Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis

Welch, Vivian; Ghogomu, Elizabeth; Hossain, Alomgir; Awasthi, Sanjay; Bhutta, Zulfiqar A; Cumberbatch, Chisa; Fletcher, Robert H.; McGowan, Jessie; Krishnaratne, Shari; Kristjansson, Elizabeth; Sohani, Salim; Suresh, Shalini; Tugwell, Peter; White, Howard; Wells, George A.

doi:10.1016/s2214-109x(16)30242-x

Cited by 106 publications

(85 citation statements)

References 24 publications

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“…This is not true since reviews drawing on programme theory that collect evidence on outcomes along the causal chain can explain heterogeneity in findings -usually variation in quality of life outcomes due to differences in rates of programme adherence (for example, Welch et al 2017). However, analysis of the rest of the causal chain usually requires turning to evidence in studies which are often excluded from systematic reviews on the grounds of study design.…”

Section: Fostering Learning By Using Programme Theory and Telling A Gmentioning

confidence: 99%

What have we learned after ten years of systematic reviews in international development?

Waddington

Masset

Jiménez³

2018

Journal of Development Effectiveness

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Section: Fostering Learning By Using Programme Theory and Telling A Gmentioning

confidence: 99%

What have we learned after ten years of systematic reviews in international development?

Waddington

Masset

Jiménez³

2018

Journal of Development Effectiveness

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“…The National Deworming Day programme was initiated by the Indian government in February 2015 with the aim of deworming every child between 1 and 19 yr of age biannually and is one of the largest national public health programmes in the world31. While there has been considerable debate regarding the effectiveness of mass deworming programmes in the academic community323334, several studies conducted in India have suggested benefit.…”

Section: Recommended Control Strategiesmentioning

confidence: 99%

“…In this study, where undernourished pre-SAC (PSAC) were randomized to receive either tetramisole every four months or placebo, the prevalence of Ascaris decreased in the treatment group (although it was not eliminated) and the nutritional status of the children receiving treatment improved significantly at 8-12 months. In addition, there are several observational studies that have shown improvements in multiple outcomes including weight and haemoglobin levels in children in communities following deworming143234. However, treatment of infected individuals and subsequent resolution of infection do not prevent recurrence of infection.…”

Section: Recommended Control Strategiesmentioning

confidence: 99%

“…However, the largest clinical trial to date, the DEVTA trial, involving two million children4748, reported negligible weight gain following deworming. In addition, meta-analyses of multiple studies of deworming have failed to demonstrate consistent benefit of deworming on anthropometric and cognitive outcomes3234.…”

Section: Mass Drug Administration (Mda) Interventionsmentioning

confidence: 99%

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Intervention strategies to reduce the burden of soil-transmitted helminths in India

Abraham

Kaliappan

Walson

et al. 2018

Indian Journal of Medical Research

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Soil-transmitted helminth (STH) infections continue to be a major global cause of morbidity, with a large proportion of the burden of STH infections occurring in India. In addition to direct health impacts of these infections, including anaemia and nutritional deficiencies in children, these infections also significantly impact economic development, as a result of delays in early childhood cognitive development and future income earning potential. The current World Health Organization strategy for STH is focused on morbidity control through the application of mass drug administration to all pre-school-aged and school-aged children. In India, the control of STH-related morbidity requires mobilization of significant human and financial resources, placing additional burdens on limited public resources. Infected adults and untreated children in the community act as a reservoir of infection by which treated children get rapidly reinfected. As a result, deworming programmes will need to be sustained indefinitely in the absence of other strategies to reduce reinfection, including water, hygiene and sanitation interventions (WASH). However, WASH interventions require sustained effort by the government or other agencies to build infrastructure and to promote healthy behavioural modifications, and their effectiveness is often limited by deeply entrenched cultural norms and behaviours. Novel strategies must be explored to provide a lasting solution to the problem of STH infections in India other than the indefinite provision of deworming for morbidity control.

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“…Similarly, a systematic review found the evidence insufficient to link helminths to cognitive performance 16 and a further meta-analysis concluded that mass deworming of children had little or no effect on weight, height, cognition, school attendance or mortality. 17 …”

Section: How Much Do We Benefit From Mda?mentioning

confidence: 99%

A life without worms

Sanya

Nkurunungi

Andia-Biraro

et al. 2017

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Worms have co-evolved with humans over millions of years. To survive, they manipulate host systems by modulating immune responses so that they cause (in the majority of hosts) relatively subtle harm. Anthelminthic treatment has been promoted as a measure for averting worm specific pathology and to mitigate subtle morbidities which may include effects on anaemia, growth, cognitive function and economic activity. With our changing environment marked by rapid population growth, urbanisation, better hygiene practices and anthelminthic treatment, there has been a decline in worm infections and other infectious diseases and a rise in non-communicable diseases such as allergy, diabetes and cardiovascular disease. This review reflects upon our age-old interaction with worms, and the broader ramifications of life without worms for vaccine responses and susceptibility to other infections, and for allergy-related and metabolic disease. We touch upon the controversy around the benefits of mass drug administration for the more-subtle morbidities that have been associated with worm infections and then focus our attention on broader, additional aspects of life without worms, which may be either beneficial or detrimental.

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Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis

Abstract: Canadian Institutes of Health Research and WHO.

Cited by 106 publications

References 24 publications

What have we learned after ten years of systematic reviews in international development?

What have we learned after ten years of systematic reviews in international development?

Intervention strategies to reduce the burden of soil-transmitted helminths in India

A life without worms

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