Meta-analysis and public policy: Reconciling the evidence on deworming

• 成果类型: Article
• 署名作者: Croke, Kevin; Hamory, Joan; Hsu, Eric; Kremer, Michael; Maertens, Ricardo; Miguel, Edward; Wiecek, Witold
• 署名单位: Harvard University; Harvard T.H. Chan School of Public Health; University of Oklahoma System; University of Oklahoma - Norman; University of California System; University of California Berkeley; University of Chicago; National Bureau of Economic Research; Harvard University
• 刊物名称: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
• ISSN/ISSBN: 0027-10246
• DOI: 10.1073/pnas.2308733121
• 发表日期: 2024-06-18
• 关键词: chemotherapy; infections; efficacy; hookworm; CHILDREN; impacts; HEALTH; worms

摘要

The WHO recommends mass drug administration (MDA) for intestinal worm infections in areas with over 20% infection prevalence. Recent Cochrane meta- analyses endorse treatment of infected individuals but recommend against MDA. We conducted a theory- agnostic random- effects metaanalysis of the effect of multiple - dose MDA and a cost- effectiveness analysis. We estimate significant effects of MDA on child weight (0.15 kg, 95% CI: 0.07, 0.24; P < 0.001), mid - upper arm circumference (0.20 cm, 95% CI: 0.03, 0.37; P = 0.02), and height (0.09 cm, 95% CI: 0.01, 0.16; P = 0.02) when prevalence is over 20% but not on Hb (0.06 g/dL, 95% CI: -0.01, 0.14; P = 0.1). These results suggest that MDA is a cost- effective intervention, particularly in the settings where it is recommended by the WHO.