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. 2014 Jul 31:3:23.
doi: 10.1186/2049-9957-3-23. eCollection 2014.

Community-based interventions for the prevention and control of helmintic neglected tropical diseases

Rehana A Salam  1 , Hasina Maredia  2 , Jai K Das  1 , Zohra S Lassi  1 , Zulfiqar A Bhutta  3
Affiliations

Community-based interventions for the prevention and control of helmintic neglected tropical diseases

Rehana A Salam et al. Infect Dis Poverty. .

Abstract

In this paper, we aim to systematically analyze the effectiveness of community-based interventions (CBIs) for the prevention and control of helminthiasis including soil-transmitted helminthiasis (STH) (ascariasis, hookworms, and trichuriasis), lymphatic filariasis, onchocerciasis, dracunculiasis, and schistosomiasis. We systematically reviewed literature published before May 2013 and included 32 studies in this review. Findings from the meta-analysis suggest that CBIs are effective in reducing the prevalence of STH (RR: 0.45, 95% CI: 0.38, 0.54), schistosomiasis (RR: 0.40, 95% CI: 0.33, 0.50), and STH intensity (SMD: -3.16, 95 CI: -4.28, -2.04). They are also effective in improving mean hemoglobin (SMD: 0.34, 95% CI: 0.20, 0.47) and reducing anemia prevalence (RR: 0.90, 95% CI: 0.85, 0.96). However, it did not have any impact on ferritin, height, weight, low birth weight (LBW), or stillbirths. School-based delivery significantly reduced STH (RR: 0.49, 95% CI: 0.39, 0.63) and schistosomiasis prevalence (RR: 0.50, 95% CI: 0.33, 0.75), STH intensity (SMD: -0.22, 95% CI: -0.26, -0.17), and anemia prevalence (RR: 0.87, 95% CI: 0.81, 0.94). It also improved mean hemoglobin (SMD: 0.24, 95% CI: 0.16, 0.32). We did not find any conclusive evidence from the quantitative synthesis on the relative effectiveness of integrated and non-integrated delivery strategies due to the limited data available for each subgroup. However, the qualitative synthesis from the included studies supports community-based delivery strategies and suggests that integrated prevention and control measures are more effective in achieving greater coverage compared to the routine vertical delivery, albeit it requires an existing strong healthcare infrastructure. Current evidence suggests that effective community-based strategies exist and deliver a range of preventive, promotive, and therapeutic interventions to combat helminthic neglected tropical diseases (NTDs). However, there is a need to implement and evaluate efficient integrated programs with the existing disease control programs on a larger scale throughout resource-limited regions especially to reach the unreachable.

Keywords: Community-based interventions; Neglected tropical diseases; Soil-transmitted helminthiasis.

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Figures

Figure 1
Figure 1
Search flow diagram.
Figure 2
Figure 2
Forest plot for the impact of CBIs on STH prevalence.
Figure 3
Figure 3
Forest plot for the impact of CBIs on schistosomiasis.
Figure 4
Figure 4
Forest plot for the impact of CBIs on hemoglobin.
Figure 5
Figure 5
Forest plot for the impact of CBIs on anemia.
See this image and copyright information in PMC

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