Soil-transmitted helminth infection, loss of

9 downloads 0 Views 3MB Size Report
Jan 12, 2018 - school-aged children: A systematic review and meta- ... PLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0005523 January 12, 2018 ...... Math. Multivariable analyses adjusted for age and sex only. 44 ...... and cognitive performance in children: systematic review of randomised tri- als.
RESEARCH ARTICLE

Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: A systematic review and meta-analysis Noel Pabalan1, Eloisa Singian2, Lani Tabangay3, Hamdi Jarjanazi4, Michael J. Boivin5, Amara E. Ezeamama5*

a1111111111 a1111111111 a1111111111 a1111111111 a1111111111

1 Center for Research and Development, Angeles University Foundation, Angeles City, Philippines, 2 Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles, Philippines, 3 Department of Biological Sciences, Angeles University Foundation, Angeles City, Philippines, 4 Environmental Monitoring and Reporting Branch, Biomonitoring Unit, Ontario Ministry of the Environment and Climate Change, Toronto, Ontario, Canada, 5 Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America * [email protected]

Abstract OPEN ACCESS Citation: Pabalan N, Singian E, Tabangay L, Jarjanazi H, Boivin MJ, Ezeamama AE (2018) Soiltransmitted helminth infection, loss of education and cognitive impairment in school-aged children: A systematic review and meta-analysis. PLoS Negl Trop Dis 12(1): e0005523. https://doi.org/10.1371/ journal.pntd.0005523 Editor: Christine M. Budke, Texas A&M University College Station, UNITED STATES

Background Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published between 1992 and 2016.

Received: September 6, 2016 Accepted: October 1, 2017 Published: January 12, 2018 Copyright: © 2018 Pabalan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: ES’s role on this research was supported by Angeles University Foundation grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All other authors received no specific funding for this work.

Methods Medline, Biosis and Web of Science were searched for original studies published in the English language. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Pooled effect across studies were calculated as standardized mean differences (SMD) to compare cognitive and educational measures for STH infected/nondewormed children versus STH uninfected /dewormed children using Review Manager 5.3. Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates.

Findings We included 36 studies of 12,920 children. STH infected/non-dewormed children had small to moderate deficits in three domains—learning, memory and intelligence (SMD: -0.44 to -0.27, P