Welch Vivian Andrea, Hossain Alomgir, Ghogomu Elizabeth, Riddle Alison, Cousens Simon, Gaffey Michelle, Arora Paul, Black Robert, Bundy Donald, Castro Mary Christine, Chen Li, Dewidar Omar, Elliott Alison, Friis Henrik, Hollingsworth T Déirdre, Horton Sue, King Charles H, Thi Huong Le, Liu Chengfang, Rohner Fabian, Rousham Emily K, Salam Rehana, Sartono Erliyani, Steinmann Peter, Supali Taniawati, Tugwell Peter, Webb Emily, Wieringa Franck, Winnichagoon Pattanee, Yazdanbakhsh Maria, Bhutta Zulfiqar A, Wells George A
Bruyère Research Institute, Ottawa, Ontario, Canada.
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
J Dev Effect. 2019 Dec 6;11(3):288-306. doi: 10.1080/19439342.2019.1691627. eCollection 2019.
Intestinal parasites affect millions of children globally. We aimed to assess effects of deworming children on nutritional and cognitive outcomes across potential effect modifiers using individual participant data (IPD). We searched multiple databases to 27 March 2018, grey literature, and other sources. We included randomised and quasi randomised trials of deworming compared to placebo or other nutritional interventions with data on baseline infection. We used a random-effects network meta-analysis with IPD and assessed overall quality, following a pre-specified protocol. We received IPD from 19 trials of STH deworming. Overall risk of bias was low. There were no statistically significant subgroup effects across age, sex, nutritional status or infection intensity for each type of STH. These analyses showed that children with moderate or heavy intensity infections, deworming for STH may increase weight gain (very low certainty). The added value of this review is an exploration of effects on growth and cognition in children with moderate to heavy infections as well as replicating prior systematic review results of small effects at the population level. Policy implications are that complementary public health strategies need to be assessed and considered to achieve growth and cognition benefits for children in helminth endemic areas.
肠道寄生虫影响着全球数百万儿童。我们旨在利用个体参与者数据（IPD），评估在潜在效应修饰因素中对儿童进行驱虫治疗对营养和认知结果的影响。我们检索了多个数据库直至2018年3月27日、灰色文献及其他来源。我们纳入了与安慰剂或其他营养干预措施相比的驱虫随机和半随机试验，并收集了基线感染数据。我们采用了带有IPD的随机效应网络荟萃分析，并按照预先指定的方案评估总体质量。我们从19项蛔虫驱虫试验中获得了IPD。总体偏倚风险较低。对于每种蛔虫，在年龄、性别、营养状况或感染强度方面均未发现具有统计学意义的亚组效应。这些分析表明，对于中度或重度感染的儿童，进行蛔虫驱虫治疗可能会增加体重增加（确定性极低）。本综述的附加价值在于探讨对中度至重度感染儿童生长和认知的影响，以及复制之前在人群水平上小效应的系统综述结果。政策层面的影响是，需要评估和考虑补充性公共卫生策略，以实现寄生虫流行地区儿童在生长和认知方面的益处。
