Effects of Deworming on Malnourished Preschool Children in India An Open-Labelled, Cluster-Randomized Trial 英文参考文献.docVIP

EffectsofDewormingonMalnourishedPreschool ChildreninIndia:AnOpen-Labelled,Cluster-Randomized Trial ShallyAwasthi1*,RichardPeto2,VinodK.Pande1,RobertH.Fletcher3,SimonRead2,DonaldA.P.Bundy4 1Department of Paediatrics, King George’s Medical University, Lucknow, India, 2Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom, 3Harvard MedicalSchool,HarvardUniversity,Boston,Massachusetts,UnitedStatesofAmerica,4HumanDevelopmentDivision,TheWorldBank,Washington,D.C.,UnitedStatesof America Abstract Background:Morethanathirdoftheworld’schildrenareinfectedwithintestinalnematodes.Currentcontrolapproaches emphasise treatment of school age children, and there is a lack of information on the effects of deworming preschool children. Methodology: We studied the effects on the heights and weights of 3,935 children, initially 1 to 5years of age, of five roundsofanthelmintictreatment(400mgalbendazole)administeredevery6monthsover2years.Thechildrenlivedin50 areas,eachdefinedbyprecisegovernmentboundariesasurbanslums,inLucknow,NorthIndia.Allchildrenwereoffered vitamin A every 6months, and children in 25 randomly assigned slum areas also received 6-monthly albendazole. Treatments were delivered by the State Integrated Child Development Scheme (ICDS), and height and weight were monitoredatbaselineandevery6monthsfor24months(trialregistrationnumberNC.pValuecalculationsare basedonlyonthe50area-specificmeanvalues,asrandomizationwasbyarea. Findings:TheICDSinfrastructureprovedabletodelivertheinterventions.95%(3,712/3,912)ofthosealiveattheendofthe studyhadreceivedallfiveinterventionsandhadbeenmeasuredduringallfourfollow-upsurveys,and99%(3,855/3,912) weremeasuredatthelastofthesesurveys.Atthisfinalfollowup,thealbendazole-treatedarmexhibitedasimilarheight gainbuta35(SE5)%greaterweightgain,equivalenttoanextra1(SE0.15)kgover2years(99%CI0.6–1.4kg,p=10211 ). Conclusions: In such urban slums in the 1990s, five 6-monthly rounds of single dose anthelmintic treatment of malnouris