Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta‐analysis

BackgroundSoil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide.ObjectivesTo 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.Search MethodsWe 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.Selection CriteriaWe included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection.Data Collection and AnalysisWe 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.ResultsWe 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' ConclusionsThis 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.</div

Additional file 1: of Do evidence summaries increase policy-makers’ use of evidence from systematic reviews: A systematic review protocol

Appendix 1. (DOC 17 kb

Additional file 1: Table S1. of Extending the PRISMA statement to equity-focused systematic reviews (PRISMA-E 2012): explanation and elaboration

Systematic reviews with equity in the title (2013/11/28 to 2014/11/27). Table S2. Review of the research on the effectiveness of health service interventions to reduce variations in health. (DOC 35 kb

Checklist of items for reporting equity-focused systematic reviews.

<p>This checklist should be read in conjunction with the Statement and Explanation and Elaboration document, when available.</p><p>PICOS, participants, interventions, comparisons, outcomes, and study design.</p

Additional file 2: of The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: a systematic review

Grey Literature Searches. (DOCX 15 kb

Additional file 1: of How to select outcome measurement instruments for outcomes included in a “Core Outcome Set” – a practical guideline

Search strategies for MEDLINE, EMBASE, PsycINFO and Cinahl. (DOCX 19 kb

Additional file 2: of How to select outcome measurement instruments for outcomes included in a “Core Outcome Set” – a practical guideline

Guideline for selecting outcome measurement instruments for outcomes included in a COS. (PDF 194 kb

Proportion of responses (%) falling into each response category for all items in PRISMA-Equity 2012.

<div><p>Mean (±SD) proportion of responses (%) falling into each response category was calculated across all items in the PRISMA-Equity 2012 reporting guidelines. </p> <p>KEY.</p> <p>A. I would always address this item so a checklist would make no difference.</p> <p>B. I may sometimes address this item, but a checklist would help to remind me.</p> <p>C. A checklist would make it much more likely for me to address this item.</p> <p>D. I do not think this item is relevant, so a checklist would make no difference. </p></div

Additional file 4: of Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity

Screenshot of E4E Landing Page and. (PNG 23 kb

Additional file 5: of Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity

Screenshot of HIV Topic Landing Page. (PNG 32 kb