Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta-analysis.
Journal
Campbell systematic reviews
ISSN: 1891-1803
Titre abrégé: Campbell Syst Rev
Pays: United States
ID NLM: 9918227275506676
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
medline:
20
11
2019
pubmed:
20
11
2019
entrez:
3
5
2023
Statut:
epublish
Résumé
Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. To use individual participant data network meta-analysis (NMA) to explore the effects of different types and frequency of deworming drugs on anaemia, cognition and growth across potential effect modifiers. We developed a search strategy with an information scientist to search MEDLINE, CINAHL, LILACS, Embase, the Cochrane Library, Econlit, Internet Documents in Economics Access Service (IDEAS), Public Affairs Information Service (PAIS), Social Services Abstracts, Global Health CABI and CAB Abstracts up to March 27, 2018. We also searched grey literature, websites, contacted authors and screened references of relevant systematic reviews. We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection. We conducted NMA with individual participant data (IPD), using a frequentist approach for random-effects NMA. The covariates were: age, sex, weight, height, haemoglobin and infection intensity. The effect estimate chosen was the mean difference for the continuous outcome of interest. We received data from 19 randomized controlled trials with 31,945 participants. Overall risk of bias was low. There were no statistically significant subgroup effects across any of the potential effect modifiers. However, analyses showed that there may be greater effects on weight for moderate to heavily infected children (very low certainty evidence). This analysis reinforces the case against mass deworming at a population-level, finding little effect on nutritional status or cognition. However, children with heavier intensity infections may benefit more. We urge the global community to adopt calls to make data available in open repositories to facilitate IPD analyses such as this, which aim to assess effects for the most vulnerable individuals.
Sections du résumé
Background
UNASSIGNED
Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide.
Objectives
UNASSIGNED
To use individual participant data network meta-analysis (NMA) to explore the effects of different types and frequency of deworming drugs on anaemia, cognition and growth across potential effect modifiers.
Search Methods
UNASSIGNED
We developed a search strategy with an information scientist to search MEDLINE, CINAHL, LILACS, Embase, the Cochrane Library, Econlit, Internet Documents in Economics Access Service (IDEAS), Public Affairs Information Service (PAIS), Social Services Abstracts, Global Health CABI and CAB Abstracts up to March 27, 2018. We also searched grey literature, websites, contacted authors and screened references of relevant systematic reviews.
Selection Criteria
UNASSIGNED
We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection.
Data Collection and Analysis
UNASSIGNED
We conducted NMA with individual participant data (IPD), using a frequentist approach for random-effects NMA. The covariates were: age, sex, weight, height, haemoglobin and infection intensity. The effect estimate chosen was the mean difference for the continuous outcome of interest.
Results
UNASSIGNED
We received data from 19 randomized controlled trials with 31,945 participants. Overall risk of bias was low. There were no statistically significant subgroup effects across any of the potential effect modifiers. However, analyses showed that there may be greater effects on weight for moderate to heavily infected children (very low certainty evidence).
Authors' Conclusions
UNASSIGNED
This analysis reinforces the case against mass deworming at a population-level, finding little effect on nutritional status or cognition. However, children with heavier intensity infections may benefit more. We urge the global community to adopt calls to make data available in open repositories to facilitate IPD analyses such as this, which aim to assess effects for the most vulnerable individuals.
Identifiants
pubmed: 37131850
doi: 10.1002/cl2.1058
pii: CL21058
pmc: PMC8356492
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e1058Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Informations de copyright
© 2019 The Authors. Campbell Systematic Reviews published by John Wiley & Sons Ltd on behalf of The Campbell Collaboration.
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