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The impact of population level deworming on the haemoglobin levels of schoolchildren in TangaTanzania. Blood in the stool Eight studies evaluated the prevalence of blood in the stool see Table F in S1 Text and the meta-analysis summary estimate indicated a significant reduction after chemotherapy for schistosomiasis OR 0. Using the selected search terms, initial screening of the databases yielded study reports after removing duplicates.
For urogenital infection with S. To test for outliers or the effects of larger chhk studies s070 our analysis, sensitivity analysis by exclusion of one study at a time from the meta-analysis did not affect the outcome performance of the odds ratio, Z, and p-values, and the significance of observed associations did ch change S2 — S4 Figs.
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S2 Fig Sensitivity analysis Forest Plot of the impact of therapy on left lobe hepatomegaly prevalence. Publications eliminated in the first stage were excluded because they were animal studies, review studies, case reports, immunological studies, studies of parasitological efficacy and safety only, diagnostic studies, reinfection studies, spatial distribution studies, or evaluations of mass treatment programs, surgical intervention, other diseases, prevalence of coinfection, or studies to estimate prevalence and intensity of infection.
After titles and abstracts were assessed, reports were selected for full review. However, the more advanced chronic forms of disease were less responsive to single rounds of treatment, even with adequate ERRs, and our stratified analysis suggests that multiple rounds of treatment are necessary to improve or hopefully prevent these outcomes.
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Significant heterogeneity was observed among the studies included Fig 2 which could be reduced by subgroup stratification according to region, age, and follow-up time Table E in S3 Text. Nevertheless, studies of morbidity reduction related to drug treatment have had some conflicting results [ 23 — 26 ], which may be a reflection of differences in follow-up after treatment, methods used to measure morbidities, chl Schistosoma species, the presence of co-infections especially malariathe type of population and the region, the initial prevalence of infection, the incidence of reinfection, and other factors [ 727 ].
Significant s0007 was observed among the studies Fig 2 and the subgroup analysis was performed in order to identify the s0077 see Table G in S3 Text. In our summary 0s07, only two morbidities showed no consistent or significant change between pre- and post-treatment surveys.
In addition, the numbers of subjects evaluated at cgk and at each follow-up were required, along with reporting of morbidity prevalence or mean laboratory values before and after treatment intervention.
Panel B, Forest plot and meta-analysis for the difference in mean hemoglobin levels, pre-intervention vs. Random effects meta-analysis was used to derive summary estimates: For those morbidities related to intestinal schistosomiasis, i. Nevertheless, it was observed that even near-total reduction in egg counts by drug treatment was unlikely to lead to complete reduction of all morbidity risk. The impact of chemotherapy on morbidity due to schistosomiasis.
Regression of splenomegaly and hepatomegaly in children treated for Schistosoma haematobium infection. Our meta-regression profiles indicate that acute reductions in worm burden, as reflected by the ERRs achieved after chkk therapy, are associated with reversal of most of the acute pathologies of infection.
The impact of Schistosoma japonicum infection and treatment on ultrasound-detectable morbidity: Th2 responses in schistosomiasis. Toward the elimination of schistosomiasis. Sensitivity analysis by exclusion of a single study at a time from the meta-analysis did not affect the results S10 Fig.
There was significant heterogeneity among the studies in the three types of evaluation Fig 2that was not significantly reduced by subgroup analyses see Table A in S3 Text. Cross-sectional studies suggest pre-treatment correlation between infection intensity and risk for Schistosoma -related pathology. Sensitivity analysis by exclusion of one single study at a time from the meta-analysis did not affect the results S5 Fig.
The summary OR and confidence interval is indicated by the red diamond at the bottom of each plot. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: Despite the potential benefits of treatment, many affected persons have not yet been reached by treatment fhk [ 28 ]. Technical Report Series Given this context, and that one of the main objectives of schistosomiasis control programs has been to achieve reductions in morbidity associated with Schistosoma infection [ 29 ], there is a need to accurately quantify the reduction of morbidity levels as a result of chemotherapy intervention, so that the specific benefits of more intensive interventions can be identified.
Eight studies evaluated the cessation of episodes of diarrhea after anti-schistosomal chemotherapy see Table E in S1 Text. S8 Fig Sensitivity analysis Forest Plot of the impact of therapy on diarrhea prevalence.
However, this was not the case for splenomegaly reduction or for periportal fibrosis. In our subgroup analyses, some study features were clearly linked to either better or more limited reductions in morbidity prevalence after treatment. Eggs are most consistently detected in stool or urine with heavier infections, and persons with light intensity infection may have morbidity but have egg-negative status on the day of survey testing.
We found no evidence of publication bias using unweighted, non-randomized values in the Egger test. Significant heterogeneity was observed among the studies included Fig 2 which could be modified by subgroup stratification according to region, age, and time of follow-up. Forest plot showing sensitivity analysis, performed by removing one study at a time, for the effect of treatment on prevalence of right hepatic lobe hepatomegaly.
Of importance to public health, it appears that monitoring of schistosomiasis-associated anemia impact should be planned for a period at one year or more after treatment.
The aim of this project was to systematically review evidence on drug-based control of schistosomiasis and to develop a quantitative estimate of the impact of post-treatment reductions in infection intensity on prevalence of infection-associated morbidity. Post-treatment odds e007 splenomegaly and periportal fibrosis were not significantly reduced for infection with S. Schistosomiasis and soil-transmitted helminthiases: Reversibility of urinary tract abnormalities due to Schistosoma haematobium infection.