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Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:The impact of deworming on parasite load, nutritional status and other health outcomes of non-pregnant adolescent girls and adult women is uncertain. METHODS:MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials, the WHO International Clinical Trials Registry Platform, the Cochrane Database of Systematic Reviews and Food and Technology Abstracts databases were searched until 24 September 2018. Studies were included if they were randomised controlled trials (RCTs), controlled before and after studies or interrupted time studies comparing deworming with no intervention or placebo in non-pregnant adolescent girls and women 10 to 49 years old. Outcomes of interest included parasite load, reinfection, anaemia, severe anaemia, iron deficiency, diarrhoea or all-cause morbidity. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS:We included four RCTs of mass deworming involving 1086 participants, in the analyses. Mass deworming probably reduces the prevalence of roundworm infection (RR 0.29; 95% CI 0.14 to 0.62; 2 trials; 1498 participants, moderate certainty evidence), prevalence of hookworm infection (RR 0.32; 95% CI 0.18 to 0.59; 2 trials; 1498 participants, moderate certainty evidence), prevalence of whipworm infection (RR 0.77; 95% CI 0.65 to 0.91; 2 trials; 1498 participants, moderate certainty evidence) compared to the control group. Deworming may make little or no difference in prevalence of anaemia (RR 0.82; 95% CI 0.60 to 1.11, 3 studies, 683 participants, low certainty evidence) and prevalence of iron-deficiency (RR 0.89; 95% CI 0.64 to 1.23, 1 study, 186 participants, low certainty evidence) compared to control. We are uncertain whether deworming reduces the prevalence of severe anaemia compared to control as the certainty of evidence was very low. None of the included studies assessed screen and treat deworming or reported reinfection, diarrhoea or adverse events. CONCLUSIONS:Mass deworming probably reduces the prevalence of soil-transmitted helminth infections but may have little or no effect on anaemia and iron-deficiency in adolescent girls and non-pregnant women in comparison to no intervention or placebo. We are uncertain about the effect on severe anaemia. These results are limited by sparse data and the moderate to very low quality of evidence available. SYSTEMATIC REVIEW REGISTRATION:The protocol was registered in PROSPERO (registration number: CRD42016039557 ). Primary source of funding: Evidence and Programme Guidance unit, Department of Nutrition for Health and Development, World Health Organization (WHO).

SUBMITTER: Tanjong Ghogomu E

PROVIDER: S-EPMC6300900 | biostudies-other | 2018 Dec

REPOSITORIES: biostudies-other

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Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis.

Tanjong Ghogomu Elizabeth E Suresh Shalini S Rayco-Solon Pura P Hossain Alomgir A McGowan Jessie J Peña-Rosas Juan Pablo JP Welch Vivian V

Systematic reviews 20181220 1

<h4>Background</h4>The impact of deworming on parasite load, nutritional status and other health outcomes of non-pregnant adolescent girls and adult women is uncertain.<h4>Methods</h4>MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials, the WHO International Clinical Trials Registry Platform, the Cochrane Database of Systematic Reviews and Food and Technology Abstracts databases were searched until 24 September 2018. Studies were included if they were randomised controlle ...[more]

PMID: 30572948

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Project description:To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs.Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls' MHM.India.Adolescent girls.Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time.Data from 138 studies involving 193 subpopulations and 97,070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I(2) 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I(2) 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I(2) 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I(2) 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I(2) 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I(2) 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I(2) 97.8%, n=17). Half of the girls' homes had a toilet (PP 51%, 36% to 67%, I(2) 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0-7).Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed.CRD42015019197.

Project description:BackgroundAdolescent girls face several challenges relating to menstruation and its proper management. Lack of adequate sanitary products, inadequate water supply, and privacy for changing sanitary pads continue to leave adolescent girls with limited options for safe and proper menstrual hygiene in many low-income settings, including Ethiopia. These situations are also compounded by societal myths, stigmas surrounding menstruation, and discriminatory social norms. This systematic review and meta-analysis aimed to estimate the pooled proportion of safe menstrual hygiene management among adolescent girls in Ethiopia using the available studies.MethodsWe searched PubMed, Google Scholar, African Journal Online (AJOL), Hinari, Science Direct, ProQuest, Direct of Open Access Journals, POPLINE, and Cochrane Library database inception to May 31, 2021. Studies reporting the proportion of menstrual hygiene management among adolescent girls in Ethiopia were considered. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. Since the included studies revealed considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled proportion of menstrual hygiene management (MHM).ResultsOf 1,045 identified articles, 22 studies were eligible for analysis (n = 12,330 participants). The pooled proportion (PP) of safe MHM in Ethiopia was 52.69% (95%CI: 44.16, 61.22). The use of commercial menstrual absorbents was common 64.63% (95%CI: 55.32, 73.93, I2 99.2%) followed by homemade cloth 53.03% (95%CI: 22.29, 83.77, I2 99.2%). Disposal of absorbent material into the latrine was the most common practice in Ethiopia 62.18% (95%CI: 52.87, 71.49, I2 98.7%). One in four girls reported missing one or more school days during menstruation (PP: 32.03%, 95%CI: 22.65%, 41.40%, I2 98.2%).ConclusionThis study revealed that only half of the adolescent girls in Ethiopia had safe MHM practices. To ensure that girls in Ethiopia can manage menstruation hygienically and with dignity, strong gender-specific water, sanitation, and hygiene (WASH) facilities along with strong awareness creation activities at every level are needed.

Project description:IntroductionIn Ethiopia, undernutrition is the common public health concern, swaying the lives of lots of adolescent girls. Its sequelae are not only limited to them, but rather their upcoming offspring are vulnerable too. Even though some studies have been carried out in different parts of the country, the national pooled prevalence and determinants of undernutrition are not known. Therefore, this study is aimed at determining the pooled prevalence and determinants of undernutrition among adolescent girls in Ethiopia.MethodsPublished articles will be retrieved from databases such as Medline and PubMed. Electronic search engines such as Google Scholar and Google will be used. To identify eligible studies, the Joanna Briggs Institute quality appraisal checklists prepared for different study designs will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain the scientific robustness of the study. The presence of heterogeneity among studies will be examined by forest plot as well as I2 heterogeneity test. Potential causes of heterogeneity will be explored by carrying out sensitivity and subgroup analyses. The DerSimonian and Laird random-effects model will be used provided that heterogeneity is observed. Publication bias will be examined by observing funnel plots, and objectively by Egger's regression test. If the funnel plot is asymmetric and/or Egger's test was found to be statistically significant (p<0.05), the trim and fill (Duval and Tweedie's) analysis will be performed. The presence of a statistical association between independent and dependent variables will be declared if the p value is <0.05 with the 95% CI.Ethics and disseminationSince this is a systematic review and meta-analysis, ethical clearance will not be a concern. The results of the study will be published in a peer-reviewed reputable journal and presented at different scientific research conferences.Trial registration numberCRD42018106180.

Project description:BackgroundThyroid dysfunction during pregnancy is associated with adverse outcomes for both mother and fetus. The present meta-analysis was conducted to evaluate thyroid dysfunction in Iranian pregnant women.MethodsWe registered this review at PROSPERO (registration number: CRD42020166655). The research steps in this systematic review and meta-analysis were performed according to the MOOSE protocol, and finally, reports were provided based on the PRISMA guidelines. The literature search was performed in October 2019 using the international online databases, including Web of Science, Ovid, Science Direct, Scopus, EMBASE, PubMed/Medline, Cochrane Library, EBSCO, CINAHL, Google Scholar as well as national databases were reviewed. Data were extracted after applying the inclusion and exclusion criteria and qualitative evaluation of the studies. I2 index and Q test were used to assess differences in studies. All analyses were performed using Comprehensive Meta-Analysis Software. P-value less than 0.05 was considered statistically significant. We identified 1261 potential articles from the databases, and 426 articles remained after removing the duplicate and unrelated studies. After evaluating the full text, 52 articles were removed.ResultsFinally, 19 eligible studies including 17,670 pregnant women included for meta-analysis. The prevalence of thyroid dysfunction in Iranian pregnant women was 18.10% (95%CI: 13.89-23.25). The prevalence of hypothyroidism, clinical hypothyroidism, and subclinical hypothyroidism in Iranian pregnant women was respectively estimated to be 13.01% (95%CI: 9.15-18.17), 1.35% (95%CI: 0.97-1.86) and 11.90% (95%CI: 7.40-18.57). The prevalence of hyperthyroidism, clinical hyperthyroidism, and subclinical hyperthyroidism in Iranian pregnant women was respectively estimated to be 3.31% (95%CI: 1.62-6.61), 1.06% (95%CI: 0.61-1.84) and 2.56% (95%CI: 0.90-7.05). The prevalence of anti-thyroperoxidase antibody was estimated to be 11.68% (95%CI: 7.92-16.89).ConclusionThe results of this meta-analysis showed a high prevalence of thyroid disorders, especially hypothyroidism. The decision to recommend thyroid screening during pregnancy for all women is still under debate, because the positive effects of treatment on pregnancy outcomes must be ensured. On the other hand, evidence about the effect of thyroid screening and treatment of thyroid disorders on pregnancy outcomes is still insufficient. Nevertheless, a large percentage of general practitioners, obstetricians and gynecologists perform screening procedures in Iran.

Project description:BackgroundAnemia is the reduction of red blood cells in size and numbers and an indicator of both poor nutrition and poor health. It is a major global public health problem. Anemia in adolescents and young adults can have negative effects on their cognitive performance and growth. In Ethiopia, previous studies yielded variable prevalence. This review aimed to determine the pooled prevalence of adolescent girls' anemia and associated factors in Ethiopia.MethodsWe searched for studies reporting anemia and associated factors among adolescent girls as reported in peer reviews publications in Ethiopia from 1988 to 2021 from PubMed, Google Scholar, Web of Science, Science Direct, Cochrane Library, and Worldwide Science database. The search strategy identified 309 cross-sectional studies. After screening for potentially eligible articles, we identified 37 publications for full text review, following which 10 publications were included in the final review. Using data from the review, we performed meta-analysis to produce pooled estimates and assess the prevalence of anemia and associated risk factors. Data were extracted using a standardized data extraction format prepared in Microsoft Excel™ and transferred to Stata ™ Version 14.0 for management and further analysis. To identify the source of heterogeneity, subgroup analysis using sample size and study setup was computed, and I2 test was used to declare the presence or absence of significant heterogeneity during subgroup analysis. A random-effect meta-analysis model was used to estimate the pooled prevalence of adolescent girls' anemia. Moreover associated factors for adolescent anemia were assessed too.ResultsThe overall pooled prevalence of anemia among adolescent girls' in Ethiopia was 23.02% (95% CI: 17.21to 28.84). In the subgroup analysis, studies that have a higher sample size than mean have a higher pooled prevalence (27.35%) (95% CI: 21.42 to 33.28) compared to their counterparts. Age being 15-19 (OR: 2.13; 95% CI: 1.52 to 2.96), living in rural areas (OR: 2.05; 95% CI: 1.66 to 2.54), and low dietary diversity (OR: 1.35; 95% CI: 1.00 to 2.34), were the identified factors associated with anemia among adolescent girls'.ConclusionThe pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Being in 15-19 years, rural residence, and low dietary diversity score were found to be the significant factors of anemia among adolescent girls in Ethiopia.

Dataset Information

Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis.

Publications

Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis.

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