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. 2019 Sep 11;9(9):CD000371.
doi: 10.1002/14651858.CD000371.pub7.

Public health deworming programmes for soil-transmitted helminths in children living in endemic areas

Affiliations

Public health deworming programmes for soil-transmitted helminths in children living in endemic areas

David C Taylor-Robinson et al. Cochrane Database Syst Rev. .

Abstract

Background: The World Health Organization (WHO) recommends treating all school children at regular intervals with deworming drugs in areas where helminth infection is common. Global advocacy organizations claim routine deworming has substantive health and societal effects beyond the removal of worms. In this update of the 2015 edition we included six new trials, additional data from included trials, and addressed comments and criticisms.

Objectives: To summarize the effects of public health programmes to regularly treat all children with deworming drugs on child growth, haemoglobin, cognition, school attendance, school performance, physical fitness, and mortality.

Search methods: We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; LILACS; the metaRegister of Controlled Trials (mRCT); reference lists; and registers of ongoing and completed trials up to 19 September 2018.

Selection criteria: We included randomized controlled trials (RCTs) and quasi-RCTs that compared deworming drugs for soil-transmitted helminths (STHs) with placebo or no treatment in children aged 16 years or less, reporting on weight, height, haemoglobin, and formal tests of cognition. We also sought data on other measures of growth, school attendance, school performance, physical fitness, and mortality.

Data collection and analysis: At least two review authors independently assessed the trials for inclusion, risk of bias, and extracted data. We analysed continuous data using the mean difference (MD) with 95% confidence intervals (CIs). Where data were missing, we contacted trial authors. We stratified the analysis based on the background burden of STH infection. We used outcomes at time of longest follow-up. We assessed the certainty of the evidence using the GRADE approach.

Main results: We identified 51 trials, including 10 cluster-RCTs, that met the inclusion criteria. One trial evaluating mortality included over one million children, and the remaining 50 trials included a total of 84,336 participants. Twenty-four trials were in populations categorized as high burden, including nine trials in children selected because they were helminth-stool positive; 18 with intermediate burden; and nine as low burden.First or single dose of deworming drugsFourteen trials reported on weight after a single dose of deworming drugs (4970 participants, 14 RCTs). The effects were variable. There was little or no effect in studies conducted in low and intermediate worm burden groups. In the high-burden group, there was little or no effect in most studies, except for a large effect detected from one study area in Kenya reported in two trials carried out over 30 years ago. These trials result in qualitative heterogeneity and uncertainty in the meta-analysis across all studies (I2 statistic = 90%), with GRADE assessment assessed as very low-certainty, which means we do not know if a first dose or single dose of deworming impacts on weight.For height, most studies showed little or no effect after a single dose, with one of the two trials in Kenya from 30 years ago showing a large average difference (2621 participants, 10 trials, low-certainty evidence). Single dose probably had no effect on average haemoglobin (MD 0.10 g/dL, 95% CI 0.03 lower to 0.22 higher; 1252 participants, five trials, moderate-certainty evidence), or on average cognition (1596 participants, five trials, low-certainty evidence). The data are insufficient to know if there is an effect on school attendance and performance (304 participants, one trial, low-certainty evidence), or on physical fitness (280 participants, three trials, very low-certainty evidence). No trials reported on mortality.Multiple doses of deworming drugsThe effect of regularly treating children with deworming drugs given every three to six months on weight was reported in 18 trials, with follow-up times of between six months and three years; there was little or no effect on average weight in all but two trials, irrespective of worm prevalence-intensity. The two trials with large average weight gain included one in the high burden area in Kenya carried out over 30 years ago, and one study from India in a low prevalence area where subsequent studies in the same area did not show an effect. This heterogeneity causes uncertainty in any meta-analysis (I2 = 78%). Post-hoc analysis excluding trials published prior to 2000 gave an estimate of average difference in weight gain of 0.02 kg (95%CI from 0.04 kg loss to 0.08 gain, I2 = 0%). Thus we conclude that we do not know if repeated doses of deworming drugs impact on average weight, with a fewer older studies showing large gains, and studies since 2000 showing little or no average gain.Regular treatment probably had little or no effect on the following parameters: average height (MD 0.02 cm higher, 95% CI 0.09 lower to 0.13 cm higher; 13,700 participants, 13 trials, moderate-certainty evidence); average haemoglobin (MD 0.01 g/dL lower; 95% CI 0.05 g/dL lower to 0.07 g/dL higher; 5498 participants, nine trials, moderate-certainty evidence); formal tests of cognition (35,394 participants, 8 trials, moderate-certainty evidence); school performance (34,967 participants, four trials, moderate-certainty evidence). The evidence assessing an effect on school attendance is inconsistent, and at risk of bias (mean attendance 2% higher, 95% CI 5% lower to 8% higher; 20,650 participants, three trials, very low-certainty evidence). No trials reported on physical fitness. No effect was shown on mortality (1,005,135 participants, three trials, low-certainty evidence).

Authors' conclusions: Public health programmes to regularly treat all children with deworming drugs do not appear to improve height, haemoglobin, cognition, school performance, or mortality. We do not know if there is an effect on school attendance, since the evidence is inconsistent and at risk of bias, and there is insufficient data on physical fitness. Studies conducted in two settings over 20 years ago showed large effects on weight gain, but this is not a finding in more recent, larger studies. We would caution against selecting only the evidence from these older studies as a rationale for contemporary mass treatment programmes as this ignores the recent studies that have not shown benefit.The conclusions of the 2015 edition have not changed in this update.

PubMed Disclaimer

Conflict of interest statement

None of the review authors receive salary, payment, or academic fees for the promotion or delivery of soil‐transmitted helminth deworming programmes in low‐ and middle‐income countries (LMICs).

DTR is funded by the MRC on a Clinician Scientist Fellowship (MR/P008577/1), and has no known conflicts of interest.

NM worked on this update as both an employee of Cochrane Response and then as an independent consultant. She has no known conflicts of interest.

SD has no known conflicts of interest.

MR has no known conflicts of interest.

PG is the Director of the Research, Evidence and Development Initiative (READ‐It) project, that aims to increase the number of decisions in the health sector in LMICs based on reliable evidence. He has no known conflicts of interest.

Figures

1
1
Logic model for public health programmes to regularly treat all children with worms for soil‐transmitted helminth infection in endemic areas
2
2
Study flow diagram.
3
3
‘Risk of bias’ summary: review authors’ judgements about each risk of bias item presented as percentages across all included studies.
4
4
‘Risk of bias’ summary: review authors’ judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Single dose, Outcome 1 Weight (kg).
1.2
1.2. Analysis
Comparison 1 Single dose, Outcome 2 Height (cm).
1.3
1.3. Analysis
Comparison 1 Single dose, Outcome 3 Mid‐upper arm circumference (cm).
1.4
1.4. Analysis
Comparison 1 Single dose, Outcome 4 Triceps skin fold thickness (mm).
1.5
1.5. Analysis
Comparison 1 Single dose, Outcome 5 Subscapular skin fold thickness (mm).
1.6
1.6. Analysis
Comparison 1 Single dose, Outcome 6 Body mass index.
1.7
1.7. Analysis
Comparison 1 Single dose, Outcome 7 Haemoglobin (g/dL).
2.1
2.1. Analysis
Comparison 2 Multiple doses, Outcome 1 Weight (kg).
2.2
2.2. Analysis
Comparison 2 Multiple doses, Outcome 2 Height (cm).
2.3
2.3. Analysis
Comparison 2 Multiple doses, Outcome 3 Mid‐upper arm circumference (cm).
2.4
2.4. Analysis
Comparison 2 Multiple doses, Outcome 4 Triceps skin fold thickness (mm).
2.5
2.5. Analysis
Comparison 2 Multiple doses, Outcome 5 Subscapular skin fold thickness (mm).
2.6
2.6. Analysis
Comparison 2 Multiple doses, Outcome 6 Body mass index.
2.7
2.7. Analysis
Comparison 2 Multiple doses, Outcome 7 Haemoglobin (g/dL).
2.8
2.8. Analysis
Comparison 2 Multiple doses, Outcome 8 School attendance (days present at school).
3.1
3.1. Analysis
Comparison 3 Single dose (by worm type), Outcome 1 Weight (kg).
3.2
3.2. Analysis
Comparison 3 Single dose (by worm type), Outcome 2 Haemoglobin (g/dL).
4.1
4.1. Analysis
Comparison 4 Multiple doses (by worm type), Outcome 1 Weight (kg).
4.2
4.2. Analysis
Comparison 4 Multiple doses (by worm type), Outcome 2 Haemoglobin (g/dL).
5.1
5.1. Analysis
Comparison 5 Single dose (only low risk of bias for allocation concealment), Outcome 1 Weight (kg).
5.2
5.2. Analysis
Comparison 5 Single dose (only low risk of bias for allocation concealment), Outcome 2 Height (cm).
5.3
5.3. Analysis
Comparison 5 Single dose (only low risk of bias for allocation concealment), Outcome 3 Mid‐upper arm circumference (cm).
5.4
5.4. Analysis
Comparison 5 Single dose (only low risk of bias for allocation concealment), Outcome 4 Haemoglobin (g/dL).
6.1
6.1. Analysis
Comparison 6 Multiple doses (only low risk of bias for allocation concealment), Outcome 1 Weight (kg).
6.2
6.2. Analysis
Comparison 6 Multiple doses (only low risk of bias for allocation concealment), Outcome 2 Haemoglobin (g/dL).
7.1
7.1. Analysis
Comparison 7 Multiple doses ‐ ordered by year, Outcome 1 Weight (kg).
7.2
7.2. Analysis
Comparison 7 Multiple doses ‐ ordered by year, Outcome 2 Weight (kg).

Update of

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Stoltzfus 2001 {published data only}
    1. Stoltzfus RJ, Chway HM, Montresor A, Tielsch JM, Jape JK, Albonico M, et al. Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. Journal of Nutrition 2004;134(2):348‐56. - PubMed
    1. Stoltzfus RJ, Kvalsvig JD, Chwaya HM, Montresor A, Albonico M, Tielsch JM, et al. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study. BMJ 2001;323(7326):1389‐93. - PMC - PubMed
Sur 2005 {published data only}
    1. Sur D, Saha DR, Manna B, Rajendran K, Bhattacharya SK. Periodic deworming with albendazole and its impact on growth status and diarrhoeal incidence among children in an urban slum of India. Transactions of the Royal Society of Tropical Medicine and Hygiene 2005;99(4):261‐7. - PubMed
Tee 2013 (Screened) {published data only}
    1. Tee MH, Lee YY, Majid NA, Noori NM, Raj SM. Growth reduction among primary school children with light trichuriasis in Malaysia with albendazole. Southeast Asian Journal of Tropical Medicine and Public Health 2013;44(1):19‐24. - PubMed
Watkins 1996 {published data only}
    1. Watkins WE, Cruz JR, Pollitt E. The effects of deworming on indicators of school performance in Guatemala. Transactions of the Royal Society of Tropical Medicine and Hygiene 1996;90(2):156‐61. - PubMed
    1. Watkins WE, Pollitt E. Effect of removing Ascaris on the growth of Guatemalan schoolchildren. Pediatrics 1996;97(6 Pt 1):871‐6. - PubMed
Willett 1979 {published data only}
    1. Willett WC, Kilama WL, Kihamia CM. Ascaris and growth rates: a randomized trial of treatment. American Journal of Public Health 1979;69(10):987‐91. - PMC - PubMed
Wiria 2013 (Cluster) {published data only}
    1. Wiria AE, Hamid F, Wammes LJ, Kaisar MM, May L, Prasetyani MA, et al. The effect of three‐monthly albendazole treatment on malarial parasitemia and allergy: a household‐based cluster‐randomized, double‐blind, placebo‐controlled trial. PLOS One 2013;8(3):e57899. [DOI: 10.1371/journal.pone.0057899] - DOI - PMC - PubMed
Yap 2014 (Screened) {published data only}
    1. Yap P, Wu FW, Du ZW, Hattendorf J, Chen R, Jiang JY, et al. Effect of deworming on physical fitness of school‐aged children in Yunnan, China: a double‐blind, randomized, placebo‐controlled trial. PLoS Neglected Tropical Diseases 2014;8(7):e2983. [DOI: 10.1371/journal.pntd.0002983] - DOI - PMC - PubMed

References to studies excluded from this review

Araujo 1987 {published data only}
    1. Araujo RL, Araujo MB, Machado RD, Braga AA, Leite BV, Oliveira JR. Evaluation of a program to overcome vitamin A and iron deficiencies in areas of poverty in Minas Gerais, Brazil. Archivos Latinoamericanos de Nutrición 1987;37(1):9‐22. - PubMed
Assaré 2016a {published data only}
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Assaré 2016b {published data only}
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Baird 2011 {unpublished data only}
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Baird 2016 {published data only}
    1. Baird S, Hicks JH, Kremer M, Miguel E. Worms at work: Long‐run impacts of a child health investment. 2016. Available from www.nber.org/papers/w21428 (accessed prior to 20 August 2019). - PMC - PubMed
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Bhutta 2009 {published data only}
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Boivin 1993 {published data only}
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Bruckner 2015 {published data only}
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Bruckner 2016 {published data only}
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Campbell 2015 {published data only}
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Campbell 2016 {published data only}
    1. Campbell SJ, Nery SV, D'Este CA, Gray DJ, McCarthy JS, Traub RJ, et al. Water, sanitation and hygiene related risk factors for soil‐transmitted helminth and Giardia duodenalis infections in rural communities in Timor‐Leste. International Journal for Parasitology 2016;46(12):771‐9. - PubMed
Campbell 2017 {published data only}
    1. Campbell SJ, Nery SV, D'Este CA, Gray DJ, McCarthy JS, Traub RJ, et al. Investigations into the association between soil‐transmitted helminth infections, haemoglobin and child development indices in Manufahi District, Timor‐Leste. Parasites and Vectors 2017;10(1):192. - PMC - PubMed
Chen 2016 {published data only}
    1. Chen K, Xie HM, Tian W, Zheng X, Jiang AC. Effect of single‐dose albendazole and vitamin A supplementation on the iron status of pre‐school children in Sichuan, China. British Journal of Nutrition 2016;115(8):1415‐23. - PubMed
Cooper 2006 {published data only}
    1. Cooper PJ, Chico ME, Vaca MG, Moncayo AL, Bland JM, Mafla E, et al. Effect of albendazole treatments on the prevalence of atopy in children living in communities endemic for geohelminth parasites: a cluster‐randomised trial. Lancet 2006;367(9522):1598‐603. - PubMed
Cowden 2000 {published data only}
    1. Cowden J, Hotez P. Mebendazole and albendazole treatment of geohelminth infections in children and pregnant women. Pediatric Infectious Disease Journal 2000;19(7):659‐60. - PubMed
Croke 2014 {published data only}
    1. Croke K. The long run effects of early childhood deworming on literacy and numeracy: Evidence from Uganda. http://scholar.harvard.edu/files/kcroke/files/ug_lr_deworming_071714.pdf (accessed 10 July 2015). - PMC - PubMed
de Ruiter 2017 {published data only}
    1. Ruiter K, Tahapary DL, Wammes LJ, Wiria AE, Hamid F, Lieshout L, et al. The effect of three‐monthly albendazole treatment on Th2 responses: Differential effects on IgE and IL‐5. Parasite Immunology 2017;39(6):e12428. - PubMed
Diouf 2002 {published data only}
    1. Diouf S, Diagne I, Moreira C, Signate SY, Faye O, Ndiaye O, et al. Integrated treatment of iron deficiency, vitamin A deficiency and intestinal parasitic diseases: impact on Senegalese children's growth [Traitement integre de la carence en fer, de l'avitaminose A et des parasitoses intestinales: impact sur la croissance des enfants senegalais]. Archives de Pédiatrie 2002;9(1):102‐3. - PubMed
Evans 1986 {unpublished data only}
    1. Evans J, Martin J, Mascie‐Taylor CG. The Effect of Periodic Deworming with Pyrantel Pamoate on the Growth and Nutritional Status of Pre‐school Children in Northern Bangladesh [Monograph No. 3]. London: Save the Children Fund, 1986.
Fernando 1983 {published and unpublished data}
    1. Fernando MA, Balasuriya, Somaratne. Effect of Ascaris lumbricoides infestation on growth of children. Indian Pediatrics 1983;20(10):721‐31. - PubMed
Forrester 1998 {published data only}
    1. Forrester JE, Bailar JC 3rd, Esrey SA, José MV, Castillejos BT, Ocampo G. Randomised trial of albendazole and pyrantel in symptomless trichuriasis in children. Lancet 1998;352(9134):1103‐8. - PubMed
Friis 2003 {published data only}
    1. Friis H, Mwaniki D, Omondi B, Muniu E, Thiong'o F, Ouma J, et al. Effects on haemoglobin of multi‐micronutrient supplementation and multi‐helminth chemotherapy: a randomized, controlled trial in Kenyan school children. European Journal of Clinical Nutrition 2003;57(4):573‐9. - PubMed
Gilgen 2001 {published data only}
    1. Gilgen D, Mascie‐Taylor CG. The effect of anthelmintic treatment on helminth infection and anaemia. Parasitology 2001;122(Pt 1):105‐10. - PubMed
    1. Gilgen DD, Mascie‐Taylor CG, Rosetta L. Intestinal helminth infections, anaemia and labour productivity of female tea pluckers in Bangladesh. Tropical Medicine and International Health 2001;6(6):449‐57. - PubMed
Hadidjaja 1998 {published data only}
    1. Hadidjaja P, Bonang E, Suyardi MA, Abidin SA, Ismid IS, Margono SS. The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides. American Journal of Tropical Medicine and Hygiene 1998;59(5):791‐5. - PubMed
Hamidu 2014 {published data only}
    1. Hamidu BB, Tettevi EJ, Larbi JA, Osei‐Atweneboana MY. The efficacy of albendazole and levamisole drug combination in individuals with reduced efficacy for single‐dose albendazole treatment against hookworm infections. American Journal of Tropical Medicine and Hygiene 2014;Conference: 63rd Annual Meeting of the American Society of Tropical Medicine and Hygiene, ASTMH 2013 New Orleans, LA United States. Conference Start: 20141102 Conference End: 20141106. Conference Publication: (var.pagings). 91 (5 SUPPL. 1):152.
Hathirat 1992 {published data only}
    1. Hathirat P, Valyasevi A, Kotchabhakdi NJ, Rojroongwasinkul N, Pollitt E. Effects of an iron supplementation trial on the Fe status of Thai schoolchildren. British Journal of Nutrition 1992;68(1):245‐52. - PubMed
Hosseini 2017 {published data only}
    1. Hosseini M, Shalchiantabrizi P, Dadgarmoghaddam M, Ahmady‐Simab S, Behjati A, Salari M. The effect of oral levamisole co‐administration on the level of immune response to hepatitis b vaccine in healthy individuals: a randomized clinical trial. Iranian Journal of Allergy, Asthma, and Immunology 2017;16(3):219‐27. - PubMed
Jalal 1998 {published data only}
    1. Jalal F, Nesheim MC, Agus Z, Sanjur D, Habicht JP. Serum retinol concentrations in children are affected by food sources of beta‐carotene, fat intake, and anthelmintic drug treatment. American Journal of Clinical Nutrition 1998;68(3):623‐9. - PubMed
Jinabhai 2001a {published data only}
    1. Jinabhai CC, Taylor M, Coutsoudis A, Coovadia HM, Tomkins AM, Sullivan KR. Epidemiology of helminth infections: implications for parasite control programmes, a South African perspective. Public Health Nutrition 2001;4(6):1211‐9. - PubMed
Jinabhai 2001b {published data only}
    1. Jinabhai CC, Taylor M, Coutsoudis A, Coovadia HM, Tomkins AM, Sullivan KR. A randomized controlled trial of the effect of antihelminthic treatment and micronutrient fortification on health status and school performance of rural primary school children. Annals of Tropical Paediatrics 2001;21(4):319‐33. - PubMed
Karyadi 1996 {published data only}
    1. Karyadi E, Gross R, Sastroamidjojo S, Dillon D, Richards AL, Sutanto I. Anthelminithic treatment raises plasma iron levels but dose not decrease the acute‐phase response in Jakarta School children. Southeast Asian Journal of Tropical Medicine and Public Health 1996;27(4):742‐53. - PubMed
Klarmann‐Schulz 2017 {published data only}
    1. Klarmann‐Schulz U, Specht S, Debrah AY, Batsa L, Ayisi‐Boateng NK, Osei‐Mensah J, et al. Comparison of doxycycline, minocycline, doxycycline plus albendazole and albendazole alone in their efficacy against onchocerciasis in a randomized, open‐label, pilot trial. PLOS Neglected Tropical Diseases 2017;11(1):e0005156. - PMC - PubMed
Krubwa 1974 {published data only}
    1. Krubwa F, Gatti F, Lontie M, Nguete M, Vandepitte J, Thienpont D. Quarterly administration of mebendazole to suburban school children [Administration trimestrielle de mebendazole en milieu scolaire suburbain]. Médecine Tropicale 1974;34(5):679‐87.
Kvalsvig 1991b {published data only}
    1. Kvalsvig JD, Cooppan RM, Connolly KJ. The effects of parasite infections on cognitive processes in children. Annals of Tropical Medicine and Parasitology 1991;85(5):551‐68. - PubMed
Latham 1990 {published data only}
    1. Latham MC, Stephenson LS, Kurz KM, Kinoti SN. Metrifonate or praziquantel treatment improves physical fitness and appetite of Kenyan schoolboys with Schistosoma haematobium and hookworm infections. American Journal of Tropical Medicine and Hygiene 1990;43(2):170‐9. - PubMed
Marinho 1991 {published data only}
    1. Marinho HA, Shrimpton R, Giugliano R, Burini RC. Influence of enteral parasites on the blood vitamin A levels in preschool children orally supplemented with retinol and/or zinc. European Journal of Clinical Nutrition 1991;45(11):539‐44. - PubMed
Mofid 2015 {published data only}
    1. Mofid LS, Casapia M, Montresor A, Rahme E, Fraser WD, Marquis GS, et al. Maternal Deworming Research Study (MADRES) protocol: A double‐blind, placebo‐controlled randomised trial to determine the effectiveness of deworming in the immediate postpartum period. BMJ Open 2015;5(6):e008560. - PMC - PubMed
Moser 2016 {published data only}
    1. Moser W, Ali SM, Ame SM, Speich B, Puchkov M, Huwyler J, et al. Efficacy and safety of oxantel pamoate in school‐aged children infected with Trichuris trichiura on Pemba Island, Tanzania: a parallel, randomised, controlled, dose‐ranging study. Lancet Infectious Diseases 2016;16(1):53‐60. - PubMed
Mwaniki 2002 {published data only}
    1. Mwaniki D, Omondi B, Muniu E, Thiong'o F, Ouma J, Magnussen P, et al. Effects on serum retinol of multi‐micronutrient supplementation and multi‐helminth chemotherapy: a randomised, controlled trial in Kenyan school children. European Journal of Clinial Nutrition 2002;56(7):666‐73. - PubMed
Ozier 2011 {unpublished data only}
    1. Ozier O. Exploiting externalities to estimate the long‐term effects of early childhood deworming. http://files.givewell.org/files/DWDA%202009/Interventions/Deworming/Ozie... (accessed 10 July 2015).
Ozier 2016 {published data only}
    1. Ozier O. Exploiting externalities to estimate the long‐term effects of early childhood deworming. 2016. http://economics.ozier.com/owen/papers/ozier_early_deworming_20160727.pdf (accessed prior to 20 August 2019).
Pollitt 1991 {published data only}
    1. Pollitt E, Wayne W, Perez‐Escamilla R, Latham M, Stephenson LS. Double blind clinical trial on the effects of helminth infection on cognition. FASEB Journal 1991;5:A1081.
Rohner 2010 {published data only}
    1. Rohner F, Zimmermann MB, Amon RJ, Vounatsou P, Tschannen AB, N'goran EK, et al. In a randomized controlled trial of iron fortification, anthelmintic treatment and intermittent preventive treatment of malaria for anemia control in Ivorian children, only anthelmintic treatment shows modest benefit. Journal of Nutrition 2010;140(3):635‐41. - PubMed
Srichaikul 2016 {published data only}
    1. Srichaikul B, Samappito S, Wongyai S, Bakker G. The comparative double‐blind clinical study in antihelmintic efficacy between Thai traditional herbal formulae and mebendazole. American Journal of Therapeutics 2016;23(4):e1025‐31. - PubMed
Steinmann 2008 {published data only}
    1. Steinmann P, Zhou XN, Du ZW, Jiang JY, Xiao SH, Wu ZX, et al. Tribendimidine and albendazole for treating soil‐transmitted helminths, Strongyloides stercoralis and Taenia spp.: open‐label randomized trial. PLOS Neglected Tropical Diseases 2008;2(10):e322. - PMC - PubMed
Stephenson 1980 {published data only}
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Stephenson 1985 {published data only}
    1. Stephenson LS, Latham MC, Kurz KM, Kinoti SN, Oduori ML, Crompton DW. Relationships of Schistosoma hematobium, hookworm and malarial infections and metrifonate treatment to hemoglobin level in Kenyan school children. American Journal of Tropical Medicine and Hygiene 1985;34(3):519‐28. - PubMed
Stobaugh 2017 {published data only}
    1. Stobaugh HC, Bollinger LB, Adams SE, Crocker A H, Grise JB, Kennedy JA, et al. Effect of a package of health and nutrition services on sustained recovery in children after moderate acute malnutrition and factors related to sustaining recovery: a cluster‐randomized trial. American Journal of Clinical Nutrition 2017;106(2):657‐66. - PMC - PubMed
Tahapary 2015 {published data only}
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Tahapary 2017 {published data only}
    1. Tahapary DL, Ruiter K, Martin I, Brienen EAT, Lieshout L, Cobbaert CM, et al. Effect of anthelmintic treatment on insulin resistance: a cluster‐randomized placebo‐controlled trial in Indonesia. Clinical Infectious Diseases 2017;65(5):764‐71. - PubMed
Tanumihardjo 1996 {published data only}
    1. Tanumihardjo SA, Permaesih D, Muherdiyantiningsih, Rustan E, Rusmil K, Fatah AC, et al. Vitamin A status of Indonesian children infected with Ascaris lumbricoides after dosing with vitamin A supplements and albendazole. Journal of Nutrition 1996;126(2):451‐7. - PubMed
Tanumihardjo 2004 {published data only}
    1. Tanumihardjo SA, Permaesih D, Muhilal. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions. European Journal of Clinical Nutrition 2004;58(9):1223‐30. - PubMed
Taylor 2001 {published data only}
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Thein‐Hlaing 1991 {published data only}
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Trehan 2016 {published data only}
    1. Trehan I. A combined package of micronutrients and albendazole does not improve environmental enteric dysfunction or stunting in rural Malawian children. Journal of Pediatric Gastroenterology and Nutrition 2016;63:S37‐8.
Uscátegui 2009 {published data only}
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Van der Zalm 2016 {published data only}
    1. Zalm MM, Soelen N, Mandalakas AM, Jacobsen M, Detjen AK, Marx FM, et al. The effect of deworming on tests of tuberculosis infection in children with recent tuberculosis exposure: a randomized controlled trial. Pediatric Infectious Disease Journal 2016;35(6):622‐7. - PMC - PubMed
Wammes 2016 {published data only}
    1. Wammes LJ, Hamid F, Wiria AE, May L, Kaisar MM, Prasetyani‐Gieseler MA, et al. Community deworming alleviates geohelminth‐induced immune hyporesponsiveness. Proceedings of the National Academy of Sciences of the United States of America 2016;113(44):12526‐31. - PMC - PubMed
Wang 2017 {published data only}
    1. Wang AZ, Shulman RJ, Crocker AH, Thakwalakwa C, Maleta KM, Devaraj S, et al. A combined intervention of zinc, multiple micronutrients, and albendazole does not ameliorate environmental enteric dysfunction or stunting in rural Malawian children in a double‐blind randomized controlled trial. Journal of Nutrition 2017;147(1):97‐103. - PubMed
Wright 2009 {published data only}
    1. Wright VJ, Ame SM, Haji HS, Weir RE, Goodman D, Pritchard DI, et al. Early exposure of infants to GI nematodes induces Th2 dominant immune responses which are unaffected by periodic anthelminthic treatment. PLOS Neglected Tropical Diseases 2009;3(5):e433. - PMC - PubMed
Yang 2003 {published data only}
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References to studies awaiting assessment

Carmona‐Fonseca 2015 {published data only}
    1. Carmona‐Fonseca J, Correa‐Botero A. Effect of periodic albendazole and vitamin A treatment on intestinal helminths and anaemia in children from Uraba (Antioquia, Colombia) [Efecto del albendazol y la vitamina A periódicos sobre helmintos intestinales y anemia en niños del Urabá Antioqueño]. Biosalud 2015;14(1):9‐25.

References to ongoing studies

NCT00367627 {unpublished data only}
    1. NCT00367627. Relative efficacy of two regimens of ante‐helminthic treatment. clinicaltrials.gov/ct2/show/NCT00367627 first posted 23 August 2006.
NCT02725255 {published data only}
    1. NCT02725255. Design and clinical evaluation of a school meal with deworming properties. clinicaltrials.gov/ct2/show/NCT02725255 first posted 31 March 2016.
NCT02754583 {published data only}
    1. NCT02754583. Sanitation, Water, and Instruction in Face‐washing for Trachoma (SWIFT). clinicaltrials.gov/ct2/show/NCT02754583 first posted 28 April 2016.

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