title: The Effect of Deworming on Growth in One-Year-Old Children Living in a Soil-Transmitted Helminth-Endemic Area of Peru: A Randomized Controlled Trial.
abstract: BACKGROUND
  Appropriate health and nutrition interventions to prevent long-term adverse effects in children are necessary before two years of age. One such intervention may include population-based deworming, recommended as of 12 months of age by the World Health Organization in soil-transmitted helminth (STH)-endemic areas; however, the benefit of deworming has been understudied in early preschool-age children.
  
  
  RESULTS
  A randomized, double-blind, placebo-controlled trial was conducted to determine the effect of deworming (500 mg single-dose crushed mebendazole tablet) on growth in one-year-old children in Iquitos, Peru. Children were enrolled during their routine 12-month growth and development clinic visit and followed up at their 18 and 24-month visits. Children were randomly allocated to: Group 1: deworming at 12 months and placebo at 18 months; Group 2: placebo at 12 months and deworming at 18 months; Group 3: deworming at both 12 and 18 months; or Group 4: placebo at both 12 and 18 months (i.e. control group). The primary outcome was weight gain at the 24-month visit. An intention-to-treat approach was used. A total of 1760 children were enrolled between September 2011 and June 2012. Follow-up of 1563 children (88.8%) was completed by July 2013. STH infection was of low prevalence and predominantly light intensity in the study population. All groups gained between 1.93 and 2.05 kg on average over 12 months; the average difference in weight gain (kg) compared to placebo was: 0.05 (95% CI: -0.05, 0.17) in Group 1; -0.07 (95%CI: -0.17, 0.04) in Group 2; and 0.04 (95%CI: -0.06, 0.14) in Group 3. There was no statistically significant difference in weight gain in any of the deworming intervention groups compared to the control group.
  
  
  CONCLUSIONS
  Overall, with one year of follow-up, no effect of deworming on growth could be detected in this population of preschool-age children. Low baseline STH prevalence and intensity and/or access to deworming drugs outside of the trial may have diluted the potential effect of the intervention. Additional research is required to overcome these challenges and to contribute to strengthening the evidence base on deworming.
  
  
  BACKGROUND
  ClinicalTrials.gov (NCT01314937).
authors.affiliation: McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Québec, Canada; Research Institute of the McGill University Health Centre, Division of Clinical Epidemiology, Montréal, Québec, Canada.
authors.forename: Serene A
authors.initials: SA
authors.lastname: Joseph
authors.affiliation: Asociación Civil Selva Amazónica, Iquitos, Peru.
authors.forename: Martín
authors.initials: M
authors.lastname: Casapía
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.affiliation: Research Institute of the McGill University Health Centre, Division of Clinical Epidemiology, Montréal, Québec, Canada; McGill University, Department of Medicine, Montréal, Québec, Canada.
authors.forename: Elham
authors.initials: E
authors.lastname: Rahme
authors.affiliation: JD MacLean Centre for Tropical Diseases, McGill University, Department of Medicine, Montréal, Québec, Canada; National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Ward
authors.affiliation: McGill University, School of Dietetics and Human Nutrition, Sainte Anne-de-Bellevue, Québec, Canada.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Marquis
authors.affiliation: Asociación Civil Selva Amazónica, Iquitos, Peru.
authors.forename: Lidsky
authors.initials: L
authors.lastname: Pezo
authors.affiliation: McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Québec, Canada; Research Institute of the McGill University Health Centre, Division of Clinical Epidemiology, Montréal, Québec, Canada.
authors.forename: Brittany
authors.initials: B
authors.lastname: Blouin
authors.affiliation: Department of Infectious Disease Epidemiology, Imperial College London, St. Mary's Hospital, London, United Kingdom.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Maheu-Giroux
authors.affiliation: McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Québec, Canada; Research Institute of the McGill University Health Centre, Division of Clinical Epidemiology, Montréal, Québec, Canada; McGill University, Department of Medicine, Montréal, Québec, Canada; JD MacLean Centre for Tropical Diseases, McGill University, Department of Medicine, Montréal, Québec, Canada.
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
mesh_terms: D001827:Body Height; D001835:Body Weight; D004311:Double-Blind Method; D019353:Endemic Diseases; D005243:Feces / Q000469:parasitology; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance; D012987:Soil / Q000469:parasitology*; D013997:Time Factors
chemical_list: D012987:Soil