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Does mass deworming affect child nutrition ? meta-analysis, cost-effectiveness, and statistical power

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  • Croke,Kevin
  • Hicks,Joan Hamory
  • Hsu,Eric
  • Kremer,Michael Robert
  • Miguel,Edward A.

Abstract

The WHO has recently debated whether to reaffirm its long-standing recommendation of mass drug administration (MDA) in areas with more than 20 percent prevalence of soil-transmitted helminths (hookworm, whipworm, and roundworm). There is consensus that the relevant deworming drugs are safe and effective, so the key question facing policymakers is whether the expected benefits of MDA exceed the roughly $0.30 per treatment cost. The literature on long run educational and economic impacts of deworming suggests that this is the case. However, a recent meta-analysis by Taylor-Robinson et al. (2015), (hereafter TMSDG), disputes these findings. The authors conclude that while treatment of children known to be infected increases weight by 0.75 kg (95 percent CI: 0.24, 1.26; p=0.0038), there is substantial evidence that MDA has no impact on weight or other child outcomes. This paper updates the TMSDG analysis by including studies omitted from that analysis and extracting additional data from included studies, and finds that the TMSDG analysis is underpowered: Power is inadequate to rule out weight gain effects that would make MDA cost effective relative to comparable interventions in similar populations, and underpowered to reject the hypothesis that the effect of MDA is different from the effect that might expected, given deworming's effects on those known to be infected. The hypothesis of a common zero effect of multiple-dose MDA deworming on child weight at longest follow-up is rejected at the 10 percent level using the TMSDG dataset, and with a p value

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  • Croke,Kevin & Hicks,Joan Hamory & Hsu,Eric & Kremer,Michael Robert & Miguel,Edward A., 2016. "Does mass deworming affect child nutrition ? meta-analysis, cost-effectiveness, and statistical power," Policy Research Working Paper Series 7921, The World Bank.
  • Handle: RePEc:wbk:wbrwps:7921
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    References listed on IDEAS

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    1. Does Mass Deworming Affect Child Nutrition? Meta-analysis, Cost-Effectiveness, and Statistical Power
      by maximorossi in NEP-LTV blog on 2016-09-07 22:03:51

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    Cited by:

    1. Fox, Jonathan & Grigoriadis, Theocharis, 2018. "A rural health supplement to the hookworm intervention in the American South," Discussion Papers 2018/5, Free University Berlin, School of Business & Economics.
    2. Amanda Beatty & Evan Borkum & William Leith & Marisa Henry & Margo Berends & Clair Null & Nicholas Ingwersen, "undated". "MCC Indonesia Nutrition Project Impact Evaluation Final Report," Mathematica Policy Research Reports 177dad81487243d59a9fefbcf, Mathematica Policy Research.
    3. Roodman, David, 2018. "The Impacts of Hookworm Eradication in the American South. A replication study of Bleakley (The Quarterly Journal of Economics, 2007)," International Journal for Re-Views in Empirical Economics (IREE), ZBW - Leibniz Information Centre for Economics, vol. 2(2018-3), pages 1-45.
    4. Vivian A. Welch & Elizabeth Ghogomu & Alomgir Hossain & Shally Awasthi & Zulfi Bhutta & Chisa Cumberbatch & Robert Fletcher & Jessie McGowan & Shari Krishnaratne & Elizabeth Kristjansson & Salim Sohan, 2016. "Deworming and adjuvant interventions for improving the developmental health and well‐being of children in low‐ and middle‐income countries: a systematic review and network meta‐analysis," Campbell Systematic Reviews, John Wiley & Sons, vol. 12(1), pages 1-383.
    5. Stanley, T. D. & Doucouliagos, Chris, 2019. "Practical Significance, Meta-Analysis and the Credibility of Economics," IZA Discussion Papers 12458, Institute of Labor Economics (IZA).
    6. Bloom, David E. & Kuhn, Michael & Prettner, Klaus, 2018. "Health and Economic Growth," IZA Discussion Papers 11939, Institute of Labor Economics (IZA).
    7. Isaiah Andrews & Maximilian Kasy, 2019. "Identification of and Correction for Publication Bias," American Economic Review, American Economic Association, vol. 109(8), pages 2766-2794, August.
    8. Eszter Czibor & David Jimenez‐Gomez & John A. List, 2019. "The Dozen Things Experimental Economists Should Do (More of)," Southern Economic Journal, John Wiley & Sons, vol. 86(2), pages 371-432, October.
    9. Isaiah Andrews & Jesse M. Shapiro, 2021. "A Model of Scientific Communication," Econometrica, Econometric Society, vol. 89(5), pages 2117-2142, September.
    10. Mathur, Maya B & VanderWeele, Tyler, 2020. "Robust metrics and sensitivity analyses for meta-analyses of heterogeneous effects," OSF Preprints r2s78, Center for Open Science.
    11. Joan Hamory & Edward Miguel & Michael W. Walker & Michael Kremer & Sarah J. Baird, 2020. "Twenty Year Economic Impacts of Deworming," NBER Working Papers 27611, National Bureau of Economic Research, Inc.
    12. Kevin Croke & Joan Hamory Hicks & Eric Hsu & Michael Kremer & Edward Miguel, 2017. "Should the WHO withdraw support for mass deworming?," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 11(6), pages 1-3, June.
    13. Kumar, Tanu & Post, Alison E. & Ray, Isha, 2018. "Flows, leaks and blockages in informational interventions: A field experimental study of Bangalore's water sector," World Development, Elsevier, vol. 106(C), pages 149-160.

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    More about this item

    Keywords

    Education For All; Education for Development (superceded); Public Health Promotion; School Health; Disease Control&Prevention; Educational Populations;
    All these keywords.

    JEL classification:

    • C49 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Other
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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