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Adult Patients with an Endoscopic Diagnosis of Hookworm Infection: One-year Experience in a Primary Referral Hospital in Indonesia
Zein Ahmad FMZ1, Amanah Amanah2 
1Department of Internal Medicine, 2Department of Parasitology, Faculty of Medicine, Universitas Swadaya Gunung Jati.

Corresponding Author
Dr Ahmad Fariz Malvi Zamzam Zein


Aim: This study was aimed to investigate the clinical profiles of adult patients with hookworm infection in a primary referral hospital in Indonesia.
Methods: A descriptive study was conducted from January to December 2018. The medical records of hospitalized adult patients diagnosed with hookworm infection in Waled General Hospital, Cirebon, West Java, Indonesia were reviewed. The diagnosis of ancylostomiasis was based on microscopic examination of stool specimens and/or endoscopic findings. The clinical profile encompassed clinical characteristics and in-hospital clinical outcomes. Data was analyzed using descriptive statistics. 
Results: There were 12 subjects in this study. The mean age was 57.17 years old. Their occupations included homemaking (41.7%), farming (33.3%), and traditional trading (25.0%). The chief complaints of the patients included fatigue (58.3%), followed by melena, and nausea-vomiting. The laboratory results showed anaemia in all subjects with half of them having severe anaemia. None of the faecal specimens revealed hookworm eggs. The endoscopic findings showed duodenitis in all subjects. Histologic speciation of the worms revealed A. duodenale in all cases and N. americanus in 8.3% of cases. Most subjects (83.3%) required blood transfusions with mean volume of blood transfused being 4.4 blood bags. 33.3% of subjects required endoscopic hemostasis. There were no reported deaths. The mean length of hospital stay was 8.4+1.4 days.
Conclusion: Hookworm infection in adult patients has a high burden of morbidity. Due to its intriguing clinical characteristics, the identification of an at-risk population is highly needed. Endoscopy has a role in the diagnosis and management of hookworm infection.