1. Commentary
The findings of this Cochrane systematic review may at first glance appear counter intuitive and invite controversy. However, when one focuses on the patterns that emerge, it becomes clear that the findings are consistent with biological expectations.
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2. What are the main findings of the review?
- 1.Deworming was beneficial when administered to children who were screened and found to have worm infestation as compared to no treatment.
- 2.Studies carried out in high endemic areas are expected to be more likely to show benefit following deworming than other regions; however, this was not observed in sub-group analyses in the review of trials conducted in high, moderate or low endemic areas.
- 3.More recent studies tended to show less benefits compared to earlier studies carried out in the same region.
3. What are the likely explanations for these findings?
It is well known that bulk of the health-related effects due to worm infestations depend on the worm loads. Indeed, when one screens children for worm infestation in an endemic area, one is separating those with higher worm loads from the rest. Similarly, there are likely to be more children with higher worm loads in high endemic areas. It seems very likely that if there has been a secular trend towards declining worm load in countries from where the data for this review emerged, then more recent studies will tend to show little or no benefit following mass deworming as compared to earlier studies.
4. Conclusions
This systematic review must compel health-planners in endemic areas to review their future course of action based on the current levels of infection and the anticipated benefits that may follow attempts to get rid of intestinal worms by deworming programmes.
Conflicts of interest
The author has none to declare.
Reference
- Does regular deworming of schoolchildren in areas endemic for intestinal worms improve their physical health and school performance? Summary of the evidence and implications for public health programmes.CEGH. 2013; 1: 25-29
Article Info
Publication History
Published online: February 13, 2013
Accepted:
January 29,
2013
Received:
January 26,
2013
Identification
Copyright
© 2013 INDIACLEN. Publishing Services by Reed Elsevier India Pvt Ltd. Published by Elsevier Inc. All rights reserved.
ScienceDirect
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- Does regular deworming of school children in areas endemic for intestinal worms improve their physical health and school performance? Summary of the evidence and implications for public health programmesClinical Epidemiology and Global HealthVol. 1Issue 1
- PreviewAn update of a Cochrane Review summarized the effects on nutritional indicators, haemoglobin, cognition, school attendance; and the impacts on school performance and mortality of deworming programmes for soil-transmitted intestinal worms in children from randomised, quasi-randomised, and cluster randomised trials. It included data from 41 trials that randomised 65,168 children (<17 years) in high, medium, and low helminths-endemic areas from 23 countries in Africa, China, South Asia, and South East Asia, to selective or targeted deworming (with mostly albendazole or mebendazole), or to placebo or no treatment.
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