Detection of hookworm and hookworm-like larvae in human fecocultures in Suriname

Estimation of the prevalence of hookworm infection is usually based on finding eggs of the parasite in the stool. Eggs of the different hookworm species are difficult to distinguish and can be confused with those of hookworm-like species. Proper identification can be made after hatching the eggs and cultivating larvae to the infective stage. We have used the Harada-Mori method to study the stools of Bushnegroes in Suriname and have identified the emerged larvae. Of the 804 individuals examined, 53.6% had positive fecal cultures. The identification of emerged larvae revealed that 75% of the positive cultures contained Necator americanus and Strongyloides stercoralis was detected in 19.7%. Oesophagostomum and Ternidens species were also found. Ancylostoma duodenale larvae were not found. Six percent of fecal cultures in which larvae emerged contained only hookworm-like larvae hatching from eggs that resembled hookworm eggs. The diagnosis of hookworm infection, based solely on the microscopic detection of eggs in the stool, must be considered with special caution.