Relationship of anaemia and hypoproteinaemia to the functional and structural changes in the small bowel in hookworm disease.

A variable proportion of patients with hookworm disease have functional and structural changes of the small bowel leading to the clinical features of malabsorption and nutritional deficiencies (Sheehy, Meroney, Cox, and Soler, 1962; Salem and Truelove, 1964; Chaudhuri and Saha, 1964; Tandon, Das, Saraya, and Deo, 1966a; Burman, 1966; Chuttani, Puri, and Misra, 1967). This observation has great significance for investigators in India and other tropical countries where hookworm infection and idiopathic tropical malabsorption are prevalent. These patients usually belong to a low socioeconomic class, are poorly nourished, and have moderate to severe anaemia. Hence three factors, namely, the parasite (Sheehy et al, 1962), severe anaemia, and hypoalbuminaemia (Layrisse, Blumenfeld, Carbonell, Desenne, and Roche, 1964) have been considered for the study of the pathogenesis of malabsorption in hookworm disease.