Thayer Winter Maxwell, Clermont Adrienne, Walker Neff
Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
BMC Public Health. 2017 Nov 7;17(Suppl 4):830. doi: 10.1186/s12889-017-4747-0.
Soil-transmitted helminth infections are widespread. Many studies have been published on the topic of deworming. The Lives Saved Tool (LiST) is a software package that uses a deterministic mathematical model to estimate the effect of scaling up interventions on maternal and child health outcomes. This review investigates the scope of available evidence for benefits of deworming treatments in order to inform a decision about possible inclusion of deworming as an intervention in LiST.
We searched PubMed, the Cochrane Library, and Google Scholar. We included studies that reported pre/post data in children younger than 5 years or pregnant women for outcomes related to mortality and growth. We excluded studies that compared different anthelminthic treatments but did not include a placebo or non-treatment group, and those that did not report post-intervention outcomes. We categorized articles by treated population (children younger than 5 years and pregnant women), experimental versus observational, mass drug administration (MDA) versus treatment, and reported outcome.
We identified 58 relevant trials; 27 investigated children younger than 5 years and 11 investigated pregnant women; one reported on both children younger than 5 years and pregnant women. We conducted meta-analyses of relevant outcomes in children younger than 5 years.
Deworming did not show consistent benefits for indicators of mortality, anemia, or growth in children younger than five or women of reproductive age. We do not recommend including the effect of deworming in the LiST model.
土壤传播的蠕虫感染十分普遍。关于驱虫这一主题已发表了许多研究。挽救生命工具(LiST)是一个软件包,它使用确定性数学模型来估计扩大干预措施对孕产妇和儿童健康结果的影响。本综述调查了驱虫治疗益处的现有证据范围,以便就是否可能将驱虫作为一种干预措施纳入LiST做出决策。
我们检索了PubMed、考克兰图书馆和谷歌学术。我们纳入了报告5岁以下儿童或孕妇与死亡率和生长相关结局的前后数据的研究。我们排除了比较不同驱虫治疗但未设安慰剂或未治疗组的研究,以及未报告干预后结局的研究。我们根据治疗人群(5岁以下儿童和孕妇)以及实验性与观察性、群体药物管理(MDA)与治疗以及报告的结局对文章进行分类。
我们确定了58项相关试验;27项研究5岁以下儿童,11项研究孕妇;1项报告了5岁以下儿童和孕妇的情况。我们对5岁以下儿童的相关结局进行了荟萃分析。
驱虫对于5岁以下儿童或育龄妇女的死亡率、贫血或生长指标并未显示出一致的益处。我们不建议将驱虫效果纳入LiST模型。