title: Effect of Deworming on Indices of Health, Cognition, and Education Among Schoolchildren in Rural China: A Cluster-Randomized Controlled Trial.
abstract: AbstractSoil-transmitted helminths (STHs) infect over one billion people worldwide. There is concern that chronic infection with STHs among school-aged children may detrimentally affect their development, including their health, cognition, and education. However, two recent Cochrane reviews examining the impact of deworming drugs for STH on nutrition, hemoglobin, and school performance found that randomized controlled trials (RCTs) in the literature provide an insufficient evidence base to draw reliable conclusions. This study uses a cluster-RCT to add to existing evidence by assessing the impact of a deworming intervention on nutrition, cognition, and school performance among schoolchildren in rural China. The intervention, implemented by local health practitioners in a setting with a baseline infection prevalence of 41.9% (95% confidence interval [CI] = 39.8%, 43.9%) and infection intensity of 599.5 eggs per gram of feces among positive-tested schoolchildren (95% CI = 473.2, 725.8), consisted of distributing a 400-mg dose of albendazole accompanied with educational training about STH infection, treatment, and prevention. The intervention was conducted twice over the course of the study-at baseline in May 2013 and later in November 2013. We found that the deworming intervention reduced both infection prevalence and infection intensity, but these declines in infection were not accompanied by an impact on outcomes of nutrition, cognition, or school performance. Our interpretation is that the impact of deworming was attenuated by the light infection intensity in our sample population. Evidence from future RCTs is needed to assess the effect of deworming on key outcomes in areas with moderate and severe worm infections.
authors.affiliation: China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China.
authors.forename: Chengfang
authors.initials: C
authors.lastname: Liu
authors.affiliation: Freeman Spogli Institute, Stanford University, Stanford, California.|Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Louise
authors.initials: L
authors.lastname: Lu
authors.affiliation: Center for Chinese Agricultural Policy, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.
authors.forename: Linxiu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China.
authors.forename: Renfu
authors.initials: R
authors.lastname: Luo
authors.affiliation: School of Economics, Renmin University of China, Beijing, China.
authors.forename: Sean
authors.initials: S
authors.lastname: Sylvia
authors.affiliation: Freeman Spogli Institute, Stanford University, Stanford, California.
authors.forename: Alexis
authors.initials: A
authors.lastname: Medina
authors.affiliation: Freeman Spogli Institute, Stanford University, Stanford, California.
authors.forename: Scott
authors.initials: S
authors.lastname: Rozelle
authors.affiliation: Stanford University School of Medicine, Stanford, California.
authors.forename: Darvin Scott
authors.initials: DS
authors.lastname: Smith
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Yingdan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Tingjun
authors.initials: T
authors.lastname: Zhu
mesh_terms: D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002681:China / Q000453:epidemiology; D003071:Cognition; D004522:Educational Status; D005260:Female; D006304:Health Status; D006373:Helminthiasis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D000074381:Mass Drug Administration; D009483:Neuropsychological Tests; D009752:Nutritional Status; D010270:Parasite Egg Count; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012572:School Health Services
chemical_list: D000871:Anthelmintics; D015766:Albendazole