DONALD G. McNEIL Jr.
Almost seven million pregnant women in sub-Saharan Africa are infected with hookworm, the parasite that lives in the intestine and causes anemia, according to a study released last week by the journal PLoS Neglected Tropical Diseases.
That amounts to a quarter to a third of all pregnant women on the subcontinent, said the authors, who reviewed 105 studies and databases to make their estimate.
Severe anemia — a low red-blood-cell count — is a major contributor to deaths of mothers during pregnancy and to low birth weights, which contribute to deaths of newborns.
Maternal anemia is common in Africa. It has many causes, including poor diet, malaria and genetics; some can be avoided with iron supplements, mosquito nets and the like.
It is unclear exactly how important hookworms are as a factor in deaths. For that reason, world health authorities have been reluctant to make deworming drugs part of regular maternal care, for fear that they might affect the fetus.
But because heavy hookworm loads are associated with low hemoglobin levels in pregnant women, the authors, from the London School of Hygiene and Tropical Medicine, the Sabin Vaccine Institute and the World Bank, believe such drugs will do more good than harm. They argue for further studies with drugs.
One of the authors, Dr. Peter J. Hotez, notes that he is the editor of the journal that published the study and that he holds a patent on a hookworm vaccine.