2003)
52% of a total of 526 tested households infected
Could not identify species, but previous studies in North Vietnam reported N. americanus in more than 95% of hookworm larvaeMinas Gerais, Brazil (Fleming et al. 2006)
63% infection rate of predominantly N. americanusKwaZulu-Natal, South Africa (Mabaso et al. 2004)
Inland areas had a prevalence rate of 9% of N. americanus
Coastal plain areas had a prevalence rate of 63% of N. americanusLowndes County, Alabama, United States 
35% infection rate of predominantly N. americanusThere have also been technological developments that may facilitate more accurate mapping of hookworm prevalence. Some researchers have begun to use geographical information systems (GIS) and remote sensing (RS) to examine helminth ecology and epidemiology. Brooker et al. utilized this technology to create helminth distribution maps of sub-Saharan Africa. By relating satellite derived environmental data with prevalence data from school-based surveys, they were able to create detailed prevalence maps. The study focused on a wide range of helminths, but interesting conclusions about hookworm specifically were found. As compared to other helminths, hookworm is able to survive in much hotter conditions and was highly prevalent throughout the upper end of the thermal range.Improved molecular diagnostic tools are another technological advancement that could help improve existing prevalence statistics. Recent research has focused on the development of a DNA-based tool that can be used for diagnosis of infection, specific identification of hookworm, and analysis of genetic variability in hookworm populations. Again this can serve as a major tool for different public health measures against hookworm infection.
Signs and symptoms
No symptoms or signs are specific for hookworm infection, but they give rise to a combination of intestinal inflammation and progressive iron-deficiency anemia and protein deficiency. Coughing, chest pain, wheezing, and fever sometimes result from severe infection. Epigastric pains, indigestion, nausea, vomiting, constipation, and diarrhea can occur early or in later stages, as well, although gastrointestinal symptoms tend to improve with time. Signs of advanced severe infection are those of anemia and protein deficiency, including emaciation, cardiac failure, and abdominal distension with ascites.Larval invasion of the skin (mostly in the Americas) can produce a skin disease called cutaneous larva migrans also known as creeping eruption. The hosts of these worms are not human and the larvae can only penetrate the upper five layers of the skin, where they give rise to intense, local itching, usually on the foot or lower leg, known as ground itch. This infection is due to larvae from the A. braziliense hookworm. The larvae migrate in tortuous tunnels between the stratum basale and stratum corneum of the skin, causing serpiginous vesicular lesions. With advancing movement of the larvae, the rear portions of the lesions become dry and crusty. The lesions are typically intensely itchy. Incubation period
The incubation period can vary between a few weeks to many months, and is largely dependent on the number of hookworm parasites an individual is infected with. Cause
Hookworm infections in humans include ancylostomiasis and necatoriasis.