Emerging patterns of hookworm infection:: Influence of aging on the intensity of Necator infection in Hainan Province, People's Republic of China

We examined risk factors associated with Necator americanus infection among persons aged greater than or equal to50 years in Hainan Province, People's Republic of China. Age and sex made the most important contributions to the variation in infection intensity (28%-30%), with age alone responsible for 27% of this variation. When stratified by 20-year age intervals, the influence of shared residence was 23% for persons aged greater than or equal to50 years and 27% for those aged <20 years, who had the highest and lowest levels of infection intensity, respectively. This points to shared residence as a means of capturing the complex relationship between aging and shared socioeconomic, environmental, and behavioral factors that influence transmission of Necator infection. None of the other 26 personal or 32 household risk factors were found to be significant. The importance of aging in Necator infection reveals an emerging public health problem among the elderly population of developing countries.