Vivian Welch|Elizabeth Ghogomu|Alomgir Hossain|Sanjay Awasthi|Zulfiqar A. Bhutta|Chisa Cumberbatch|Robert H. Fletcher|Jessie McGowan|Shari Krishnaratne|Elizabeth Kristjansson|Salim Sohani|Shalini Suresh|Peter Tugwell|Howard White|George A. Wells
Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis
University of Ottawa|Bruyère|Bruyère|University of Ottawa|King George's Medical University|Aga Khan University|University of Toronto|Hospital for Sick Children|SickKids Foundation|Public Health Ontario|Harvard Pilgrim Health Care|Harvard University|University of Ottawa|London School of Hygiene & Tropical Medicine|University of Ottawa|Canadian Red Cross Society|Bruyère|University of Ottawa|Bruyère|Campbell Collaboration|University of Ottawa
soiltransmitted helminthiasis schistosomiasis considered among neglected tropical diseases affect third worlds population varying intensity infection aimed evaluate effects mass deworming soiltransmitted helminths without deworming schistosomiasis cointerventions growth educational achievement cognition school attendance quality life adverse effects children endemic helminth areaswe searched 11 databases jan 14 2016 websites trial registers contacted authors reviewed reference lists included studies published language children aged 6 months 16 years mass deworming soiltransmitted helminths schistosomiasis alone combination interventions 4 months longer reported primary outcomes interest included randomised quasirandomised trials controlled beforeafter studies interrupted time series quasiexperimental studies screened duplicate extracted data appraised risk bias duplicate pretested form conducted randomeffects metaanalysis bayesian network metaanalysiswe included 52 studies duration 5 years less 1 108 541 children four longterm studies 810 years mass deworming programmes 160 000 children overall risk bias moderate mass deworming soiltransmitted helminths compared controls led little improvement weight period 12 months 099 kg 95 credible interval cri 009 028 moderate certainty evidence height 007 cm 95 cri 010 024 moderate certainty evidence little difference proportion stunted eight fewer per 1000 children 95 cri 48 32 high certainty evidence cognition measured shortterm attention 023 points 100 point scale 95 ci 056 014 high certainty evidence school attendance 1 higher 95 ci 1 3 high certainty evidence mortality one fewer per 1000 children 95 ci 3 1 high certainty evidence found data quality life little evidence adverse effects mass deworming schistosomiasis might slightly increase weight 041 kg 95 cri 020 091 little effect height low certainty evidence cognition moderate certainty evidence analyses suggest indirect benefits untreated children exposed treated children community uncertain effects longterm economic productivity hours worked cognition literacy school enrolment owing low certainty evidence results consistent across sensitivity subgroup analyses age worm prevalence baseline nutritional status infection status impact worms infection intensity types worms ascaris hookworm trichuris risk bias cluster versus individual trials compliance attritionmass deworming soiltransmitted helminths without deworming schistosomiasis little effect schistosomiasis mass deworming might effective weight probably ineffective height cognition attendance future research assess subset children benefit mass deworming using individual participant data metaanalysiscanadian institutes health research