Anemia is probably the commonest effect of nutritional deficiency in human beings and has certainly been the most extensively studied. Iron deficiency is widely recognized as the most important cause of anemia in the world (Finch, 1969; Beaton, 1974).

The Hematopoietic System

Publisher Summary Hookworms are parasites of mammals, being most frequent in primates, carnivores, and ungulates, with a few species in other groups, including two aquatic mammals. Their natural distribution, which is determined primarily by the temperature requirements for development of their free-living stages, is equatorial, tropical, or sub-tropical. Three species of hookworm occur in man: Ancylostoma duodenale , Necator americanus and Ancylostoma ceylanicum . The two principal hookworms, A. duodenale and N. americanus , have different geographical distributions. A. duodenale is sub-tropical and does not occur in the northern hemisphere above 52˚ latitude. Above 47˚ latitude its larvae require artificial shelter from the climate since the free-living stages require temperatures in excess of 22˚C. The optimum temperatures for N. americanus are higher, in the tropical range of 25–28˚C. The distributions of both species overlap, although one or other usually predominates. Whenever A. ceylanicum has been recovered from man, it has been found that it usually constitutes only a small proportion of mixed hookworm burdens. The world prevalence of hookworm infection in man exceeds the prevalence of almost all other helminthic infections and of other individual diseases, with the exception of only the common cold.

Hookworm Infection in Man

A new method for the determination of urinary formiminoglutamic acid (FIGLU) using conventional electrophoresis at 200 to 500 v. on cellulose acetate strips is reported. Experience in 166 determinations on 137 patients shows the method to be a simple, practical, and apparently sensitive one for the determination of FIGLU in the urine. Results of the application of the measurement of urinary FIGLU with histidine loading as a test for folic acid deficiency are also reported.

Conventional voltage electrophoresis forformiminoglutami c-acid determination infolic aciddeficiency

In bone marrow from 3 patients with prolonged, severe self-induced starvation, fat atrophy, hypoplasia of haemopoietic cells and characteristic gelatinous transformation of marrow were noted The gelatinous substance appeared amorphous and stained pink with the Wright-Giemsa stains Histochemical and ultrasturctural studies indicated that it consisted of acid mucopolysaccharides and was extracellular in nature Similar marrow abnormalities were produced in rabbits by limitating their food intake for 4 months These marrow abnormalities in the experimental animals could be reverted to normal by restoring their nutritional status It is proposed that the gelatinous transformation of marrow is caused by excessive production of mucopolysacchrides of the ground substance to compensate for the mobilization of marrow fat which occurs to meet the energy requirement It is further postulated that excessive production of acid mucopolysaccharides may provide a microenvironment unsuitable for haemopoietic proliferation The relevance of these findings to other conditions associated with marrow aplasia, is discussed

Gelatinous transformation of bone marrow in prolonged self-induced starvation.

1 Helminth zoonoses in African perspective.- Dog and man in Africa.- Cattle and man in Africa.- Future medical-veterinary-zoological cooperation.- Conclusions.- Notes.- References.- 2 Echinococcosis - a plague on pastoralists.- Life cycle.- Current status of human hydatidosis in Africa.- Public health importance of E. granulosus in Africa.- Diagnosis of human hydatidosis.- Serology.- Treatment of human hydatidosis.- Domestic intermediate hosts.- Role of domestic dogs.- Wildlife cycles in Africa.- Species and strain differences of Echinococcus in Africa.- Control.- Conclusions and future prospects.- References.- 3 The zoonotic Taeniae of Africa.- History and biology.- Epidemiology.- Zoonotic importance.- Meat inspection.- Public health measures.- Economic impact.- Diagnosis.- Cysticerosis.- Treatment.- Immunoprophylaxis.- Conclusions.- References.- 4 Trichinella in Africa and the nelsoni affair.- North Africa.- Africa south of the Sahara.- Epidemiology.- The nelsoni affair.- L'envoi.- Afterword.- References.- 5 The African 'hookworm' problem: an overview.- Importance and distribution.- Other hookworm-like parasites.- Zoonotic aspects.- Clinical and immunological aspects.- Treatment.- Control.- Future prospects.- References.- 6 Onchocerciasis - river blindness.- Life cycle.- Pathology.- Epidemiology and control within Africa.- Experimental investigations with laboratory models.- Acknowledgements.- References.- 7 Dracunculus in Africa.- Public health importance of dracunculiasis.- Current situation in Africa.- Control measures.- Anthelmintic treatment.- Dracunculiasis as a zoonosis.- References.- 8 Animal reservoirs of schistosomiasis.- Life cycle.- Schistosoma haematobium.- Schistosoma mansoni.- Concluding remarks and recommendation for future studies.- References.- 9 Baboons, bovine and bilharzia vaccines.- Heterologous immunity - the first experimental evidence.- Heterologous and homologous immunity to 5. mansoni compared in baboons.- Heterologous immunity between schistosomes and liver flukes -implications for understanding the immune mechanisms involved.- Pathogenesis of bovine bilharziasis.- Practical evaluation of live vaccines - sheep and cattle.- Practical evaluation of live vaccines in baboons.- References.- 10 Zoonotic helminths of wild and domestic animals in Africa.- Trematode zoonoses.- Cestode zoonoses.- Nematode zoonoses.- Future prospects.- References.

Parasitic helminths and zoonoses in Africa.

A significant anaemia, progressively greater with the severity of the general condition, was found to accompany kwashiorkor. It was partly masked by haemoconcentration when the child was admitted, but later became more evident as the serum albumin increased, probably because the blood volume was enlarged. The anaemia resulted from diminished erythroid activity in the bone marrow, which was believed to be an effect of the impaired protein metabolism. Reticulocyte and platelet counts were low. If hookworm or malaria parasites were present, there was more anaemia. Treatment with milk diets caused an increase in marrow activity which gradually corrected the anaemia. There was a remarkable thrombocytosis. The increased activity appeared to be due to the protein of the diets, not to vitamins or haematinics. Of the 100 children examined, 15 were megaloblastic on admission, or became so later. In 5 children loaded with histidine, FIGLU was not excreted until the block in the metabolism of this amino acid was corrected. The excretion stopped after the injection of folic acid.

R.F.A. Dean

Papers

The anaemia of kwashiorkor in uganda.