title: Community-based interventions for the prevention and control of helmintic neglected tropical diseases.
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.
authors.affiliation: Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan.
authors.forename: Rehana A
authors.initials: RA
authors.lastname: Salam
authors.affiliation: Brown University, Providence, RI, USA.
authors.forename: Hasina
authors.initials: H
authors.lastname: Maredia
authors.affiliation: Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan.
authors.forename: Jai K
authors.initials: JK
authors.lastname: Das
authors.affiliation: Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan.
authors.forename: Zohra S
authors.initials: ZS
authors.lastname: Lassi
authors.affiliation: Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan ; Center for Global Child Health Hospital for Sick Children, Toronto, Canada.
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
keywords: Community-based interventions; Neglected tropical diseases; Soil-transmitted helminthiasis
references.citation: Trop Med Int Health. 1999 Nov;4(11):744-50
references.pmid: 10588768
references.citation: J Nutr. 2010 Mar;140(3):635-41
references.pmid: 20107144
references.citation: Bull World Health Organ. 2001;79(8):695-703
references.pmid: 11545325
references.citation: PLoS Med. 2012 Jan;9(1):e1001162
references.pmid: 22291577
references.citation: BMC Med. 2007 Sep 03;5:27
references.pmid: 17767713
references.citation: Clin Infect Dis. 2010 Feb 15;50(4):531-40
references.pmid: 20067426
references.citation: Parasitology. 2011 Oct;138(12):1578-85
references.pmid: 21320386
references.citation: Trans R Soc Trop Med Hyg. 1989 Nov-Dec;83(6):805-10
references.pmid: 2515637
references.citation: Trends Parasitol. 2006 Jul;22(7):285-91
references.pmid: 16730230
references.citation: BMJ. 2000 Jun 24;320(7251):1697-701
references.pmid: 10864543
references.citation: Trop Med Int Health. 2006 Oct;11(10):1485-95
references.pmid: 17002722
references.citation: Am J Trop Med Hyg. 2003 Apr;68(4 Suppl):121-7
references.pmid: 12749495
references.citation: Am J Trop Med Hyg. 1991 Oct;45(4):509-17
references.pmid: 1951860
references.citation: J Health Popul Nutr. 2010 Jun;28(3):230-7
references.pmid: 20635633
references.citation: Trans R Soc Trop Med Hyg. 2001 Mar-Apr;95(2):195-201
references.pmid: 11355560
references.citation: Infect Dis Poverty. 2014 Jul 31;3:22
references.pmid: 25105014
references.citation: Trans R Soc Trop Med Hyg. 2008 Jun;102(6):509-19
references.pmid: 18413278
references.citation: BMC Public Health. 2009 Jul 28;9:266
references.pmid: 19638191
references.citation: Trans R Soc Trop Med Hyg. 2002 Nov-Dec;96(6):685-90
references.pmid: 12625151
references.citation: Lancet. 2013 Apr 20;381(9875):1417-1429
references.pmid: 23582723
references.citation: Trans R Soc Trop Med Hyg. 2001 Mar-Apr;95(2):211-6
references.pmid: 11355564
references.citation: Trans R Soc Trop Med Hyg. 2007 Jan;101(1):34-9
references.pmid: 17028047
references.citation: Tanzan J Health Res. 2010 Jan;12(1):86-99
references.pmid: 20737834
references.citation: Eur J Clin Nutr. 2001 Apr;55(4):223-8
references.pmid: 11360125
references.citation: PLoS Negl Trop Dis. 2012;6(7):e1709
references.pmid: 22815999
references.citation: Trans R Soc Trop Med Hyg. 1990 Nov-Dec;84(6):819-25
references.pmid: 2128985
references.citation: Annu Rev Nutr. 2002;22:35-59
references.pmid: 12055337
references.citation: Am J Clin Nutr. 1997 Apr;65(4):1057-61
references.pmid: 9094893
references.citation: Lancet. 2013 Aug 3;382(9890):452-477
references.pmid: 23746776
references.citation: Am J Epidemiol. 2009 Nov 1;170(9):1127-36
references.pmid: 19778983
references.citation: N Engl J Med. 2007 Sep 6;357(10):1018-27
references.pmid: 17804846
references.citation: J Nutr. 1994 Aug;124(8):1199-206
references.pmid: 8074755
references.citation: Cochrane Database Syst Rev. 2012 Jul 11;(7):CD000371
references.pmid: 22786473
references.citation: Am J Trop Med Hyg. 1995 Dec;53(6):577-80
references.pmid: 8561256
references.citation: J Nutr. 2002 Mar;132(3):418-22
references.pmid: 11880565
references.citation: PLoS Negl Trop Dis. 2008 Apr 30;2(4):e174
references.pmid: 18446203
references.citation: Am J Trop Med Hyg. 2001 Nov;65(5):484-90
references.pmid: 11716102
references.citation: Trends Parasitol. 2007 Nov;23(11):511-4
references.pmid: 17951109
references.citation: Am J Trop Med Hyg. 2006 Aug;75(2):278-86
references.pmid: 16896133
references.citation: JAMA. 2008 Apr 23;299(16):1937-48
references.pmid: 18430913
references.citation: Food Nutr Bull. 2003 Dec;24(4):332-42
references.pmid: 14870620
references.citation: Trends Parasitol. 2006 Jul;22(7):313-21
references.pmid: 16713738
references.citation: Wkly Epidemiol Rec. 2010 May 7;85(19):166-76
references.pmid: 20449943
references.citation: J Infect Dis. 2007 Sep 1;196(5):659-69
references.pmid: 17674306
references.citation: N Engl J Med. 2009 Jan 8;360(2):121-8
references.pmid: 19129526
references.citation: J Infect Dis. 1999 Apr;179(4):996-1003
references.pmid: 10068597
references.citation: Br J Nutr. 1992 Jul;68(1):245-52
references.pmid: 1390607
references.citation: Bull World Health Organ. 1993;71(2):207-14
references.pmid: 8490984
references.citation: Infect Dis Poverty. 2014 Jul 31;3:21
references.pmid: 25110585
references.citation: Ann Trop Med Parasitol. 1997 Dec;91(8):907-15
references.pmid: 9579210