Background The disease burden of hookworm is disproportionately borne by tropical and sub-tropical regions because hookworm thrives in warm surroundings with moist soil. Climate change will alter the ecological strength of transmission, affecting the spatial extent and intensity of hookworm burden.
Methods This paper explains the relationship between hookworm transmission strength and geographic factors, and constructs a global hookworm ecological index (HEI) at a 0·5-degree spatial resolution. We test the HEI against spatial variation in hookworm prevalence, and then use three climate models to estimate the change in the spatial extent of ecological suitability for hookworm. Finally, we estimate the impact of climate change on public health costs and human capital loss due to hookworm.
Results The models predict that East Asia, Latin America and the Middle East will experience increases in hookworm prevalence while South Asia and Sub-Saharan Africa will experience decreases. Our estimates suggest that if climate change occurred now, public health costs to avert DALYs from hookworm would rise by $680 million, 72-268 thousand fewer children would enroll in school, up to 165 thousand fewer children would attain literacy, and incomes would decrease for people across much of the developing world.
Conclusion This paper represents the first assessment of the global effect of climate change on the population at risk and economic burden of hookworm infections.