Deworming drugs for treating soil-transmitted intestinal worms in children: effects on growth and school performance.

Taylor-Robinson, DC ORCID: 0000-0002-5828-7724, Jones, AP and Garner, P ORCID: 0000-0002-0607-6941 (2007) Deworming drugs for treating soil-transmitted intestinal worms in children: effects on growth and school performance. The Cochrane database of systematic reviews (4). CD000371-.

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Abstract

<h4>Background</h4>In areas where intestinal worm infections occur, the World Health Organization recommends treating all school children at regular intervals with deworming drugs to improve growth and school performance. The evidence base for this policy needs to be established for countries to commit resources to implement these programmes.<h4>Objectives</h4>To summarize the effects of deworming drugs used to treat soil-transmitted intestinal worms (nematode geohelminths) on growth and school performance in children.<h4>Search strategy</h4>In May 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 2), MEDLINE, EMBASE, LILACS, mRCT, and reference lists.<h4>Selection criteria</h4>Randomized and quasi-randomized controlled trials (RCTs) comparing deworming drugs for geohelminth worms with placebo or no treatment in children aged 16 years or less, reporting on growth, nutritional status, school performance, or cognition tests.<h4>Data collection and analysis</h4>Two authors independently assessed the trials and evaluated methodological quality; one author extracted data, and another checked a sample. Continuous data were analysed using the weighted mean difference (WMD) with 95% confidence intervals (CI). The random-effects model (RE model) was used in the presence of statistically significant heterogeneity.<h4>Main results</h4>Thirty-four RCTs, including six cluster-RCTs, met the inclusion criteria. Four trials had adequate allocation concealment, and three cluster-RCTs failed to take design effects into account in their analysis. Weight increased after one dose of a deworming drug (WMD 0.34 kg, 95% CI 0.05 to 0.64, RE model; 2448 children, 9 trials); however, there was considerable heterogeneity between trials that was not explained by background intestinal worm infection or intensity. A meta-analysis of multiple dose trials reporting on outcomes within a year of starting treatment showed no significant difference in weight gain (1714 children, 6 trials); however, one cluster-RCT did show effects on weight at one year in a subgroup analysis. In the seven multiple dose trials with follow up beyond 12 months, only one showed a significant increase in weight. Six of seven trials reported clear data on cognitive tests and school performance: five reported no significant effects, and one showed some improvements in three out of 10 cognitive tests.<h4>Authors' conclusions</h4>Deworming drugs used in targeted community programmes may be effective in relation to weight gain in some circumstances but not in others. No effect on cognition or school performance has been demonstrated.

Item Type:	Article
Additional Information:	This version first published online: 17th October 2007 in Issue 4, 2007. Full-text for this item only available by clicking on the doi link provided or accessing it from the Cochrane Database of Systematic Reviews website http://www.thecochranelibrary.com. As the Cochrane Reviews are regularly updated as new evidence emergences and in response to feedback, the Cochrane Database of Systematic Reviews should be consulted for the most recent version. The bibliographic information provided in the metadata is for the original electronic version prior to any revision. The item should be cited as : This record should be cited as: Taylor-Robinson DC, Jones AP, Garner P. Deworming drugs for treating soil-transmitted intestinal worms in children: effects on growth and school performance. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000371. DOI: 10.1002/14651858.CD000371.pub3.
Uncontrolled Keywords:	Humans, Helminthiasis, Intestinal Diseases, Parasitic, Weight Gain, Anthelmintics, Child Development, Cognition, Nutritional Status, Growth, Adolescent, Child, Child, Preschool, Randomized Controlled Trials as Topic
Subjects:	?? RA0421 ??
Divisions:	Faculty of Health and Life Sciences
Depositing User:	Symplectic Admin
Date Deposited:	14 Aug 2008 11:37
Last Modified:	17 Dec 2022 00:50
DOI:	10.1002/14651858.cd000371.pub3
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/734