Empowering Women and Improving Female Reproductive Health through Control of Neglected Tropical Diseases

om the World Health Organization (WHO) concluded that a woman living in a developing country is practically always on the verge of iron deficiency anemia either because of pregnancy, which requires the transfer of 300 mg of iron to the fetus during the third trimester and an additional 500 mg of iron to accommodate an increase in red blood cell mass, or lactation, in which each episode transfers 0.75 mg of iron from mother to child. Moreover, even before she becomes pregnant, a woman of childbearing age suffers substantial iron losses from menstruation. Anemia, defined as a reduction in hemoglobin to <11 g/dl in the first and third trimester and <10.5 g/dl in the second trimester, creates a dangerous state of health for both mother and child [4]. It is estimated that 20% of maternal deaths in Africa are attributed to anemia, while simultaneously anemia represents a key risk factor for poor pregnancy outcome and low birth weight. It now appears that human hookworm infection, one of the most common NTDs affecting 576–740 million people in developing countries, considerably adds to the iron loss and anemia that occurs during pregnancy. An estimated 44 million pregnant women are infected with hookworm at any one time, including up to one-third of all pregnant women in sub-Saharan Africa. In Africa and Latin America, hookworm is a major contributor to anemia in pregnancy, while in Nepal and presumably elsewhere in Asia hookworm is responsible for 54% of cases of moderate to severe anemia during pregnancy. Not surprisingly, deworming during pregnancy has major beneficial effects in terms of reduced maternal morbidity and mortality, as well as improved perinatal outcome, and most likely leads to a reduction in maternal anemia. Such studies have led to calls for including deworming in antenatal packages in hookworm-endemic areas in developing countries.

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