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Community-based interventions for the prevention and control of helmintic neglected tropical diseases.
[dracunculiasis]
In
this
paper
,
we
aim
to
systematically
analyze
the
effectiveness
of
community-based
interventions
(
CBIs
)
for
the
prevention
and
control
of
helminthiasis
including
soil-transmitted
helminthiasis
(
STH
)
(
ascariasis
,
hookworms
,
and
trichuriasis
)
,
lymphatic
filariasis
,
onchocerciasis
,
dracunculiasis
,
and
schistosomiasis
.
We
systematically
reviewed
literature
published
before
May
2013
and
included
32
studies
in
this
review
.
Findings
from
the
meta
-analysis
suggest
that
CBIs
are
effective
in
reducing
the
prevalence
of
STH
(
RR
:
0
.
45
,
95
%
CI
:
0
.
38
,
0
.
54
)
,
schistosomiasis
(
RR
:
0
.
40
,
95
%
CI
:
0
.
33
,
0
.
50
)
,
and
STH
intensity
(
SMD
:
-
3
.
16
,
95
CI
:
-
4
.
28
,
-
2
.
04
)
.
They
are
also
effective
in
improving
mean
hemoglobin
(
SMD
:
0
.
34
,
95
%
CI
:
0
.
20
,
0
.
47
)
and
reducing
anemia
prevalence
(
RR
:
0
.
90
,
95
%
CI
:
0
.
85
,
0
.
96
)
.
However
,
it
did
not
have
any
impact
on
ferritin
,
height
,
weight
,
low
birth
weight
(
LBW
)
,
or
stillbirths
.
School
-based
delivery
significantly
reduced
STH
(
RR
:
0
.
49
,
95
%
CI
:
0
.
39
,
0
.
63
)
and
schistosomiasis
prevalence
(
RR
:
0
.
50
,
95
%
CI
:
0
.
33
,
0
.
75
)
,
STH
intensity
(
SMD
:
-
0
.
22
,
95
%
CI
:
-
0
.
26
,
-
0
.
17
)
,
and
anemia
prevalence
(
RR
:
0
.
87
,
95
%
CI
:
0
.
81
,
0
.
94
)
.
It
also
improved
mean
hemoglobin
(
SMD
:
0
.
24
,
95
%
CI
:
0
.
16
,
0
.
32
)
.
We
did
not
find
any
conclusive
evidence
from
the
quantitative
synthesis
on
the
relative
effectiveness
of
integrated
and
non-integrated
delivery
strategies
due
to
the
limited
data
available
for
each
subgroup
.
However
,
the
qualitative
synthesis
from
the
included
studies
supports
community-based
delivery
strategies
and
suggests
that
integrated
prevention
and
control
measures
are
more
effective
in
achieving
greater
coverage
compared
to
the
routine
vertical
delivery
,
albeit
it
requires
an
existing
strong
healthcare
infrastructure
.
Current
evidence
suggests
that
effective
community-based
strategies
exist
and
deliver
a
range
of
preventive
,
promotive
,
and
therapeutic
interventions
to
combat
helminthic
neglected
tropical
diseases
(
NTDs
)
.
However
,
there
is
a
need
to
implement
and
evaluate
efficient
integrated
programs
with
the
existing
disease
control
programs
on
a
larger
scale
throughout
resource-
limited
regions
especially
to
reach
the
unreachable
.
Diseases
Validation
Diseases presenting
"albeit it requires an existing strong healthcare infrastructure"
symptom
dracunculiasis
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