Welch Vivian A, Ghogomu Elizabeth, Hossain Alomgir, Riddle Alison, Gaffey Michelle, Arora Paul, Dewidar Omar, Salam Rehana, Cousens Simon, Black Robert, Hollingsworth T Déirdre, Horton Sue, Tugwell Peter, Bundy Donald, Castro Mary Christine, Elliott Alison, Friis Henrik, Le Huong T, Liu Chengfang, Rousham Emily K, Rohner Fabian, King Charles, Sartono Erliyani, Supali Taniawati, Steinmann Peter, Webb Emily, Wieringa Franck, Winnichagoon Pattanee, Yazdanbakhsh Maria, Bhutta Zulfiqar A, Wells George
Centre for Global Health Bruyère Research Institute Ottawa Ontario Canada.
School of Epidemiology Public Health and Preventive Medicine, University of Ottawa Ottawa Ontario Canada.
Campbell Syst Rev. 2019 Nov 20;15(4):e1058. doi: 10.1002/cl2.1058. eCollection 2019 Dec.
Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide.
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.
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.
We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection.
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.
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.
土壤传播（或肠道）蠕虫和血吸虫影响着全球数百万儿童。
利用个体参与者数据网络荟萃分析（NMA），探讨不同类型和频率的驱虫药物对贫血、认知和生长的影响，涵盖潜在效应修饰因素。
我们与一位信息科学家共同制定了检索策略，检索截至2018年3月27日的MEDLINE、CINAHL、LILACS、Embase、Cochrane图书馆、Econlit、互联网经济文献访问服务（IDEAS）、公共事务信息服务（PAIS）、社会服务摘要、全球健康CABI和CAB摘要。我们还检索了灰色文献、网站，联系了作者并筛选了相关系统评价的参考文献。
我们纳入了儿童驱虫的随机和半随机试验，将其与安慰剂或其他干预措施进行比较，并提供基线感染数据。
我们使用个体参与者数据（IPD）进行NMA，采用频率学派方法进行随机效应NMA。协变量包括：年龄、性别、体重、身高、血红蛋白和感染强度。所选的效应估计值是感兴趣的连续结局的平均差异。
我们收到了来自19项随机对照试验的31945名参与者的数据。总体偏倚风险较低。在任何潜在效应修饰因素中均未发现具有统计学意义的亚组效应。然而，分析表明，对于中度至重度感染儿童，体重可能有更大影响（证据确定性极低）。
该分析强化了反对在人群层面进行大规模驱虫的观点，发现对营养状况或认知几乎没有影响。然而，感染程度较重的儿童可能受益更多。我们敦促全球社会响应呼吁，将数据存放在开放的存储库中，以促进此类IPD分析，这类分析旨在评估对最脆弱个体的影响。
