EVIDENCE SYNTHESIS TO HELP ENSURE SOUND POLICIES AND INVESTMENT

Paul Garner On behalf of the Cochrane infectious Diseases Group EditorsAnd the Effective Health Care Research Programme Consortium

Competing interests

Funded by the UK Aid Programme to increase the number of decisions based

on reliable evidence in health for the poor in developing countries

Thanks to everyone that helps, including

17 editors

Staff in LSTM

700 authors in 55 countries

Consortium partners

UK Aid

1993

500 authors

17 editors

12 staff

112 Systematic reviews

Systematic reviews of effects

• objectives

• methods (how trials are identified)

• apply inclusion criteria to trials

• extract predetermined outcomes

• contact authors for more data

Title Type

Bur Treatment of Buruli ulcer Intervention review ongoing

fil DEC salt for filariasis Intervention review publishedfil Albendazole for filariasis Intervention review Needs update

HAT

Chemotherapy for second-stage Human African

trypanosomiasis Intervention review published

HAT Community engagement in HAT Scoping review PHD/Staff

intestin

al

Deworming drugs for soil-transmitted intestinal

worms in children: effects on nutritional

indicators, haemoglobin and school performance Intervention review Being updated

NTD Wolbachia (scoping and Intervention) Intervention review open

Schisto Drugs for treating Schistosoma mansoni infection Intervention review published

Schisto Drugs for treating urinary schistosomiasis Intervention review published

Schisto

Circulating antigen tests and urine reagent strips

for diagnosis of active schistosomiasis in endemic

areas Diagnostic review in press

Schisto

Prophylactic drug interventions for

Schistosomiasis japonicum Intervention review ongoing

Schisto

Therapeutic drug interventions for

Schistosomiasis japonicum Intervention review ongoing

systems Mass Drug Administration User views ongoing

systems

Strategies for integrating PHC at the point of care

in LMIC Intervention review open

excluded: leishmania, headlice, dengue, neurocystercosis

Water and sanitation

• Water quality (in progress)

• Fecal disposal (in progress)

• Wash (in progress)

5 Cochrane authors: “it is probably misleading to justify contemporary deworming programmes based on evidence…”

Trial from 1999

Another one! completed 2004

Unpublished in 2013Devta in Hindi=“divine being”

Miguel and Kramer (Kenya) 2004trial used by Nobel Prize winners

“major, moderate and minor errors”

On re-analysis

• No between school effects

• No evidence of an effect on nutrition

• effect on school attendance preserved