How Much Human Helminthiasis Is There in the World?

Abstract

impact of Norman Stoll's presidential address to the American Society of Parasitologists in Boston at Christmas time in 1946 has been and continues to be immense. Since its publication in 1947, have any helminthologists not read it? Have any parasitology text books not cited it since then? Does any parasitology course today not refer students to it? Despite our expanding knowledge of DNA, molecular biology, and immunology and the application of mathematical techniques to our understanding of epidemiology and helminth population biology, Stoll's appraisal of the wormy world still excites and challenges our imaginations. A measure of the influence of Stoll's paper is the fact that we regularly use the title of This Wormy as we seek to draw attention to the global public health significance of human helminth infections. CRC Press reprinted the paper (renamed as The Wormy World) and supplied a commentary in each of a series of volumes dealing with zoonoses (CRC, 1982). World Health Organization used the same title for an issue of its official magazine (WHO, 1984) and recently Parasitology Today devoted an issue to revisiting the subject of This Wormy in which Bundy (1997a) explained why Stoll's paper has been supremely important in directing our approach to the study and management of human helminth infections and colleagues evaluated the current status of several major helminthiases. Only last year, Bundy and de Silva (1998) again wrote about this wormy world, this time with themes of optimism and encouragement over prospects for control. In this article, I have sought to place Stoll's evaluation of human helminthiasis in a contemporary setting. I have tried to address some of the questions he asked and to review aspects of current progress in the control of human helminthiasis. Most of all, I hope this paper will be seen as a tribute to Stoll's inspirational leadership and will serve as a reminder of our need to tackle what he saw as an unremittingly corrosive burden of disease.