiasis]] are [[asymptomatic]]. Common symptoms of ancylostomiasis include: [[anorexia]], [[flatulence]], [[Diarrhea]], [[Weight loss]], [[Pallor]], [[Dyspnea]], [[Weakness]], [[Generalized edema]], [[Melena]], [[Hematemesis]], [[Dizziness]], [[Syncope]], [[Cough]], [[Sneezing]], [[Hemoptysis]], [[Nausea]], [[Vomiting]], [[Pharyngeal irritation]], [[Itchy]], [[erythematous]], [[serpiginous]] [[skin lesions]].
+The majority of [[patients]] with [[ancylostomiasis]] are [[asymptomatic]]. Common symptoms of ancylostomiasis include: [[anorexia]], [[flatulence]], [[diarrhea]], [[weight loss]], [[pallor]], [[dyspnea]], [[weakness]], [[generalized edema]], [[melena]], [[hematemesis]], [[dizziness]], [[syncope]], [[cough]], [[sneezing]], [[hemoptysis]], [[nausea]], [[vomiting]], [[pharyngeal irritation]], [[itchy]], [[erythematous]], [[serpiginous]] [[skin lesions]].
 ===Physical examination===
-Physical examination include: [[Pallor]], [[fatigue]], [[Dizziness]], [[serpiginous]], [[erythematous]], and [[palpable plaque]] associated with [[edema]], [[abdominal distension]].
+Physical examination include: [[pallor]], [[fatigue]], [[dizziness]], [[serpiginous]], [[erythematous]], and [[palpable plaque]] associated with [[edema]], [[abdominal distension]].
 ===Lab Findings===
-Lab findings include: decreased [[hemoglobin]], [[eosinophilia]], Presence of several [[live and motile]] [[worms]] in [[upper gastrointestinal]] [[endoscopy]].
+Lab findings include: decreased [[hemoglobin]], [[eosinophilia]], presence of several [[live and motile]] [[worms]] in [[upper gastrointestinal]] [[endoscopy]].
 ===X Ray===
 There are no x-ray findings associated with ancylostomiasis.
@@ Line 50: / Line 53: @@
 ==Treatment==
 ===Medical Therapy===
-[[Anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]]. [[Efficacy]] of [[treatment]] varies according to the [[severity]] of [[infection]], [[geographical]] [[distribution]], and [[age groups]]. [[Multiple blood transfusion]], [[Iron supplements]] are also be given in severe cases.
+[[Anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]]. [[Efficacy]] of [[treatment]] varies according to the [[severity]] of [[infection]], [[geographical]] [[distribution]], and [[age groups]]. [[Multiple blood transfusion]], [[iron supplements]] are also be given in severe cases.
 ===Surgery===
 Surgical intervention is not recommended for the management of ancylostomiasis.
 ===Primary Prevention===
-Effective measures for the primary prevention of ancylostomiasis include periodic mass anthelminthic treatment of at-risk populations, avoid Gardening barefooted, Patient Education on [[proper hygiene]] and [[sanitation]].
+Effective measures for the primary prevention of ancylostomiasis include periodic mass anthelminthic treatment of at-risk populations, avoid gardening barefooted, patient education on [[proper hygiene]] and [[sanitation]].
 ==References==