BMJ 2000;321:1224 ( 11 November )

Letters

Treatment for intestinal helminth infection

    Contrary to authors' comments, meta-analysis supports global helminth control initiatives
    Conclusions should have been based on broader considerations
    Studies of short term treatment cannot assess long term benefits of regular treatment
    Message does not follow from systematic review's findings
    Review needed to take account of all relevant evidence, not only effects on growth and cognitive performance
    Authors' reply

Contrary to authors' comments, meta-analysis supports global helminth control initiatives

The first 150 words of the full text of this article appear below.

EDITOR---Dickson et al's meta-analysis of the effects of treatment for intestinal helminth infection on growth and cognitive performance in children has produced two important findings, only one of which has been discussed by the authors.1

The meta-analysis has helped highlight the poor quality of many of the trials carried out so far. The more important result (not remarked on) is the extraordinary finding that, despite the many systematic differences observed between the studies used in the meta-analysis, treatment unfailingly has a positive average effect on both the outcomes studied (table 3). In addition, the fact that many systematic differences were observed between the studies in the meta-analysis seriously questions the value of trying to derive global summary results for any of the comparisons on both statistical and biological grounds.

The result of the meta-analysis supports an important principle for judging causality from the results of clinical trials---that . . . [Full text of this article]
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Relevant Article

Effects of treatment for intestinal helminth infection on growth and cognitive performance in children: systematic review of randomised trials
Rumona Dickson, Shally Awasthi, Paula Williamson, Colin Demellweek, and Paul Garner
BMJ 2000 320: 1697-1701. [Abstract] [Full Text] [PDF]

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