Study casts doubts on value of mass deworming in children
Health workers administer medication to a child. There was a mass deworming programme across schools in Kenya in early 2000 which showed that children got rid of worm infections and this led to an increase in school participation. PHOTO| FILE| NATION MEDIA GROUP
A new study has cast doubts on the long-term effectiveness of mass deworming programmes in contributing to the health and nutrition of children in Kenya and Uganda.
It says there is no reliable evidence showing that deworming in children improves nutrition, health, education and therefore contributes to economic development through higher incomes.
The research published early this month in the International Journal of Epidemiology critically analysed three widely cited research studies relating to mass deworming in Africa and concluded they have substantial problems in their methods and analysis.
The new analysis found substantial doubt on the validity of the previous studies based on the information provided and the process of analysis that has been documented.
The study, The Impact of Mass Deworming Programmes on Schooling and Economic Development: An Appraisal of Long-term Studies, however praises the efforts of parasitologists, economists and development specialists in mass drug administration to tackle worm infections.
The research points out that these previous studies are not as reliable as previously thought as some exclusively presented positive results with no evidence of effect and the conflicting findings within the analysis, as is expected of scientific studies.
INTERNATIONAL STANDARDS
“When we apply international standards for methodological rigor in these studies, unfortunately they don’t pass muster. Multiple significance testing and then selection of supportive results seems to be a potential problem. This is an example from the field of development economics where bias needs to be taken into account before the authors make policy recommendations,” say the senior author of the new analysis, Prof Paul Garner, from the Liverpool School of Tropical Medicine’s Centre for Evidence Synthesis in Global Health.
The queries over the reliability of previous studies is drawn from three studies that evaluated the effects of trials in Kenya (in Busia) and Uganda (Eastern region), nine years after they were concluded. In both countries, the school going children receive deworming tablets every six months.
One was a mass deworming programme across schools in Kenya in early 2000 which showed that children got rid of worm infections and this led to an increase in school participation.
The 2017 impact assessment study also appraised another study done in 2012 that questioned the efficacy of mass deworming as opposed to deworming administered only to infected individuals. While benefits were noted in infected children, there was no substantial increase in the health or cognition in the healthy ones.
Other studies on the benefits of deworming said it led to higher scores in Maths and English among children aged between 10 and 11 after less than two additional doses of deworming tablets during early childhood. But the new study has attributed this to chance and nothing else.
The stated effects from the previous studies in Kenya and Uganda were inconsistent with the indirect nature of the exposure to deworming and therefore there was no cause and effect of the deworming exercises.
The new analysis found substantial doubt on the validity of the previous studies based on the information provided and the process of analysis that has been documented.
