Systematic intestinal deworming in pediatric populations: An evidence based review

Abstract

Objectives: To determine whether systematic intestinal deworming with anthelmintic medications in pediatric populations affects height, weight, cognitive and academic performance, morbidity and mortality in children. Data Sources: MEDLINE database, electronic evidence-based medicine websites and World Health Organization publications. Review Methods: A search for articles using the MeSH terms albendazole, mebendazole, and pyrantel pamoate, published between January, 2000 and March, 2011 was conducted. Some related citations were also included. The Jadad Score was used to assess the quality of randomized clinical trials. The Strength of Recommendation Taxonomy (SORT) scale of the American Family Physician was used to assess the corresponding quality and strength of recommendations. Results: The search produced a total of 746 articles, of which 12 met the inclusion criteria. These included three systematic reviews, one meta-analysis, four clinical trials and four clinical practice guidelines. In children living in countries with a high prevalence of intestinal parasite infection, deworming proved to be beneficial in promoting height and weight gain. With reference to cognitive development and school performance, no evidence was found as to the benefits of deworming. Studies show inconsistent results in terms of morbidity. However, there seems to be an improvement in median hemoglobin levels, as well as a decrease in anemia and diarrhea. Conclusions:There is evidence for the benefits of systematic intestinal deworming with anthelmintics in children living in countries with a prevalence of intestinal parasite infection higher than 50% resulting from soil-transmitted helminths (SOR B). In countries with a low prevalence of infection, such as Portugal, individual treatment based on a diagnosis of infection is recommended (SOR C).