Abstract
Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. To 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. We 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. We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection. We 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. We 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). This 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.
Highlights
Soil transmitted helminths and schistosomes affect millions of children worldwide
The primary objective is to use individual participant data (IPD) network meta‐analysis (NMA) to explore whether the effects of different types and frequency of deworming drugs as well as their combination with food or micronutrients on anaemia, cognition and growth vary with child‐level and study‐ level characteristics, : intensity of infection, infection status, age, nutritional status, socioeconomic status and sanitation environment
When we add data obtained for this IPD analysis from unpublished results on weight gain to studies included in our prior meta‐analysis, the overall effect across 25 studies of deworming compared to placebo is 0.07 kg (−0.01, 0.13)
Summary
Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. Objectives: To 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. Selection Criteria: We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection. Data Collection and Analysis: We conducted NMA with individual participant data (IPD), using a frequentist approach for random‐effects NMA. Analyses showed that there may be greater effects on weight for moderate to heavily infected children (very low certainty evidence). 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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
