Meta-Analysis and Public Policy: Reconciling the Evidence on Deworming
The WHO recommends mass drug administration (MDA) for intestinal worm infections in areas with >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.
Published Versions
Kevin Croke & Joan Hamory & Eric Hsu & Michael Kremer & Ricardo Maertens & Edward Miguel & Witold Więcek, 2024. "Meta-analysis and public policy: Reconciling the evidence on deworming," Proceedings of the National Academy of Sciences, vol 121(25).