Abstract
The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized. The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4-17 years. A search for RCTs was conducted on eight databases from inception to 12th June 2019. Cochrane Risk of Bias tool was used to assess the risk of bias in all included studies. Meta-analysis and narrative synthesis were conducted to describe and analyze the results of the review. Outcomes were summarized using the mean difference or standardized mean difference where appropriate. The search produced 1,816 records. Six studies met the inclusion criteria (five individually RCTs and one cluster RCT). Four studies reported data on all three STH species, while one study only reported data on Ascaris lumbricoides infections and the last study reported data on only hookworm infections. Overall, the risk of bias in four individual studies was low across most domains. Nutritional supplementation failed to statistically reduce the re-infection rates of the three STH species. The effect of nutritional supplements on measures of physical wellbeing in school-aged children could not be determined. The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges. Conclusion of earlier reviews on general populations may not necessarily apply to children since children possibly have a higher re-infection rate.
Highlights
Soil-transmitted helminths (STHs) are considered the most prevalent of the Neglected Tropical Diseases (NTDs) [1]
The risk of bias in four individual studies was low across most domains
The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges
Summary
Soil-transmitted helminths (STHs) are considered the most prevalent of the Neglected Tropical Diseases (NTDs) [1]. The three main species of STH are roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura) and hookworm (Ancylostoma duodenale and Necator americanus). The infections caused by these worms occur largely in impoverished rural areas of sub-Saharan Africa, Latin America, Southeast Asia, and China [4]. The global prevalence of Trichuris trichiura and hookworm reaches 790 million and 740 million respectively, and sub-Saharan Africa and China account for over 50% of hookworm prevalence [5]. The global prevalence of Ascaris lumbricoides is over 1.2 billion, with China accounting for over 50% of cases [5]. The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized
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