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A study published today by reveals that between a quarter and a third of pregnant women in sub-Saharan Africa, or almost 7 million, are infected with hookworms, putting them at risk of anaemia.

Hookworm infection is among the major causes of anaemia in poor countries but its importance in causing maternal anaemia is poorly understood, which has hampered effective lobbying for the inclusion of treatment with anthelmintics (drugs that treat parasitic worm infections) in maternal health packages.

Simon Brooker, a Reader in Tropical Epidemiology and Disease Control at the °®ÍþÄÌapp of Hygiene & Tropical Medicine, together with colleagues from the George Washington University and the World Bank, sought to review existing evidence on the role of hookworm as a risk factor for anaemia in pregnant women, and to estimate the number of hookworm infections in women sub-Saharan Africa.

By carrying out a search of medical databases, reference lists and unpublished data, the team was able to compare haemoglobin concentrations according to the intensity of hookworm infection among the women studied.

They estimated that 37.7 million women of reproductive age, and 6.9 million pregnant women in sub-Saharan Africa - between a quarter and a third of the total - were infected with hookworm in 2005, and were therefore at risk of anaemia.

"All the studies we identified showed a benefit of deworming for both maternal and child health," comments Simon Brooker, "but since a variety of outcome measures were used, quantitative evaluation was not possible. However, given the large numbers of pregnant women identified as being affected by hookworm, and therefore at risk of hookworm-related anaemia, which is easily treatable, further studies are warranted, and efforts should be made to increase coverage of anthelmintic treatment among pregnant women in sub-Saharan Africa."