Abstract
Deworming and adjuvant interventions for improving the developmental health and well‐being of children in low‐ and middle‐income countries: a systematic review and network meta‐analysis
Highlights
1.1 DESCRIPTION OF THE PROBLEM1.1.1 Disease burdenThe burden of disease of soil-transmitted helminths and schistosomes was estimated at almost 3 million disability adjusted life years DALYS globally in 2004 according to the World Health Organization’s (WHO) Global Burden of Disease [1]
The Campbell Collaboration | www.campbellcollaboration.org cognitive impairment, which lead to reduced school attendance, and this hypothesized effect may be mediated by the burden of infection as well as other factors [9]
Because this systematic review involves multi-component interventions, we have developed a logic model to elucidate the causal chain from worm infection to nutritional status and educational effects, how deworming in combination with other strategies intervene in these causal pathways, and which factors are important in moderating these effects (Figure 1) [28]
Summary
The burden of disease of soil-transmitted helminths and schistosomes was estimated at almost 3 million disability adjusted life years DALYS globally in 2004 according to the World Health Organization’s (WHO) Global Burden of Disease [1]. Infections by worms affect the nutritional status of children through various mechanisms, such as feeding on host tissue and interfering with absorption of nutrients [2] These mechanisms lead to anaemia and related micronutrient deficiencies which may contribute to impaired growth, cause fatigue and further hinder school attendance [3, 4]. The four species of soil-transmitted worms most commonly associated with malnutrition and disease in children are: Ascaris lumbricoides (roundworm), Trichuris trichura (whipworm), Ancylostoma duodenale and Necator americanus (hookworms). These worms cause infection through ingestion of eggs from contaminated soil, food (e.g. vegetables) or water or active penetration of the skin by larvae in soil. The Campbell Collaboration | www.campbellcollaboration.org cognitive impairment, which lead to reduced school attendance, and this hypothesized effect may be mediated by the burden of infection as well as other factors [9]
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