We appreciate the comments from Mr. Hastings and colleagues and their important reminder on the links between poverty and helminth infections among girls and women. Indeed, Dr. Hotez has written a book titled For-gotten People, Forgotten Diseased that explores in-depth the link between poverty and neglected tropical diseases such as hookworm infection and schistosomiasis. A key observation is that helminth infections both occur in the setting of poverty and reinforce poverty because of their long-term effects on child growth and development, agricultural productivity, and pregnancy outcome. We have even turned our global health lens inward on the southern United States to reveal a hidden burden of neglected tropical diseases among the poor, including now several million Americans living on less than $2.00 per day.
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