Effects of treatment for intestinal helminth infection on growth and cognitive performance in children: systematic review of randomised trials

Abstract

Objective To summarise the effects of anthelmintic drug treatment on growth and cognitive performance in children. Results Thirty randomised controlled trials in more than 15 000 children were identified. Effects on mean weight were unremarkable, and heterogeneity was evident in the results. There were some positive effects on mean weight change in the trials reporting this outcome: after a single dose (any anthelmintic) the pooled estimates were 0.24 kg (95% confidence interval 0.15 kg to 0.32 kg; fixed effects model assumed) and 0.38 kg (0.01 kg to 0.77 kg; random effects model assumed). Results from trials of multiple doses showed mean weight change in up to one year of follow up of 0.10 kg (0.04 kg to 0.17 kg; fixed effects) or 0.15 kg (0.00 to 0.30; random effects). At more than one year of follow up, mean weight change was 0.12 kg (−0.02 kg to 0.26 kg; fixed effects) and 0.43 (−0.61 to 1.47; random effects). Results from studies of cognitive performance were inconclusive. Conclusions There is some limited evidence that routine treatment of children in areas where helminths are common has effects on weight gain, but this is not consistent between trials. There is insufficient evidence as to whether this intervention improves cognitive performance. Data sources

Improving Learning in Primary Schools of Developing Countries

“…The treatments included deworming medications (Dickson, Awasthi, Williamson, Demellweek, & Garner, 2000;Taylor-Robinson, Maayan, Soares-Weiser, Donegan, & Garner, 2012), iron supplementation (Falkingham et al, 2011;Grantham-McGregor & Ani, 2001;Hermoso et al, 2011), multiple micronutrient supplementation (Best et al, 2011;Eilander et al, 2010), malaria medications (S. D. Fernando, Rodrigo, & Rajapakse, 2010), and school feeding programs (Jomaa, McDonnell, & Probart, 2010;Kristjansson et al, 2006). Finally, I consulted World Bank reports on learning in developing countries (Bruns, Filmer, & Patrinos, 2011;Vegas & Petrow, 2008 …”

Early Helminth Infections Are Inversely Related to Anemia, Malnutrition, and Malaria and Are Not Associated with Inflammation in 6- to 23-Month-Old Zanzibari Children

“…Contemporary studies looking at the relationship between helminth infections and different health outcomes present conflicting results 8,20 and differential effects by age. 5,21 A few intervention trials providing anthelmintic drugs to children less than 5 years of age have found no overall improvements in biochemical status and growth, 22,23 in line with the notion that deworming benefits are seen only in children with heavier worm burdens, most of whom are school age.…”

“…Helminth infections are known to aggravate malnutrition, anemia, and poor appetite, 4,5 and may retard both physical and cognitive development. [6][7][8] Infection intensity increases with age and reaches a maximum between 5-14 years. 1,2 The impact of helminth infections in children less than 2 years of age has not been clearly defined, mainly because it has been assumed that these infections are rare or light and therefore not harmful.…”

Adult tribal malnutrition in India: an anthropometric and socio-demographic review

“…Prolonged malnutrition is a major public health problem throughout the developing world, particularly in Southern Asia and Sub-Saharan Africa (WHO 2002;FAO 2004). The high prevalence of bacterial and parasitic diseases in developing countries contributes greatly to malnutrition there (Brabin and Coulter 2003;FAO 2004;De Onis et al 1993;Dickson et al 2000;Stoltzfus et al 2004). Malnutrition also increases susceptibility to infectious disease and is thus a major component of illness and death from disease (Brabin and Coulter 2003;Pinstrup et al 1993;Murray and Lopez 1997;Rice et al 2000;Black 2003).…”