背景:在发展中国家的儿童中,由肠寄生虫感染引起的贫血患病率很高。因此,正在对所有儿童进行大规模治疗,特别是在学校环境中使用抗蠕虫药物。很少有研究评估驱虫对学龄儿童贫血患病率的影响。因此,我们旨在对驱虫对学龄儿童贫血患病率或血红蛋白水平的影响评估进行系统评价,以便决策者和其他秸秆持有者可以就做出决定的方向汇集证据。
方法:本综述是通过对1998年至2015年发表的文章进行系统的文献检索进行的。五个书目数据库和图书馆:PubMed/Medline,全球卫生数据库,Embase,Cochrane图书馆,使用了非洲指数药物。清洁和分类后,使用STATA版本11进行分析。汇总估计是通过固定效应模型进行的。异质性通过I2和发表偏倚通过漏斗图进行评估。
结果:保留了8项研究用于最终分析,共招募了1,005,239名学童。驱虫后血红蛋白水平的总体变化为1.62(95CI=1.01-2.25)克/分升。随机效应模型和固定效应模型之间没有差异。该计划后,贫血的患病率发生了明显的变化,特别是在实施驱虫与卫生计划的研究中,铁和视黄醇的共同给药。
结论:基于学校的驱虫计划降低了贫血的患病率,并将有助于减少社区的贫血。因此,该计划应在所有领域扩展,并与其他儿童保育计划相结合。
BACKGROUND: High prevalence of anemia attributable to intestinal parasite infection occurs among children in developing countries. As a result mass treatment of all children with anti-helminthic drugs particularly in school setting is being implemented. There are few studies conducted to assess impact of deworming on anemia prevalence among school children with inconclusive finding. Therefore we aimed to conduct a systematic
review on impact assessment of deworming on anemia prevalence or hemoglobin level of school children so that policy makers and other stalk holders could have pooled evidence on the direction to make decision.
METHODS: The
review was conducted through a systematic literature search of articles published between 1998 and 2015. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled estimate was through a fixed-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot.
RESULTS: Eight studies were retained for final analysis which enrolled a total of 1,005,239 school children. The overall change in the hemoglobin level after deworming was 1.62(95%CI=1.01-2.25) gram/deciliter. There was no difference between the random effect model and the fixed effect model. The prevalence of anemia was markedly changed after the program, particularly in the studies which implemented deworming with hygiene program, co-administration of iron and retinol.
CONCLUSIONS: School based deworming program decreases prevalence of anemia and will contribute to reduction of anemia in the community. Therefore the program should be expanded in all areas and integrated with other child care programs.