Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 31;12(5):e0006500.
doi: 10.1371/journal.pntd.0006500. eCollection 2018 May.

Deworming in pre-school age children: A global empirical analysis of health outcomes

Nathan C Lo  1   2 , Jedidiah Snyder  3   4 , David G Addiss  3 , Sam Heft-Neal  5 , Jason R Andrews  2 , Eran Bendavid  6   7
Affiliations

Deworming in pre-school age children: A global empirical analysis of health outcomes

Nathan C Lo et al. PLoS Negl Trop Dis. .

Abstract

Background: There is debate over the effectiveness of deworming children against soil-transmitted helminthiasis (STH) to improve health outcomes, and current evidence may be limited in study design and generalizability. However, programmatic deworming continues throughout low and middle-income countries.

Methodology and principal findings: We performed an empirical evaluation of the relationship between deworming in pre-school age children (ages 1-4 years) within the previous 6 months, as proxy-reported by the mother, and health outcomes of weight, height, and hemoglobin. We used nationally representative cross-sectional data from 45 countries using the Demographic and Health Surveys (DHS) during the period 2005-2016. We used logistic regression with coarsened exact matching, fixed effects for survey and year, and person-level covariates. We included data on 325,115 children in 45 STH-endemic countries from 66 DHS surveys. Globally in STH-endemic countries, children who received deworming treatment were less likely to be stunted (1.2 percentage point decline from mean of 36%; 95% CI [-1.9, -0.5%]; p<0.001), but we did not detect consistent associations between deworming and anemia or weight. In sub-Saharan Africa, we found that children who received deworming treatment were less likely to be stunted (1.1 percentage point decline from mean of 36%; 95% CI [-2.1, -0.2%]; p = 0.01) and less likely to have anemia (1.8 percentage point decline from mean of 58%; 95% CI [-2.8, -0.7%]; p<0.001), but we did not detect consistent associations between deworming and weight. These findings were robust across multiple statistical models, and we did not find consistently measurable associations with data from non-endemic settings.

Conclusions and significance: Among pre-school age children, we detected a robust and consistent association between deworming and reduced stunting, with additional evidence for reduced anemia in sub-Saharan Africa. We did not find a consistent relationship between deworming and improved weight. This global empirical analysis provides evidence to support the deworming of pre-school age children.

PubMed Disclaimer

Conflict of interest statement

JS and DA were employed by Children Without Worms (Task Force for Global Health), which is an organization that promotes prevention and treatment of soil-transmitted helminthiasis. The remaining authors declare no conflicts of interest.

Figures

Fig 1
Fig 1. Study countries and deworming coverage over 2005–2016.
We used data from the DHS for 45 STH endemic countries. For each, we computed the deworming coverage in pre-school age children.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hicks JH, Kremer M, Miguel E. (2015) The Case for Mass Treatment of Intestinal Helminths in Endemic Areas. PLoS Negl Trop Dis 9(10):e0004214 doi: 10.1371/journal.pntd.0004214 . - DOI - PMC - PubMed
    1. Montresor A, Addiss D, Albonico M, Ali SM, Ault SK, Gabrielli AF, et al. (2015) Methodological Bias Can Lead the Cochrane Collaboration to Irrelevance in Public Health Decision-Making. PLoS Negl Trop Dis 9(10):e0004165 doi: 10.1371/journal.pntd.0004165 . - DOI - PMC - PubMed
    1. Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P. (2015) Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin, and school performance. Cochrane Database Syst Rev 7:CD000371. doi: 10.1002/14651858.CD000371.pub6 . - DOI - PMC - PubMed
    1. Welch VA, Ghogomu E, Hossain A, Awasthi S, Bhutta ZA, Cumberbatch C, et al. (2017) Mass deworming to improve developmental health and wellbeing of children in low-income and middle-income countries: a systematic review and network meta-analysis. Lancet Glob Health 5(1):e40–e50. doi: 10.1016/S2214-109X(16)30242-X . - DOI - PubMed
    1. WHO. (2006) Preventive chemotherapy in human helminthiasis Coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers. Geneva: World Health Organization.

Publication types

MeSH terms

LinkOut - more resources