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

Croke, Kevin; Hamory, Joan; Hsu, Eric; Kremer, Michael; Maertens, Ricardo; Miguel, Edward; Więcek, Witold · Proc Natl Acad Sci U S A · 2024

meta_analysis · Level I

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Abstract

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 meta-analysis 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; <i>P</i> < 0.001), mid-upper arm circumference (0.20 cm, 95% CI: 0.03, 0.37; <i>P</i> = 0.02), and height (0.09 cm, 95% CI: 0.01, 0.16; <i>P</i> = 0.02) when prevalence is over 20% but not on Hb (0.06 g/dL, 95% CI: -0.01, 0.14; <i>P</i> = 0.1). These results suggest that MDA is a cost-effective intervention, particularly in the settings where it is recommended by the WHO.

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