The Effect of Deworming School Children on Anemia Prevalence: A Systematic Review and Meta-Analysis

Introduction: High prevalence of anemia attributable to intestinal parasite infection occurs among children in developing countries. As a result mass treatment of all children with anti-helminthic drugs particularly in school setting is being implemented. There are few studies conducted to assess impact of deworming on anemia prevalence among school children with inconclusive finding. Therefore we aimed to conduct a systematic review on impact assessment of deworming on anemia prevalence or hemoglobin level of school children so that policy makers and other stalk holders could have pooled evidence on the direction to make decision. Methods: The review was conducted through a systematic literature search of articles published between 1998 and 2015. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled estimate was through a fixed-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. Results: Eight studies were retained for final analysis which enrolled a total of 1,005,239 school children. The overall change in the hemoglobin level after deworming was 1.62(95%CI=1.01-2.25) gram/deciliter. There was no difference between the random effect model and the fixed effect model. The prevalence of anemia was markedly changed after the program, particularly in the studies which implemented deworming with hygiene program, co-administration of iron and retinol. Conclusion and Recommendation: School based deworming program decreases prevalence of anemia and will contribute to reduction of anemia in the community. Therefore the program should be expanded in all areas and integrated with other child care programs.