Worms: Identifying impacts on education and health in the presence of treatment externalities
Worms: Identifying impacts on education and health in the presence of treatment externalities
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DOI：
10.1111/j.1468-0262.2004.00481.x
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发表时间：
2004-01-01
期刊：
影响因子：
6.1
通讯作者：
Kremer, M
中科院分区：
文献类型：
--
作者：
Miguel, E;Kremer, M
肠道蠕虫——包括钩虫、蛔虫、鞭虫和血吸虫——感染了世界上四分之一以上的人口。在个体水平上进行随机医学治疗的研究可能会双重低估治疗的益处，忽略了减少疾病传播对对照组的外部性益处，因此也低估了治疗组的益处。我们对肯尼亚的一个项目进行了评估，在这个项目中，以学校为基础的大规模驱虫药物治疗随机分阶段进入学校，而不是个人，从而可以估计整个项目的效果。该项目将治疗学校的缺勤率降低了四分之一，而且比其他提高学校参与率的方法要便宜得多。驱虫大大改善了治疗学校和邻近学校中未经治疗儿童的健康状况和入学率，这些外部性足以证明有理由全额补贴治疗。然而，我们没有发现驱虫能提高学业成绩的证据。
Intestinal helminths-including hookworm, roundworm, whipworm, and schistosomiasis-infect more than one-quarter of the world's population. Studies in which medical treatment is randomized at the individual level potentially doubly underestimate the benefits of treatment, missing externality benefits to the comparison group from reduced disease transmission, and therefore also underestimating benefits for the treatment group. We evaluate a Kenyan project in which school-based mass treatment with deworming drugs was randomly phased into schools, rather than to individuals, allowing estimation of overall program effects. The program reduced school absenteeism in treatment schools by one-quarter, and was far cheaper than alternative ways of boosting school participation. Deworming substantially improved health and school participation among untreated children in both treatment schools and neighboring schools, and these externalities are large enough to justify fully subsidizing treatment. Yet we do not find evidence that deworming improved academic test scores.