Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis
Abstract Background Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. Objectives 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...
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Wiley
2019-12-01
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Series: | Campbell Systematic Reviews |
Online Access: | https://doi.org/10.1002/cl2.1058 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vivian A. Welch Elizabeth Ghogomu Alomgir Hossain Alison Riddle Michelle Gaffey Paul Arora Omar Dewidar Rehana Salam Simon Cousens Robert Black T. Déirdre Hollingsworth Sue Horton Peter Tugwell Donald Bundy Mary Christine Castro Alison Elliott Henrik Friis Huong T. Le Chengfang Liu Emily K. Rousham Fabian Rohner Charles King Erliyani Sartono Taniawati Supali Peter Steinmann Emily Webb Franck Wieringa Pattanee Winnichagoon Maria Yazdanbakhsh Zulfiqar A. Bhutta George Wells |
spellingShingle |
Vivian A. Welch Elizabeth Ghogomu Alomgir Hossain Alison Riddle Michelle Gaffey Paul Arora Omar Dewidar Rehana Salam Simon Cousens Robert Black T. Déirdre Hollingsworth Sue Horton Peter Tugwell Donald Bundy Mary Christine Castro Alison Elliott Henrik Friis Huong T. Le Chengfang Liu Emily K. Rousham Fabian Rohner Charles King Erliyani Sartono Taniawati Supali Peter Steinmann Emily Webb Franck Wieringa Pattanee Winnichagoon Maria Yazdanbakhsh Zulfiqar A. Bhutta George Wells Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis Campbell Systematic Reviews |
author_facet |
Vivian A. Welch Elizabeth Ghogomu Alomgir Hossain Alison Riddle Michelle Gaffey Paul Arora Omar Dewidar Rehana Salam Simon Cousens Robert Black T. Déirdre Hollingsworth Sue Horton Peter Tugwell Donald Bundy Mary Christine Castro Alison Elliott Henrik Friis Huong T. Le Chengfang Liu Emily K. Rousham Fabian Rohner Charles King Erliyani Sartono Taniawati Supali Peter Steinmann Emily Webb Franck Wieringa Pattanee Winnichagoon Maria Yazdanbakhsh Zulfiqar A. Bhutta George Wells |
author_sort |
Vivian A. Welch |
title |
Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis |
title_short |
Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis |
title_full |
Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis |
title_fullStr |
Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis |
title_full_unstemmed |
Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis |
title_sort |
mass deworming for improving health and cognition of children in endemic helminth areas: a systematic review and individual participant data network meta‐analysis |
publisher |
Wiley |
series |
Campbell Systematic Reviews |
issn |
1891-1803 |
publishDate |
2019-12-01 |
description |
Abstract Background Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. Objectives 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 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 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 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 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 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. |
url |
https://doi.org/10.1002/cl2.1058 |
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doaj-988f1458f6a047bea086cb7d4996aa262020-11-25T02:36:23ZengWileyCampbell Systematic Reviews1891-18032019-12-01154n/an/a10.1002/cl2.1058Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysisVivian A. Welch0Elizabeth Ghogomu1Alomgir Hossain2Alison Riddle3Michelle Gaffey4Paul Arora5Omar Dewidar6Rehana Salam7Simon Cousens8Robert Black9T. Déirdre Hollingsworth10Sue Horton11Peter Tugwell12Donald Bundy13Mary Christine Castro14Alison Elliott15Henrik Friis16Huong T. Le17Chengfang Liu18Emily K. Rousham19Fabian Rohner20Charles King21Erliyani Sartono22Taniawati Supali23Peter Steinmann24Emily Webb25Franck Wieringa26Pattanee Winnichagoon27Maria Yazdanbakhsh28Zulfiqar A. Bhutta29George Wells30Centre for Global Health Bruyère Research Institute Ottawa Ontario CanadaBruyère Research Institute University of Ottawa Ottawa Ontario CanadaCardiovascular Research Methods University of Ottawa Heart Institute Ottawa Ontario CanadaSchool of Epidemiology Public Health and Preventive Medicine, University of Ottawa Ottawa Ontario CanadaHospital for Sick Children University of Toronto Toronto Ontario CanadaPublic Health Agency of Canada in the National Public Health Laboratory and Dalla Lana School of Public Health University of Toronto Toronto Ontario CanadaBruyère Research Institute University of Ottawa Ottawa Ontario CanadaSouth Australian Health and Medical Research Institute University of Adelaide Adelaide AustraliaLondon School of Hygiene and Tropical Medicine (LSHTM) London UKDepartment of International Health Johns Hopkins School of Hygiene and Public Health Baltimore MarylandBig Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine University of Oxford Oxford UKSchool of Public Health and Health Systems University of Waterloo Waterloo Ontario CanadaSchool of Epidemiology Public Health and Preventive Medicine, University of Ottawa Ottawa Ontario CanadaBill & Melinda Gates Foundation London UKNutrition Center of the Philippines Manila PhilippinesMedical Research Council/Uganda Virus Research Institute London School of Hygiene and Tropical Medicine Uganda Research Unit Entebbe UgandaDepartment of Human Nutrition University of Copenhagen Frederiksberg DenmarkInstitute for Preventive Medicine and Public Health Hanoi Medical University Hanoi VietnamSchool of Advanced Agricultural Sciences (SAAS) China Center for Agricultural Policy (CCAP), Peking University Beijing ChinaSchool of Sport, Exercise and Health Sciences Loughborough University Leicestershire UKGroundWork Fläsch SwitzerlandDepartment of Pediatrics University of California La Jolla CaliforniaDepartment of Parasitology Leiden University Medical Center Leiden The NetherlandsDepartment Parasitology, Faculty of Medicine Universitas Indonesia Jakarta IndonesiaSwiss Tropical and Public Health Institute University of Basel Basel SwitzerlandDepartment of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UKUMR204 Nutripass Institute de Recherche pour le Développement Montpellier FranceCommunity/International Nutrition, Institute of Nutrition Mahidol University Nakhon Pathom ThailandDepartment of Parasitology Leiden University Medical Center Leiden The NetherlandsCentre for Global Child Health, The Hospital for Sick Children, Center of Excellence in Women and Child Health Aga Khan University Karachi PakistanCardiovascular Research Methods University of Ottawa Heart Institute Ottawa Ontario CanadaAbstract Background Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. Objectives 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 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 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 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 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 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.https://doi.org/10.1002/cl2.1058 |