Methodological Bias Can Lead the Cochrane Collaboration to Irrelevance in Public Health Decision-Making

Montresor, Antonio; Addiss, David G.; Albonico, Marco; Ali, Said M.; Ault, Steven K.; Gabrielli, Albis-Francesco; Garba, Amadou; Gasimov, Elkhan; Gyorkos, Theresa W.; Jamsheed, Mohamed; Levecke, Bruno; Mbabazi, Pamela Sabina; Mupfasoni, Denise; Savioli, Lorenzo; Vercruysse, Jozef; Yajima, Aya

doi:10.1371/journal.pntd.0004165

Cited by 31 publications

(35 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a need to measure these benefits using robust epidemiological methods [63], while avoiding the biases such studies can entail [64, 65], in order to provide adequate evidence to policy makers. Nevertheless, with hundreds of millions of children still at risk of worm infection worldwide, providing free school-based deworming treatment is an easy policy “win” for health, education, and development.…”

Section: Main Textmentioning

confidence: 99%

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

et al. 2017

View full text Add to dashboard Cite

The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women’s empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0288-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Main Textmentioning

confidence: 99%

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

et al. 2017

View full text Add to dashboard Cite

show abstract

“…26-30 For example, studies may be underpowered to detect a meaningful effect and relevant health outcomes may not be realized within the short timeframe of most trials. Furthermore, children may have high rates of reinfection in school-based programmes that limits improvements to health, but this could be overcome with community-wide treatment strategies.…”

Section: Preventive Chemotherapymentioning

confidence: 99%

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

Addiss

Hotez

et al. 2017

The Lancet Infectious Diseases

Self Cite

144

124

View full text Add to dashboard Cite

Summary In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale up of mass administration of anthelminthic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis (STH), which affect over 1.5 billion of the world's poorest people. Since then, over a decade of research and experience has yielded critical new knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated World Health Organization (WHO) guidelines on preventive chemotherapy. Here, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and STH. This includes the development of guidance that is specific to goals of “morbidity control” and “elimination of transmission.” We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining status quo. Without change, we estimate that the population of sub-Saharan Africa will likely lose 2.3 million disability-adjusted life years and US$3.5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and STH.

show abstract

“…This recommendation is based on the fact that infections of moderate/heavy intensity are generally not found at prevalences lower than 20% [45]. Many argue that in order to evaluate the impact of deworming interventions, analyses must be restricted to those who were infected at baseline, and thus could benefit from treatment [30]. However, new trends in ethics guidelines prevent the detection of STH infection at baseline and subsequent randomization of infected individuals to placebo control groups, thereby withholding treatment from those in need.…”

Section: Discussionmentioning

confidence: 99%

“…As uninfected individuals are not expected to benefit from deworming treatment, experts have argued that deworming trials should restrict data analyses to those participants who test positive for STH infection at baseline, so as to best estimate the effectiveness of treatment [30]. In order to obtain a baseline measure of STH infection in the total trial population, all women were asked to provide a stool specimen during the first stage of recruitment (i.e., in participants’ homes during pregnancy).…”

Section: Methodsmentioning

confidence: 99%

A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon

et al. 2017

Self Cite

View full text Add to dashboard Cite

BackgroundNutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic.Methodology/Principal FindingsFrom February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age.Conclusions/SignificanceIn a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern.Trial registrationClinicalTrials.gov (NCT01748929).

show abstract

Methodological Bias Can Lead the Cochrane Collaboration to Irrelevance in Public Health Decision-Making

Cited by 31 publications

References 18 publications

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon

Contact Info

Product

Resources

About