The University of Arizona

Hookworm disease and its relationship to capitalism and urban development

Leo Couacaud

Abstract


The last one hundred years has seen a great deal of research on hookworm disease (Ankylostomiasis). But the literature is still characterized by a lack of consensus regarding the etiology of the disease and its patterns of transmission. Parasitologists still seem to disagree as to the perceived benefits of sanitation and footwear in reducing the incidence of infection. The relationship between urbanization and the decreasing incidence of infection, or alternatively the role of plantation work and human-manure-farming in the spread of hookworm disease, are still poorly understood or inadequately appreciated. This article proposes that behind most hookworm epidemics that have emerged in human history in the last one-hundred-to-two-hundred years, the constant factor has been density of population, not the type of occupation or agricultural work as has been proposed by some parasitologists. With the exception of human-manure-farming induced hookworm disease in China, which possibly dates back to ancient times and is transmitted by the use of human manure as a fertilizer, the outbreaks of hookworm disease that were documented in the mines of Europe and North America, the plantations of India and the Caribbean, and indigenous settlements in Australia at the turn of the twentieth century were due to changes promoted by capitalism and the concentration of larger numbers of people in confined areas that lacked appropriate sanitation. But as the article also shows, the decreasing incidence of hookworm infection in parts of the world where the disease was once rife seems to be related to increasing levels of urban development in these societies.

Key words: hookworm disease, defecation habits, population density, capitalist development, epidemics.


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DOI: http://dx.doi.org/10.2458/v21i1.21140