Who is this summary for?
This evidence assessment is for Teachers, Doctors and Health Personel, Community Health Workers and stakeholders involved in the control of intestinal worms.
Key findings
- Treating children living in an endemic area, has little effect on average weight gain, haemoglobin, or cognition.
- Regular deworming treatment every three to six months may also have little effect on average weight gain.
- Regular treatment probably has no effect on average height, haemoglobin, formal tests of cognition, or exam performance.
Background
The World Health Organization currently recommends that school children in endemic areas are regularly treated with drugs which kill soil-transmitted intestinal worms. The recommended drugs are effective at eliminating or greatly reducing worm infections, but the question remains whether doing so will reduce anaemia and improve growth, and consequently improve school attendance, school performance, and economic development, as has been claimed.
Question
What are the effects of giving deworming drugs to children to treat soil-transmitted intestinal worms on weight, haemoglobin, and cognition; and the evidence of impact on physical well-being, school attendance, school performance, and mortality?
Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin, and school performance in Cameroon: Approximately 7.6 million children aged 1 to 15 years old are at risk of infection with soil-transmitted helminths in Cameroon (World Health Organization, 2013). The WHO recommends annual or bi-annual treatment of at least 75% of pre-school and school-age children. Soil-transmitted helminth infections can be treated with deworming drugs such as albendazole or mebendazole. Deworming drugs for soil-transmitted intestinal worms in children may improve nutritional indicators, haemoglobin, and school performance in Cameroon.
Table 1: Summary of the systematic review
Applicability
The included trials were undertaken in 23 different countries: Bangladesh (four trials); China (two trials); Ethiopia (two trials); Haiti (two trials); India (five trials); Indonesia (four trials); Jamaica (two trials); Kenya (five trials); Malaysia (two trials); Phillipines (two trials); South Africa (two trials);Uganda (two trials); Vietnam (three trials); Zanzibar (two trials); Benin, Botswana, Cameroon, Guatemala, Nigeria, Sierra Leone, Tanzania, Zaire (one trial in each); China, Philippines and Kenya; China and Myanmar (multi-centre trials). These interventions may be applied in other low resources settings such as Cameroon.
Conclusions
Treating children known to have worm infection may improve weight gain but there is limited evidence of other benefits. For routine deworming of school children in endemic areas, there is quite substantial evidence that deworming programmes do not show benefit in terms of average nutritional status, haemoglobin, cognition, school performance, or death.
Prepared by
M. Vouking, C.D. Evina, L. Mbuagbaw, P. Ongolo-Zogo: Centre for the Development of Best Practices in Health, Yaoundé, Cameroon.
September 2015
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