A second

experimental infection study involving two well-fed healthy volunteers in Australia ( Carroll and Grove, 1986) reported similar severe abdominal pain 5 weeks after infection with associated diarrhoea in one case; Carroll and Grove (1986) were also able to demonstrate recurrent bouts of abdominal disturbance over several months. A. ceylanicum is the most neglected of all human hookworm species, typically considered to be an unimportant pathogen ( Chowdhury and Schad, 1972, Brooker et al., 2004 and Hotez et al., 2004) due to an absence of demonstrated heavy infections and subsequent anaemia ( Brooker et al., 2004). A. ceylanicum is described as a Anti-cancer Compound Library mouse poorly adapted human hookworm ( Chowdhury and Schad, 1972) and ill-suited to the human gastrointestinal tract, resulting in patent infections with low fecundity. The evidence for clinical insignificance however comes from experimental studies involving healthy well-fed adults ( Wijers and Smit, 1966 and Carroll and Grove, 1986) and urban inhabitants ( Kian Joe and Kok Siang, 1959 and Chowdhury

and Schad, 1972). The clinically significant findings from West New Guinea ( Anten and Zuidema, 1964), with vastly different environmental exposures, has been largely overlooked for 45 years. In addition, the non-blood loss symptoms associated with A. ceylanicum infection, including cognitive impairment from light infections ( Wijers and Smit, 1966), rarely receive a mention. C59 wnt Furthermore, there is a distinct similarity between acute clinical presentation caused by A. ceylanicum, including severe abdominal pain ( Wijers and Smit, 1966, Carroll and Grove, 1986 and Traub et al., 2008) and recurrent abdominal disturbance ( Carroll and Grove, 1986), and eosinophilic enteritis caused by A. caninum else that is indicative of intestinal hypersensitivity ( Prociv and Croese, 1996). Three

community surveys in SE Asia in the past 45 years report hookworm to the species level and A. ceylanicum is prevalent, to varying degrees in all studies ( Traub et al., 2008 and Sato et al., 2010) (Conlan et al., In preparation). In a recent study in northern Laos, 46% of the human survey population from 24 villages were found to have hookworm infections and a randomly selected subset of samples showed that up to one third of infections were A. ceylanicum and two thirds N. americanus (Conlan et al., in preparation). Furthermore, almost all village dogs in northern Laos had hookworm infection and molecular analysis of a subset of samples detected A. ceylanicum in 85% of infected dogs; A. caninum, A. braziliense and N. americanus eggs were also detected in Lao village dogs (Conlan et al., in preparation). Hookworm ecology in southern Laos may be different from the north, where A.