A systematic review-meta-analysis of primary research investigating the effect of selected alternative treatments on gastrointestinal nematodes in sheep under field conditions

Abstract

Selected alternative treatments for preventing or controlling gastrointestinal nematodes (GIN) in sheep under field conditions were evaluated using a systematic review-meta-analysis methodology. Forty-three publications reporting 51 studies (21 controlled studies (CS) and 30 challenge studies (ChS)) and 85 unique treatment comparisons were included in the review. The alternative treatment categories were nutraceuticals (28 studies), breeding for genetic resistance (12), nutritional manipulation (6), homeopathies (2), administration of copper oxide wire particles (2), and biological control (1).Random effect meta-analyses (MA) and meta-regression were performed with the natural logarithm of the difference in means (lnMD) between the control and treatment groups, for fecal egg counts per gram of wet feces (FEC), worm counts (WC) or fecal egg counts per gram of dry matter (FECDM) as the outcome. Treatment effect estimates (lnMD) were back-transformed to their count ratios (CR), a relative measure of effect for controlled versus treated groups, for presentation of results. Significant heterogeneity was observed for both CS and ChS that evaluated nutraceuticals, genetic resistance and nutrition treatments.MA of ChS that investigated nutraceuticals resulted in a significant overall CR of 1.62 (P<0.01) and 1.64 (P<0.01) for FEC and FECDM, respectively and a marginal significant CR of 1.14 (P=0.06) for WC, all favoring the treated groups. MA of CS and ChS that investigated genetic resistance resulted in a significant overall CR of 5.89 and 15.42, respectively (P<0.01), again favoring treated groups.MA of CS that investigated homeopathies with FEC as an outcome were homogenous (I2=0.0%) and resulted in a non-significant pooled CR of 1.61. ChS investigating copper oxide wire particle treatments and WC as an outcome, were homogenous (I2=0.0%) and had a marginally significant pooled CR of 1.68 (P=0.06).Publication bias was observed for ChS with WC outcomes, indicating that small size studies reporting non-significant CR, were less likely to be published than similar studies that found a significant CR. In a meta-regression, randomization (6.2%) and study size (29.2%) were the main factors contributing to the total variation when the outcome was FEC, and none of the variables contributed to between study heterogeneity. When the outcome was WC, type of treatment was the only significant covariate, explaining 6% of the heterogeneity and 38.5% of the total variation. The methodological soundness and reporting of primary research in the selected studies were low. Our results indicate that from the studied alternative treatments, nutraceuticals and use of genetically resistant sheep might be more promising for control of GINs in sheep.