Re-analysis of health and educational impacts of a school-based deworming programme in western Kenya: a pure replication.
Re-analysis of health and educational impacts of a school-based deworming programme in western Kenya: a pure replication.
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DOI：
10.1093/ije/dyv127
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发表时间：
2015-10
影响因子：
7.7
通讯作者：
Hayes RJ
中科院分区：
文献类型：
--
作者：
Aiken AM;Davey C;Hargreaves JR;Hayes RJ
背景：蠕虫感染导致全世界贫困社区发病。 1998-99 年在肯尼亚进行的一项有影响力的研究报告称，以学校为基础的药物和教育干预措施对蠕虫感染和入学率有好处。在接受驱虫药物治疗的儿童、干预学校中未经治疗的儿童以及附近非干预学校的儿童中都观察到了效果。综合这些效果，据报道，干预措施使接受治疗的儿童的入学率提高了 7.5%。还调查了对其他结果（蠕虫感染、贫血、营养状况和检查表现）的影响。方法：在这个纯粹的复制中，我们使用原作者提供的数据根据他们的方法重新分析该研究。我们将这些结果与原始论文中提出的结果进行了比较。结果：虽然大多数结果均按照最初报告的方式重现，但我们发现原始结果与重新分析之间存在多种类型的差异。对于蠕虫感染，重新分析显示减少量与最初报道的类似。对于贫血患病率，与最初的发现相反，重新分析没有发现任何益处的证据。对于营养状况，最初的发现和重新分析都描述了小幅改善的适度证据。对于入学率，重新分析显示，对于接受驱虫药物和未接受驱虫药物的儿童来说，其益处与最初在干预学校中发现的益处相似。然而，在纠正编码错误后，几乎没有证据表明干预学校附近学校的儿童入学率受到间接影响。综合这些效应，接受治疗的儿童的出勤率总计增加了 3.9%，但这一结果不再具有统计学意义。与最初的结果一样，重新分析发现干预措施对考试成绩没有影响。结论：重新应用最初使用的分析方法，但纠正了各种错误，我们发现几乎没有证据表明先前报告的驱虫干预措施产生了一些间接影响。干预学校儿童对蠕虫感染、营养状况、考试成绩和出勤率的影响基本没有变化。
Background: Helminth (worm) infections cause morbidity among poor communities worldwide. An influential study conducted in Kenya in 1998–99 reported that a school-based drug-and-educational intervention had benefits regarding worm infections and school attendance. Effects were seen among children treated with deworming drugs, untreated children in intervention schools and children in nearby non-intervention schools. Combining these effects, the intervention was reported to increase school attendance by 7.5% in treated children. Effects on other outcomes (worm infections, anaemia, nutritional status and examination performance) were also investigated. Methods: In this pure replication, we used data provided by the original authors to re-analyse the study according to their methods. We compared these results against those presented in the original paper. Results: Although most results were reproduced as originally reported, we identified discrepancies of several types between the original findings and re-analysis. For worm infections, re-analysis showed reductions similar to those originally reported. For anaemia prevalence, in contrast to the original findings, re-analysis found no evidence of benefit. For nutritional status, both original findings and re-analysis described modest evidence for a small improvement. For school attendance, re-analysis showed benefits similar to those originally found in intervention schools for both children who did and those who did not receive deworming drugs. However, after correction of coding errors, there was little evidence of an indirect effect on school attendance among children in schools close to intervention schools. Combining these effects gave a total increase in attendance of 3.9% among treated children, which was no longer statistically significant. As in the original results, re-analysis found no effect of the intervention on examination performance. Conclusions: Re-applying analytical approaches originally used, but correcting various errors, we found little evidence for some previously-reported indirect effects of a deworming intervention. Effects on worm infections, nutritional status, examination performance and school attendance on children in intervention schools were largely unchanged.