Emerging evidence over the past decade has implicated helminth infections as important yet stealth causes of adverse pregnancy outcomes and impaired women's reproductive health. The two most important helminth infections affecting women living in poverty in Africa and elsewhere in the developing world are hookworm infection and schistosomiasis. In Africa alone, almost 40 million women of childbearing age are infected with hookworms, including almost 7 million pregnant women who are at greater risk of severe anemia, higher mortality, and experiencing poor neonatal outcome (reduced birth weight and increased infant mortality). Possibly, tens of millions of women in Africa also suffer from female genital schistosomiasis associated with genital itching and pain, stress incontinence, dyspareunia, and infertility and experience social stigma and depression. Female genital schistosomiasis also is linked to horizontal transmission of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and it may represent one of Africa's major cofactors in its AIDS epidemic. There is urgency to expand mass drug administration efforts for hookworm and schistosomiasis to include women of reproductive age and to shape new policies and advocacy initiatives for women's global health to include helminth control. In parallel is a requirement to better link global health programs for HIV and AIDS and malaria with helminth control and to simultaneously launch initiatives for research and development.
Emerging evidence over the past decade has implicated helminth infections as important yet stealthy causes of adverse pregnancy outcomes and impaired women's reproductive health.
Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine at Baylor College of Medicine, and the Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, Texas; and Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Corresponding author: Peter Hotez, MD, PhD, Baylor College of Medicine, National School of Tropical Medicine, 1 Baylor Plaza, MS 113, Houston, TX 77030; e-mail: firstname.lastname@example.org.
Peter Hotez received support to develop vaccines for helminth infections from the Bill & Melinda Gates Foundation, Dutch Ministry of Foreign Affairs, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Blavatnik Family Foundation, Dr. Gary Michelson, Mort and Chris Hyman, and Texas Children's Hospital.
Financial Disclosure The authors did not report any potential conflicts of interest.