TY - JOUR
T1 - Helminth infections and micronutrients in school-age children: a systematic review and meta-analysis
AU - de Gier, B.
AU - Campos Ponce, M.
AU - van de Bor, M.
AU - Doak, C.M.
AU - Polman, K.
PY - 2014
Y1 - 2014
N2 - Background: Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. Objective: We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. Design: We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. Results: Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): 20.30; 95% CI: 20.48, 20.13] but not serum ferritin (SMD: 0.00; 95% CI: 20.7, 0.7). Conversely, metaanalyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: 20.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). Conclusions: In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide. © 2014 American Society for Nutrition.
AB - Background: Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. Objective: We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. Design: We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. Results: Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): 20.30; 95% CI: 20.48, 20.13] but not serum ferritin (SMD: 0.00; 95% CI: 20.7, 0.7). Conversely, metaanalyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: 20.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). Conclusions: In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide. © 2014 American Society for Nutrition.
U2 - 10.3945/ajcn.113.069955
DO - 10.3945/ajcn.113.069955
M3 - Article
SN - 0002-9165
VL - 99
SP - 1499
EP - 1509
JO - The American Journal of Clinical Nutrition
JF - The American Journal of Clinical Nutrition
IS - 6
ER -