# Molecular identification of hookworm infection in humans, dogs and cats in Lao People’s Democratic Republic

## TL;DR

This study identifies hookworm species in humans, dogs, and cats in Laos, showing high infection rates and the need for combined human and animal control strategies.

## Contribution

The study provides the first molecular identification of hookworm species in humans and animals in Laos, revealing interspecies transmission risks.

## Key findings

- Hookworm infection prevalence was 24.1% in humans and 76.1% in dogs and cats combined, with higher rates in the southern region.
- Necator americanus was the most common species in humans, while Ancylostoma caninum and N. americanus were prevalent in dogs and cats.
- The study highlights the need for integrated One Health strategies to control zoonotic hookworm infections.

## Abstract

Hookworm infection remains a major public health concern in the Lao People’s Democratic Republic (Lao PDR), where it is endemic nationwide and particularly prevalent in remote communities. However, information regarding species-specific identification is limited. This study aimed to determine the prevalence of hookworm infection and identify the infecting species among humans, dogs, and cats in both northern and southern regions of the Lao PDR.

A cross-sectional study was conducted between May and July 2023 in Luangprabang Province (northern Lao PDR) and Champasak Province (southern Lao PDR). All residents aged 18 years and older who were present during the survey period and met the inclusion criteria were enrolled. In addition, dogs and cats owned by enrolled participants and/or their household members were included. Hookworm infection was detected by identifying eggs in preserved stool samples using the formalin-ethyl acetate concentration technique (FECT). Species identification was performed using polymerase chain reaction (PCR) targeting the internal transcribed spacer (ITS) region to amplify Necator americanus (485 bp) and Ancylostoma spp. (380 bp), followed by sequencing analysis of stool samples preserved in 70% ethanol. Descriptive statistics summarized hookworm prevalence in humans, dogs, and cats. Chi-square, Wilcoxon rank-sum, and Kruskal–Wallis tests compared rates and means, with significance defined as P < 0.05.

A total of 382 human participants, along with 37 dogs and 9 cats, completed all study procedures and were included in the analysis. Examination of preserved stool samples using FECT detected hookworm infection in 24.1% of humans (southern region: 36.6%; northern region: 11.8%) and in 76.1% of dogs and cats combined, with the highest prevalence observed in the southern region (92.6%). Molecular analysis identified N. americanus as the predominant species in humans (64.6%), followed by A. ceylanicum (20.5%). Among dogs and cats, N. americanus and A. caninum were each detected in 39.1% of samples, while A. ceylanicum accounted for 13.0%.

This study demonstrates a high prevalence of zoonotic hookworm infections in humans, dogs, and cats, highlighting the potential for interspecies transmission that complicates current prevention and control measures. Implementation of integrated control strategies—such as the One Health approach—that simultaneously address human and animal reservoirs is essential for achieving effective and sustainable hookworm control in the Lao PDR.

The online version contains supplementary material available at 10.1186/s40249-025-01403-8.