The disease is caused by two main hookworms: Ancylostoma duodenale and Necator americanus. These are helminth parasites adapted to survive in the human intestine and feed on host blood.

Transmission
Infection occurs when infective larvae in contaminated soil penetrate the skin, usually through bare feet. This is common in areas with poor sanitation and where human feces contaminate the environment.

Life cycle
The larvae enter through the skin, migrate into the bloodstream, reach the lungs, move up the respiratory tract, are swallowed, and finally reach the small intestine where they mature into adult worms.

Pathogenesis
Adult worms attach to the intestinal mucosa and feed on blood. This causes intestinal damage, chronic blood loss, iron deficiency, and malnutrition.

Symptoms

Common signs include fatigue, weakness, pale skin, abdominal pain, diarrhea, weight loss, and growth retardation in children. Severe cases may lead to mental and physical developmental delay.

Diagnosis
Diagnosis is mainly based on stool examination to detect parasite eggs under the microscope. Blood tests may also reveal anemia and low iron levels.

Treatment
Treatment includes anthelmintic drugs such as albendazole or mebendazole. Iron supplements are often given to correct anemia.

Prevention
Prevention includes wearing shoes, improving sanitation, proper disposal of human waste, avoiding open defecation, and regular deworming campaigns in endemic areas.