A close relationship between the level of hookworm infection and severity of anemia has been observed in many cross-sectional field studies. Similar, though generally less severe, levels of anemia have been associated with intensity of schistosome species and T. trichiura disease. The cause and effect relationship suggested by this data has been confirmed by longitudinal investigations of iron status following anthelmintic administration. Community studies in Kenya, India, and Papua New Guinea have recorded substantial increases (up to 6gl-1) in hemoglobin concentration between 4 and 8 weeks after treatment for hookworm. These marked improvements were seen even when parasite loads were not completely eliminated. Effective treatment of severe Schistosoma and T. trichiura infections also results in much improved iron status.
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