Yale prides itself as a global university whose research has an impact far beyond the boundaries of its New Haven campus. A recent study conducted by Yale professors 6,000 miles away in the Democratic Republic of Congo is testament to that global reach.

The study, released April 2 in the American Journal of Tropical Medicine and Hygiene, found that deworming medicine helped alleviate the strain that hookworm, an intestinal parasite, places on Congolese farming women. 

“It’s one of the first studies on the record to demonstrate the potential for deworming treatment to translate into a benefit that could improve agricultural production among small-scale women farmers,” said co-author Michael Cappello, professor of pediatrics and chair of the Council on African Studies at Yale, who co-authored the study.

The goal of the research was to determine whether the treatment of small-scale women farmers in Congo with deworming medicine would improve their work capacity, Capello said. And in the end, she said, the deworming medicine did help: Capello said participants in the study showed “significant improvement in their physical endurance.”

Hookworm infections are among the most neglected tropical diseases that affect public health in the developing world, said Serap Aksoy, a professor of epidemiology at the School of Public Health who was not involved in the study.

“This pilot trial is significant in that it paves the way for future considerations of expanding the mass drug treatment campaigns,” she said.

Cappello and his lab used their knowledge of hookworm and its treatment to help design the study. Three hundred Congolese women participated as subjects, half of whom received a deworming medicine. The other half received a placebo, a pill that contains no medicine.

“The participants were very interested and engaged in the process,” said Christian Salmon, a professor at Western New England University. Along with his sister, Margaret, Salmon conducted the study’s field research in Congo. He added that out of the first 300 women he invited to participate in the study, none rejected the offer.

Compared to the placebo group, the women who took the deworming medicine showed greater physical improvement over a period of seven months.

The rationale behind the fitness test was that hookworm often lowers endurance levels.

“We’ve known for many years that hookworm causes chronic anemia, and chronic anemia can impair one’s ability to exercise and impairs endurance,” Cappello said.

The study demonstrated a lasting impact due to treatment, Salmon said. The women received only one dose of the deworming medicine, he said, and their fitness improved noticeably even seven months after treatment.

Salmon commended the skill of the Congolese doctors with whom he partnered.

“The local, technical skill of the doctors is excellent,” he said. “What they lack are the resources.”

Capello emphasized that the study took place in the Congo, one of the most conflict-ridden regions in the world. In addition, he said, researchers targeted farming women, among the most vulnerable and neglected communities in the world.

“We should be trying to carry out the work that would benefit the poorest and most vulnerable people whenever we can,” he said.

Still, both Cappello and Salmon emphasized that the project was a pilot trial — meaning only a small number of subjects participated. The study was intentionally small, since it was designed to test the feasibility of a broader endeavor.

“It is very important that these results be validated in a larger trial and also in other areas of the world,” Capello said.

Salmon suggested  that future research should focus on genetic hookworm resistance. The Congolese women demonstrated a relatively low level of infestation before receiving the medicine, a possible indication of resistance in the women tested. He speculated that this “low burden” may be the result of either easy access to the drug supply or the low quality of available treatments.

The Centers for Disease Control and Prevention estimates that up to 740 million people in the world are infected with hookworm.

Jessica Pevner | jessica.pevner@yale.edu