Complexities and perplexities: a critical appraisal of the evidence for soil-transmitted helminth infection-related morbidity

Campbell, Suzy J., Nery, Susana V., Doi, Suhail A., Gray, Darren J., Soares Magalhaes, Ricardo J., McCarthy, James S., Traub, Rebecca J., Andrews, Ross M. and Clements, Archie C. A. (2016) Complexities and perplexities: a critical appraisal of the evidence for soil-transmitted helminth infection-related morbidity. PLoS Neglected Tropical Diseases, 10 5: . doi:10.1371/journal.pntd.0004566


Author Campbell, Suzy J.
Nery, Susana V.
Doi, Suhail A.
Gray, Darren J.
Soares Magalhaes, Ricardo J.
McCarthy, James S.
Traub, Rebecca J.
Andrews, Ross M.
Clements, Archie C. A.
Title Complexities and perplexities: a critical appraisal of the evidence for soil-transmitted helminth infection-related morbidity
Journal name PLoS Neglected Tropical Diseases   Check publisher's open access policy
ISSN 1935-2735
1935-2727
Publication date 2016-05-19
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1371/journal.pntd.0004566
Open Access Status DOI
Volume 10
Issue 5
Total pages 29
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2017
Language eng
Formatted abstract
Background: Soil-transmitted helminths (STH) have acute and chronic manifestations, and can result in lifetime morbidity. Disease burden is difficult to quantify, yet quantitative evidence is required to justify large-scale deworming programmes. A recent Cochrane systematic review, which influences Global Burden of Disease (GBD) estimates for STH, has again called into question the evidence for deworming benefit on morbidity due to STH. In this narrative review, we investigate in detail what the shortfalls in evidence are.

Methodology/Principal Findings: We systematically reviewed recent literature that used direct measures to investigate morbidity from STH and we critically appraised systematic reviews, particularly the most recent Cochrane systematic review investigating deworming impact on morbidity. We included six systematic reviews and meta-analyses, 36 literature reviews, 44 experimental or observational studies, and five case series. We highlight where evidence is insufficient and where research needs to be directed to strengthen morbidity evidence, ideally to prove benefits of deworming.

Conclusions/Significance: Overall, the Cochrane systematic review and recent studies indicate major shortfalls in evidence for direct morbidity. However, it is questionable whether the systematic review methodology should be applied to STH due to heterogeneity of the prevalence of different species in each setting. Urgent investment in studies powered to detect direct morbidity effects due to STH is required.
Keyword Soil-transmitted helminth (STH) infections
Neglected tropical diseases (NTDs)
Global Burden of Disease (GBD)
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
Admin only - CHRC
School of Public Health Publications
School of Veterinary Science Publications
Child Health Research Centre Publications
 
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