Study aims to discover if hookworm, related intestinal parasites are present in Alabama Black Belt

Researchers have hired local community health care workers to collect samples from children for testing — and will provide treatment — if it is found that children living in several Alabama Black Belt counties are infected with hookworm, and related intestinal infections.
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Hookworm2Amy Badham, director of Service Learning and Undergraduate Research at UAB, David Kimberlin, M.D., co-director of the Division of Pediatric Infectious Diseases at UAB, Claudette Poole, M.D., pediatrician in infectious diseases at UAB. Whether or not hookworm and related intestinal parasites are present in parts of Alabama’s Black Belt is the focus of a new study led by the University of Alabama at Birmingham. The study, which is funded by the Centers for Disease Control and Prevention, will take place in Wilcox and Perry counties and has started participant recruitment.

Hookworm, an intestinal parasite of humans, was once widespread in the United States, particularly in the Southeast. According to the CDC, improvements in living conditions have greatly reduced hookworm infections. Today, it is most commonly found in warm, moist climates in developing nations in South America, South Asia and Southeast Asia.

However, due to environmental and wastewater disposal issues in areas of Alabama’s Black Belt, conditions are such to support the persistence of these infections.    

“Our interest in this project stems from local concerns about health issues in children related to inadequate infrastructure in some of Alabama’s rural communities,” said Claudette Poole, M.D., a pediatrician who specializes in infectious diseases at UAB and is the study’s lead researcher. “We believe that, through partnership, community leaders, the community itself and UAB, we can improve the lives of children in our state.”

Hookworm, one of the infections under investigation, is spread through eggs that are passed in the feces of an infected person. If sewage of infected persons contaminates the environment, other persons who come in contact with the contaminated environment can become infected. These infections are indicators of inadequate sewage disposal and, if left untreated, may lead to ill health.

To find out whether children are infected with hookworm or other related intestinal parasites, the researchers have hired local community health care workers to collect stool samples from children in each county. The samples will then be delivered to J. Paul Jones Hospital, a partnering hospital of UAB, in Camden, Alabama, where they will be processed and then sent to the CDC and Georgia Institute of Technology for testing. It is there that a determination will be made whether hookworm or other intestinal parasites are indeed present.  

Community members have been integral to the inception, design and implementation of this study and as such are essential partners with UAB in this important work.  

“We have held focus groups with families in each county to talk to parents about how to collect the samples, to distribute the stool collection kits and to make sure they are comfortable with this process,” said Amy Badham, director of Service Learning and Undergraduate Research at UAB and one of the researchers. 

“Our partners here at UAB have worked closely for decades with the local communities that are part of this important project,” said David Kimberlin, M.D., co-director of the Division of Pediatric Infectious Diseases at UAB. “We are hopeful that this new investigation can continue to advance that important relationship.”

Researchers plan to collect three samples from each child. Families will receive a monetary reward for each collected sample. The first enrollment opportunity will be on Dec. 12 with Bama Kids, a not-for-profit organization in Camden, Alabama, focused on helping with holistic development of youth in Wilcox County.