A comprehensive review of hookworm control strategies and future directions: A neglected worm-eye perspective

This review delves into hookworm infections, which remain a significant global public health concern, particularly in low- and middle-income countries where inadequate sanitation and poverty facilitate their transmission. Current resource-limited settings where control strategies focus primarily on mass drug administration (MDA) with benzimidazole anthelmintics, such as albendazole and mebendazole. While MDA has led to a reduction in infection prevalence, its long-term efficacy is challenged by rapid reinfection, limited impact on morbidity, and the potential emergence of drug resistance. Integrated approaches combining MDA with improved water, sanitation, and hygiene (WASH) interventions along with health education and environmental modifications have shown promise but require sustained investment and community engagement. Advances in vaccine development, particularly recombinant and live-attenuated candidates, offer a potential long-term solution, though none are yet widely available. Novel strategies, such as targeted treatment based on diagnostic innovations in the future can make a difference. Additionally, One Health approaches that consider the zoonotic transmission dynamics of some hookworm species could enhance intervention effectiveness. Future research should prioritize sustainable, community-centred programs that integrate diagnostics, treatment, and prevention to achieve long-term elimination. Future control directions must focus on sustainable solutions such as hookworm vaccines, which show promise in preclinical and early clinical trials, and alternative therapies, including microbiome-based interventions and novel anthelmintic compounds. As global health priorities evolve, the need for renewed commitment to hookworm control must be emphasized to prevent the neglect of this parasitic disease. This review critically evaluates existing strategies and explores innovative solutions that could shape the future of hookworm control.