Meta-analysis and public policy: Reconciling the evidence on deworming

Kevin Croke, Joan Hamory, Eric Hsu, Michael Kremer, Ricardo Maertens, Edward Miguel and Witold Więcek

Department of Economics, Working Paper Series from Department of Economics, Institute for Business and Economic Research, UC Berkeley

Abstract: The WHO recommends mass drug administration (MDA) for intestinal worm infections in areas with over 20% infection prevalence. Recent Cochrane meta-analyses endorse treatment of infected individuals but recommend against MDA. We conducted a theory-agnostic random-effects meta-analysis of the effect of multiple-dose MDA and a cost-effectiveness analysis. We estimate significant effects of MDA on child weight (0.15 kg, 95% CI: 0.07, 0.24; P < 0.001), mid-upper arm circumference (0.20 cm, 95% CI: 0.03, 0.37; P = 0.02), and height (0.09 cm, 95% CI: 0.01, 0.16; P = 0.02) when prevalence is over 20% but not on Hb (0.06 g/dL, 95% CI: -0.01, 0.14; P = 0.1). These results suggest that MDA is a cost-effective intervention, particularly in the settings where it is recommended by the WHO.

Keywords: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Comparative Effectiveness Research (rcdc); Cost Effectiveness Research (rcdc); Clinical Research (rcdc); Infectious Diseases (rcdc); Humans (mesh); Intestinal Diseases; Parasitic (mesh); Helminthiasis (mesh); Mass Drug Administration (mesh); Anthelmintics (mesh); Public Policy (mesh); Cost-Benefit Analysis (mesh); Child (mesh); meta-analysis; cost-effectiveness; deworming; nutrition; Humans (mesh); Helminthiasis (mesh); Intestinal Diseases; Parasitic (mesh); Anthelmintics (mesh); Public Policy (mesh); Child (mesh); Cost-Benefit Analysis (mesh); Mass Drug Administration (mesh); cost-effectiveness; deworming; meta-analysis; nutrition; Humans (mesh); Intestinal Diseases; Parasitic (mesh); Helminthiasis (mesh); Mass Drug Administration (mesh); Anthelmintics (mesh); Public Policy (mesh); Cost-Benefit Analysis (mesh); Child (mesh) (search for similar items in EconPapers)
Date: 2024-06-18
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