THE CHANGING EPIDEMIOLOGY OF HUMAN HOOKWORM INFECTION IN AUSTRALIA

Objective: To document the distribution of human hookworm infection in Australia. Design: A retrospective study of published data and access ible archival records. Methods: The core data were derived from the re port of the Australian Hookworm Campaign, annual reports of various St ate health departments and the Queensland Institute of Medical Researc h, and unpublished files of the former Queensland Aboriginal Health Pr ogramme. Findings: Today, hookworm infection is endemic only among Abo riginal communities of northern Western Australia and the Northern Ter ritory, where Ancylostoma duodenale may be the sole species. Early thi s century, infection was also established in Queensland and northern N ew South Wales, in both Aboriginal and white communities, and Necator americanus predominated. The origin of these parasites is obscure. Sus tained control programs seem to have eradicated hookworms from Queensl and. Conclusions: Improved sanitation, hygiene and chemotherapy have e liminated hookworms from white populations of Australia. Continued ant helminthic campaigns will also clear the parasites from Aboriginal com munities, but unless living conditions improve significantly infection will recur.