Talk:Mass deworming

references

anything that is of a medical content needs references, or WP RS--Ozzie10aaaa (talk) 12:15, 29 July 2015 (UTC)

agree and understand, although exactly what is or isn't a medical claim here is under debate. JMWt (talk) 12:29, 29 July 2015 (UTC)

Why was this regarded as "too old"? Do we have a cut-off date for publications? I don't think 15 years is necessarily too old or did I miss something? This is the deleted part that I mean: However, a 2000 review of randomised controlled trials of children showed no special benefits on weight gain and cognitive performance. EvM-Susana (talk) 13:45, 29 July 2015 (UTC)

Under WP:MEDDATE, medical claims should use references from the last 5 years. Given that a lot of things have happened with the deworming debate in the last 15 years, including several updated Cochrane reviews, it is clearly not appropriate to bring in much older reviews. JMWt (talk) 13:52, 29 July 2015 (UTC)

I also think this is just generally a good idea even if it is not a medical claim. But then, as I suggested above, there must be some debate about exactly which claims made in an article like this are and are not medical claims. JMWt (talk) 13:59, 29 July 2015 (UTC)

Ah, thanks for pointing me to this link. It's only a rule of thumb though and it says "Here are some rules of thumb for keeping an article up-to-date, while maintaining the more-important goal of reliability. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published." I think this area is probably "little researched", and I also think - as you pointed out - that publications on this topic may sit on the border between medical and health economics (is health economics considered to be a sector outside of medicine?). But OK, I guess 15 years is indeed rather old so I guess we can leave that paper from the year 2000 out if you prefer. EvM-Susana (talk) 21:24, 29 July 2015 (UTC)

References

Example from Uganda

I think it could be nice to add this reference in the example section (for Uganda). Unless someone would argue that only Cochrane reviews should be cited here. I think for the reader it is also helpful to know about individual examples? Does it matter that it is from 2006, i.e. a little older? EvM-Susana (talk) 10:46, 30 July 2015 (UTC)

That's a medical claim, so I don't think it can be used - it is too old and it isn't a review. We could use it for non-medical information (numbers of children in the programme etc). I don't think the consensus is that only Cochrane reviews are relevant, but certainly medics will remove medical claims which are not considered to be high quality, and that paper doesn't, as far as I can tell, meet the standards for WP:MEDRS. I think the conclusion that "deworming of preschool children in Uganda as part of regularly scheduled health services seems practical and associated with increased weight gain" would be considered a medical claim in a primary source. JMWt (talk) 11:04, 30 July 2015 (UTC)

Also that paper had been corrected, casting further doubt on the conclusions http://www.bmj.com/content/345/bmj.e8724 JMWt (talk) 11:09, 30 July 2015 (UTC)

Mention author names or rather not?

I am sure this is covered somewhere in the MOS but I haven't got time to search right now: I tend to avoid using author names. This means rather than saying "Miller and Smith argued in 2014 that worms are difficult..." I would write: "A study in 2014 found worms to be difficult", or even just "Experts have pointed out that..." or even just "Worms are difficult" with the reference. What is the official line on this? I just think lay people do not need to be bothered with the names of the authors. EvM-Susana (talk) 10:28, 1 August 2015 (UTC)

I don't know if it is a rule, but the advice seems to be that "it is best not to clutter articles with information best left to the references" see WP:INTEXT. Generally speaking, for readability I think that names should be left out, however in this case it is unavoidable to refer to the Cochrane review and those who are criticising it, otherwise is could just be "some paper" and "some blogger" criticising it - in fact it is a "gold standard" medical review and high-profile development/economic researchers.JMWt (talk) 10:51, 1 August 2015 (UTC)

but if you just mention their names without also adding that they are "high-profile development/economic researchers" then the reader has no idea whether Smith and Miller (for example) are important in the sector or not. Then wouldn't it be better to omit the names and rather say "Other high-profile development and economic experts have stated that..."? EvM-Susana (talk) 21:54, 1 August 2015 (UTC)

Honestly, I don't know. Personally, I don't like the method as it gives a extra weight to blogs and seems to put them onto a similar level to published high quality reviews. On the other hand, if I'm a reader then I think I'm going to want to see the different criticisms, I'm not sure that it really works to keep the anonymity in the text as you describe above.JMWt (talk) 07:43, 3 August 2015 (UTC)

Oncoceriasis

Some of the content and refs at Oncoceriasis might be useful here. LeadSongDog come howl! 18:10, 4 August 2015 (UTC)

I don't think the control of Onchocerca volvulus is usually spoken of in the same context as mass deworming. Certainly the medication which the linked pages discuss are not the ones used in the mass deworming programmes. JMWt (talk) 08:18, 5 August 2015 (UTC)

Are these references MEDRS?

I have removed the following lines and references, on the basis that they are a) single primary sources b) they are making medical claims and c) they are positioned in the text as being on the same level as the Cochrane review. I'd appreciate discussion as to this, but my view is that they are not MEDRS compliant. But I also see that these can also be taken to be economic claims. So.. thoughts anyone? @Doc James: JMWt (talk) 08:09, 5 August 2015 (UTC)

--

A 2004 study in Kenya by Harvard economist Michael Kremer and University of California economist Edward Miguel found that deworming reduces worm infections in both treated children, and untreated children living nearby (through reduced disease transmission. Additionally, deworming improves school attendance for treated and nearby untreated children. Additional studies documenting the educational and economic impact of deworming include a World Bank Economic Review paper that reviews the literature.

A separate study by World Bank economist Owen Ozier's shows that preschool-age Kenyan children who lived in communities where a deworming program was conducted, and thus were exposed to epidemiological spillovers, showed cognitive improvements ten years later. A randomized controlled trial by Harvard researcher Kevin Coke] finds that Ugandan children randomly exposed to more years of deworming have higher test scores in literacy and numeracy 7 to 8 years later.

Miguel, Kremer, Hicks, and Baird find that 10 years after deworming, Kenyan women who were dewormed for more years as girls were 25% more likely to have attended secondary school, and men who were dewormed for more years as boys worked 17% more hours and had better labor market outcomes, including higher earnings. Hoyt Bleakley finds that deworming in the U.S. in the early 1900’s lead to increased school enrollment and attendance for children, and improved literacy and income for adults who were treated as children. This study is a difference-in-difference design, rather than a randomized control trial.

References

Saw mention of this at WT:MED. There was a problem here with a bunch of stuff in a "Criticism section" being used to "however" a 2015 Cochrane review, which is a big NPOV problem. If there are other recent high-quality secondary sources on the health aspects, by all means include them. But that stuff was not suitable and I've removed it. Purely economic arguments of course don't need to be sourced to WP:MEDRS. Alexbrn (talk) 09:04, 5 August 2015 (UTC)

@Alexbrn: I replied at WT:MED - there is a great danger of this turning into an edit war, between medics and economists JMWt (talk) 09:16, 5 August 2015 (UTC)

This appears to be a recent review [1]. I am of the opinion it is okay. The others are primary sources and we should be using other high quality secondary sources. Doc James (talk · contribs · email) 09:20, 5 August 2015 (UTC)

There are two issues here: first the economics papers I've placed here on the talk page and secondly the removal of criticisms by Alexbrn. As far as I'm concerned, the removal of the critical comments are not the removal of primary sources but reports and comments on that. JMWt (talk) 09:41, 5 August 2015 (UTC)

The policy WP:PSTS cares that the secondary sources are respected. Unless there are other high-quality secondary sources from an economics background challenging the Cochrane source, the issue is simple. We certainly don't "however" without equivalent-quality sources to support the text. The Miguel paper cites Taylor-Robinson 2012 (PMID 23152203), but Taylor-Robinson 2015 (PMID 26202783) draws a quite different conclusion from the prior version. (Between the two versions was a directly-addressed discussion of publication ethics: PMID 23760498. That discussion was predicated on the omission of by far the largest trial to date due to publication delays.) I'd have to conclude that the Miquel paper is outdated in this respect, despite its recent publication, a conclusion that is backed up by his (et alia) comment in Int J Epidemiol last month. LeadSongDog come howl! 16:13, 5 August 2015 (UTC)

I'm backing out of this, because I don't have a dog in the fight - however you are simply not appreciating the strength of feelings relating to the clash between epidemiology and development economics. And there are reviews (I have no idea how high quality) from economists attacking the approach of Cochrane on this, for example: http://www.ncbi.nlm.nih.gov/pubmed/23332661 JMWt (talk) 16:50, 5 August 2015 (UTC)

Well, none of us should "have a dog in the fight", we should simply be concerned with getting our content right. That is, after all, what the policies in place are for. PMID 23332661 is a paywalled 2013 historical review. So far as development economics go, it appears that the cost of semiannual deworming for 15 years is about $15. This is similar to or higher than the lifetime cost of locally providing a clean water well, so there are real tradeoffs when money is finite. Both would reduce STH infections, but the well addresses many other diseases too. We suspect mass deworming helps, but we know clean water does. Where would you spend? LeadSongDog come howl! 21:43, 5 August 2015 (UTC)

I am not a medic or a development economist, but your repeated assertions about the primacy of medical norms on pages where they are not directly relevant are not helping. That the paper is paywalled is irrelevant. Issues relating to sanitation are clearly the providence of WP Sanitation, so I don't have to discuss with you about other aspects of sanitation on the talkpage of this page, which is clearly irrelevant. It doesn't matter what I think or how I think the costs compare to sanitation. I suggest you either stick to thinking how to improve this page or go work on a different page. JMWt (talk) 07:35, 6 August 2015 (UTC)

I'm losing track of the argument here. I think everyone is agreeing that WP:MEDRS sources are needed for health stuff; other WP:RS sources can support non-health stuff. What sources are being proposed for which content now? Alexbrn (talk) 07:42, 6 August 2015 (UTC)

Contrary to what you said above, the page had a substantial section describing the Cochrane reviews high up on the page 1 and a criticism section further down the page, which also gave substantial information about the Cochrane review 2. I am not arguing about the layout, which can be improved, but clearly it is not correct to say that all wikipedia pages remove all comment and discussion relating to controversial medical-related topics because they are not WP:MEDRS. That's clearly not the case, looking at examples such as MMR_vaccine_controversy which include reports in newspapers and other comments. In fact the links originally provided here, and removed by you, did not directly make WP:MEDRS statements but were commenting upon them. As I stated above, the Criticism section is a normal part of the manual of style originally used for this page, because there is frequently controversy about programmes. So citing WP:MEDRS and simply removing the controversy section is just to say that the medical view is more important than the other comments, which as I said were further down the page and clearly in a section describing the controversy. In my opinion that's a misuse of WP:MEDRS, particularly as you did not make any effort to discuss the change first.

A secondary issue is about the sources I've removed here, but given the above experience I'm going to leave you to argue this point with development economists. JMWt (talk) 08:08, 6 August 2015 (UTC)

So you're contending that WP:MEDRS was wrongly invoked by me in this removal? Alexbrn (talk) 08:18, 6 August 2015 (UTC)

I think that's a sledgehammer approach. And likely to cause conflict with other disciplines, in this case development economics. Using this mentality, one would remove many/most of the references used in WP Sanitation pages, particularly those in Criticism sections. JMWt (talk) 08:49, 6 August 2015 (UTC)

Now I'm more lost. Are you saying they should be removed but for some reason it shouldn't be done by anybody? Alexbrn (talk) 08:51, 6 August 2015 (UTC)

I do not believe that removal of a Criticism section is WP:MEDRS. given the above. JMWt (talk) 08:57, 6 August 2015 (UTC)

Before moving on to the question of the Criticism section, can we just clear up the the removal I mentioned? Can we agree this (particular) removal was warranted per WP:MEDRS because it was of biomedical claims sourced to insufficient sources? Alexbrn (talk) 09:01, 6 August 2015 (UTC)

I am personally less uncomfortable with their removal, however as I've discussed above I think there is a case to be made that a contrary development economics position could be put using high quality secondary sources. Doc James suggested one of those removed above was a high quality secondary source, and I've found another. JMWt (talk) 09:06, 6 August 2015 (UTC)

I was away for a few days and am just catching up here. I support the views of JMWt. I thought the section on criticisms which he had put together was well done and well referenced. Perhaps the heading "criticism" could be modified and be called something else, but basically it is providing the other side of the coin. The "gold standard" of randomized controlled trials is being criticized with regards to mass deworming research and other long-term health effects, e.g. improved sanitation on rates of stunting. I heard that again recently at a sanitation conference from a UNICEF colleague. I would argue that the bullet points that were in this article under "criticism" should all go back in. It doesn't help to view everything only under the lense of medical issues (Cochrane reviews); mass deworming also has aspects of health economics, development cooperation, ethical aspects, child rights, nutrition and so forth - and therefore other types of sources should be justified. We don't have to introduce it as a "however", but basically there is a debate going on and if we only mention the Cochrane review results but not what the debate is about then we are keeping significant information from the Wikipedia readers! EvM-Susana (talk) 21:07, 7 August 2015 (UTC)

The way it has now been summarised is quite meaningless for the lay person to interprete. If I didn't know all the background, I wouldn't have a clue at what these two sentences are trying to say now: "Much of the medical evidence on deworming is of poor quality.[1] In particular, the quality of evidence on the effect of deworming on infected children is poor and only suggestive of effect on weight. The data on other factors is too poor to make a judgement.[1]" What does the first sentence supposed to mean? That if I have worms, then there is no point in deworming me, because it makes no difference?? The issue here is on mass deworming, not on deworming of an individual person. Remember the page is about "mass deworming". "Quality of evidence... is poor". A lay person does not know what is meant with this! "suggestive of effect on weight" - eh?? Which weight, what? If anything it should be about stunting or wasting (with hyperlinks). "The data on other factors" - which other factors? "Too poor" means what, really? Before, I could actually understand the argument. Now, it reads to me like a doctor has summarised everything somehow and I have no clue anymore what he or she means. I much preferred the earlier version which was written by an informed lay person for lay persons to understand. EvM-Susana (talk) 21:14, 7 August 2015 (UTC)

These are the conclusions of the Cochrane review. They classify the quality of the available research evidence and then make a decision about whether the majority of the data points in a certain direction. In this case they've pointed out that there isn't much good quality data for the wider community effects of mass deworming but they've also said there isn't much good evidence that it has long-term effects on individual infected children either. And yes, they are definitely concluding that mass deworming is not effective because of those findings. The economists (and others, actually) who are commenting are arguing with the statistics and with the design of the Cochrane review. They are not making direct medical claims. In fact they are arguing that Cochrane can only come to these conclusions by discounting other evidence. This at root is why there is a controversy, not that a reader would know reading the current version of the page. JMWt (talk) 09:42, 8 August 2015 (UTC)

We have high quality secondary sources such as the position of the World Health Organization in support of mass deworming. We have Cochrane not finding much evidence for it.

By the way the Cochrane review we cite is from 2012 not 2015?

No, there was a new Cochrane review for 2015 issued the other week which supercedes the 2012 version. Why would we cite the old version?JMWt (talk) 12:21, 8 August 2015 (UTC)

I'll let you off because the Wiley website is down today so we can't see the paper, but the most recent review is from 23 July 2015 see the Cochrane website. Therefore your recent edit is wrong. I'd appreciate you changing the ref back to the correct version. JMWt (talk) 12:33, 8 August 2015 (UTC)

2015 Cochrane review is now back online: [[2]]JMWt (talk) 13:22, 8 August 2015 (UTC)

By the way we have high quality reviews such as this one [3] that support deworming. I have added it. Doc James (talk · contribs · email) 11:33, 8 August 2015 (UTC)

Historical failures – Egypt

Why are we not mentioning the Egyptian case here? NYtimes, popular source not for the article

• Very short WHO mention
• PMID 10752705 – Original paper in the Lancet (not a review)

While the intent was to get rid of Schistosomiasis all the effort did was spread Hepatitis C through the entire population due to use of dirty needles. -- CFCF 🍌 (email) 11:57, 8 August 2015 (UTC)

Is that a medical claim? Is that source WP:MEDRS? Then that'll be your answer. JMWt (talk) 12:41, 8 August 2015 (UTC)

Historical claims don't necessarily need to abide by WP:MEDRS, also there is considerably more literature on the subject. The question was why we aren't mentioning it, not why we aren't using the specific sources I linked. -- CFCF 🍌 (email) 12:45, 8 August 2015 (UTC)

As seen above, nothing is being added to this page at present because there is an outstanding issue to be debated about the quality of sources. Clearly the spread of hepatitus by a mass vaccination is a claim that would need WP:MEDRS, so if you want to include it, find a high quality secondary review which refers to it. JMWt (talk) 12:51, 8 August 2015 (UTC)

Here is a review you might like to use. [4] JMWt (talk) 13:27, 8 August 2015 (UTC)

Once again the Lancet article I linked is cited over 600 times, 144 of which are in reviews. The question is if there is any reason we are not mentioning the case? -- CFCF 🍌 (email) 14:10, 8 August 2015 (UTC)

Of value:

• PMID 25959770 – "Schistosomiasis in Egypt: A never-ending story?"– Review 2015: Acta Tropica

-- CFCF 🍌 (email) 14:20, 8 August 2015 (UTC)

Well in one sense it is not relevant (and potentially could confuse) because the medications used at present are different to those used before 2000. Hep C was apparently spread in Egypt because of needles, that is not going to happen now because the medication is taken orally. If you cite a WP:MEDRS compliant secondary source and make it clear that needles are no longer used, I can't see a reason why it should not be mentioned. JMWt (talk) 14:45, 8 August 2015 (UTC)

That review does make some interesting points about the development of a vaccine, rather than schistosomicidal drug programmes. I'm not clear whether that would be relevant to this page or not, given that the rest is talking about mass oral medication rather than the use of a vaccine. JMWt (talk) 15:08, 8 August 2015 (UTC)

The vaccine discussion should go on the disease article IMO. Doc James (talk · contribs · email) 16:48, 8 August 2015 (UTC)

I think the sub-heading called controversy needs to go back in

Someone above has stated that "this should not be phrased as a controversy" and has removed the sub-heading called "controversy" or "criticism". Now the entire debate is described under the heading of "medical aspects". I think this leaves the reader rather confused. The old article structure was much better. First the article should talk about purely medical issues (like that the drug is taken orally; that there can be re-infection; that a vaccine might be possible in future), then there should be another section about the issues that are under debate which go further than just medical issues! The controversy touches on health economics, ethical, moral and child right issues (shouldn't each child have the right to be "worm-free" even if the cognitive outcomes are not easy to prove in some of those shorter term studies?). Let's go back to the old structure of the article and add a sub-heading making it clearer that people are arguing about the merits and de-merits of mass deworming. We have Cochrane review on the one said arguing against mass deworming and we have WHO and Worldbank on the other side arguing for mass deworming. This needs to come out clearly in the article structure, rather than - like it is now - adding one sentence after another without even connecting them with a "however" or "on the other side of the argument", etc. I think the initial assumption that Cochrane is gold standard and whatever they say goes it simply wrong in this case here, as we have also high quality sources for the "other side". We don't have to "take sides" and imply who is right or wrong but we should state arguments of high quality sources as neutrally and non-biased as possible. EvM-Susana (talk) 22:55, 8 August 2015 (UTC)

I have split that section into three subsections. I have used the heading "evidence" to discuss the different positions on effects.

The different positions by the different organizations are not really linked to each other. It is different groups looking at the evidence and using different techniques and cut off for quality coming to different conclusions. Doc James (talk · contribs · email) 07:50, 9 August 2015 (UTC)

That's better although I still think the "evidence" part under "medical aspects" does not fully fit (unless we see health economics to be totally part of "medical aspects")? Also I still think the first three sentences are not in a logical sequence. I would first put the two together which support mass deworming and then start another sentence with "However,...". Or do it the other way around: first the Cochrane 2015 study which says there is no evidence and then a "however" to introduce the other side of the argument. Readers, who are lay persons, need to be guided properly here so that they understand that there are two sides to the mass deworming issue, and two sides of looking at the evidence. - I wish we could get help from people who are actually experts on mass dewormings to contribute to this article. Should we try again to e-mail them in the background? I already have but those who I asked were tired of the arguments. EvM-Susana (talk) 12:01, 9 August 2015 (UTC)

Have made some re-structuring changes accordingly. EvM-Susana (talk) 20:40, 9 August 2015 (UTC)

The structuring guideline for this topic is this one [[]Wikipedia:Manual_of_Style/Medicine-related_articles#Drugs.2C_treatments.2C_and_devices]] or maybe this one Wikipedia:Manual_of_Style/Medicine-related_articles#Surgeries_and_procedures. Thus moved a couple of things around.

The evidence is not really a "limitation" and we typically put this before the how to advice of how something is carried out.

Have moved the info about vaccine research to the disease related article as it does not directly related to mass deworming.

Also simplified the wording some.Doc James (talk · contribs · email) 04:26, 10 August 2015 (UTC)

As it happens, I wrote the vast majority of this page originally, and I was using the Wikipedia:Manual_of_Style_(Sanitation). As such, following editors are required to use that style unless there is a good reason not to as per para 3 of WP:STYLE. Nobody has bothered to make any kind of case why this whole page should be in the perview of Wikipedia:Manual_of_Style/Medicine-related_articles, you have just asserted that it is - even though we've been making the case that it is clearly a cross-disciplinary subject. As it happens, Wikipedia:Manual_of_Style/Medicine-related_articles#Surgeries_and_procedures does not appear to be directly relevant to discussing (for example) the educational outcomes of a mass deworming activity, and given that deworming is often related to WASH it seems to me that there is a strong case for saying this is actually something for Wikipedia:Manual_of_Style_(Sanitation). I think it could also clearly be within several different wikiprojects concerned with economics, development economics and international development. I note that nobody has asked them to make a suggestion on the appropriate style of this page. I have also asked medical editors to return the correct version of the Cochrane Collaboration review on deworming, which was updated in 2015 and supercedes the 2012 version and this has not happened. This makes a nonsense of the multiple references I added to the page from the 2015, because they now state they were from the 2012 version, which I did not use to reference so I have no idea whether they are actually applicable to the quotes or not. There is no good reason to use an older, superceded version of Cochrane. I still believe this is a good faith edit, but in good faith I request that this mistake is rectified. JMWt (talk) 08:43, 10 August 2015 (UTC)

Yes thanks User:JMWt I see the issue occured in these edits by User:Alexbrn [5]. You had previously used the 2015 Cochrane review and he switched it to the 2012 version. Alex please be more careful. Doc James (talk · contribs · email) 08:51, 10 August 2015 (UTC)

I agree with User:JMWt. I didn't know there was such a rule, but it also makes sense to me that we lean more towards the MOS Sanitation here if Joe originally set it up like that. Mass deworming is not primarily a medical issue only... (unlike the page on deworming, mind you that one mainly deals with animals). Anyway, please take a look at my new structure. I think it makes more sense and it follows more closely the Manual of Style for the WikiProject Sanitation. Another thing that I noticed is that the lead and the main text were somehow disconnected. There was information in the lead which was not at all in the main text (and vice versa). The issue about difficulties with the evidence was not mentioned in the lead. The lead should be a summary of the main text... So I have gently tried to correct that. I had a problem with one sentence which I felt was equally important for the lead and the main text, so it now appears twice - which is probably not good style? Could someone take another look at the lead? EvM-Susana (talk) 09:58, 13 August 2015 (UTC)

Having the same sentence in the lead and body is okay style wise. Doc James (talk · contribs · email) 12:19, 13 August 2015 (UTC)

Evidence versus Critism versus Limitations

For this content:

Extended content

The World Health Organization recommends mass deworming of children on the grounds it will improve nutritional health, reduceanemia and increase intelligence, thereby bringing about overall health benefits and better school performance.[1] Also, a review by the World Bank concluded that evidence supports a benefit with respect to school attendance and long term income.[11] A 2015 the Cochrane review; however, found the medical evidence on mass deworming of children does not support beneficial effect on school performance, body weight, cognition, and rates of anemia.[1]

This is a discussion on the different organizations take on the benefits of mass deworming. I am happy with the heading "evidence". Would also be happy with the heading "health effects". This content however is not simply critisism or limitations of deworming. Would "health effects" work for other? Doc James (talk · contribs · email) 09:01, 10 August 2015 (UTC)

Is it really correct to say "Increase intelligence"?

I am wondering about this sentence: "The World Health Organization recommends mass deworming of children on the grounds it will improve nutritional health, reduce anemia and increase intelligence, thereby bringing about overall health benefits and better school performance.[1] " I am not sure but I think I remember that we don't talk of "increase intelligence" in development cooperation. It is an iffy subject, as it "being poor" with "being stupid". As far as I know, we normally speak more exactly of "cognitive abilities"? I can't read the source that is given as it seems to be behind a paywall. Is it really the best source to cite for this WHO recommendation? Is there no document directly from WHO that is freely accessible? EvM-Susana (talk) 20:40, 9 August 2015 (UTC)

Education increases intelligence so I do not see an issue with it. Doc James (talk · contribs · email) 04:28, 10 August 2015 (UTC)

There are different definitions of intelligence so I would say "caution!" with using that term, especially in the context of poverty and development cooperation. What was the exact sentence of statement from that reference? I can't access it, it's behind a paywall. How about my other question regarding a publication by WHO if we are making a statement about what WHO recommends? EvM-Susana (talk) 08:12, 10 August 2015 (UTC)

Sure we can go with cognition. I see them as about the same though with intelligence being easier to understand and more commonly used. Doc James (talk · contribs · email) 08:48, 10 August 2015 (UTC)

I'm pretty sure it is about educational attainment rather than intelligence or cognition. I think there would have to be strong evidence that intestinal worms actually affect the way the brain works (which may be the case, but I don't think I've read anything suggesting this) to say it was anything about cognition or intelligence. JMWt (talk) 08:50, 10 August 2015 (UTC)

Ref says "However, in mass treatment of all children in endemic areas, there is now substantial evidence that this does not improve average nutritional status, haemoglobin, cognition, school performance, or survival." [6] Was determined by "formal tests of cognition" Doc James (talk · contribs · email) 08:57, 10 August 2015 (UTC)

OK I missed that. JMWt (talk) 09:13, 10 August 2015 (UTC)

Ref - information about RCT limitations and how it relates to mass deworming

This ref does not mention mass deworming? So it does not support the content in quetsion.

"The drawbacks of randomized controlled trials have been explained in many publications and may apply in particular to research on evidence of mass deworming. This is because outcomes are long-term, such as reduction in stunted growth of children. Few organizations have the financial means to run costly RCTs over the long periods (years or decades) that would be ideal for evaluating health outcomes of mass deworming interventions."

References

Doc James (talk · contribs · email) 07:55, 12 August 2015 (UTC)

I have added it because: The central point about the discussion seems to be that the Cochrane review left out studies which showed evidence of health outcomes on the basis that they were not sufficient in terms of being RCTs. If we explain to the readers that RCTs have their own drawbacks (as the Wikipedia article on RCTs points out in great detail – hence the importance to link to it!) and that these drawbacks specifically relate to issues of long term-ness (and stunted growth only becomes obvious over the years or decades), then they can understand what the criticism is all about. - I added that reference about RCT because it explains the drawbacks of RCT with regards to cost and long-term issues. - In deworming, there is very little “money” so not many organisations have the financial means to run full-blown RCTs over 10 years to prove the evidence to such a level that the Cochrane review would consider its inclusion. This might well be different for other drugs and other diseases. - I am not attempting to “refute the Cochrane review”. I am only trying to give the layperson reader enough information so that he/she understands what the argument is all about. I think it really is about RCTs and long-term effects. EvM-Susana (talk) 08:40, 12 August 2015 (UTC)

If the study design is not an RCT than the conclusions are in doubt regardless. Non RCT designs cannot confirm something completely. Non RCTs can only hint at the situation as they have their own issues.

So what we have is a larger amount of low quality evidence finds benefits. A smaller amount of high quality evidence does not.

Some groups may be convinced by the low quality evidence and see the small amount of high quality evidence as not sufficient. Others may view it the other way around. Doc James (talk · contribs · email) 09:24, 12 August 2015 (UTC)

Philippines example

I think something was messed up with the Philippines example. It is mixing up the state programme for deworming with the Fit for School programme (which connects deworming with tooth brushing and handwashing). I will try to fix that now.EvM-Susana (talk) 10:46, 13 August 2015 (UTC)

Malawi

I just wanted to point out that the article says that by 2014, 2014 children in Malawi had been dewormed. Surely that's a typo. 128.187.112.24 (talk) 02:22, 27 November 2016 (UTC)

Thanks, I think it was me who added that so it was probably my mistake. I can't at the moment see which ref gives this information so I have removed the statement for now. JMWt (talk) 08:35, 1 December 2016 (UTC)

Value of the info box?

Just wondering what added value the new info box gives? Or will it be built up later? Here. EMsmile (talk) 20:47, 22 April 2017 (UTC)

Globalize tag to be removed

Hi, you User:Flow234 have just added the globalize tag to this article without giving any explanation for it. This article is already very much globalized, so I don't understand why you felt the need to give it a tag? Please explain. EMsmile (talk) 11:08, 8 June 2017 (UTC)

• User:EMsmile The history and the examples sections do not show a global point of view as the history only mentions the US and the Examples are only for Nicaragua and the Philippines i forgot to mention that when i added the tag Flow 234 (Nina) talk 09:43, 9 June 2017 (UTC)

Thanks for these clarifications, User:Flow234. OK, so how many additional examples would you request to see, other than Nicaragua and the Philippines? And it's true that the history only describes the situation in the U.S. but there is a link to the article on Timeline of deworming which covers the whole world. Do you want us to repeat pieces from there (could be done)? Perhaps User:Riceissa who thankfully set up that "timeline of deworming" article could help with this. EMsmile (talk) 12:08, 9 June 2017 (UTC)

Appoligize for late response my internet was down for a few days for some reason I dont care how many example but i would like to see some examples in a developed country like UK or US or Australia and we could repeat pieces from the timeline to globalize it however i did not do it as i am not sure if its allowed per the CC BY-SA 3.0 or the GFDL licenses Flow 234 (Nina) talk

No worries about being late(r). I don't understand your concern about the licence though? Copying from one Wikipedia article to another is always allowed as all Wikipedia content is CC BY SA? EMsmile (talk) 22:52, 11 June 2017 (UTC)

Please take another look: I've moved the stuff about the U.S. to the examples section and added a little bit of history from the other article. OK to remove globalize tag now or is more needed? This topic is actually extremely "globalized" - it mainly affects people in developing countries nowadays, all over the world. EMsmile (talk) 23:06, 11 June 2017 (UTC)

It can be removed and i must have not cleared my cache on my computer as the updates show up now when i cleared my cache Flow 234 (Nina) talk 23:10, 11 June 2017 (UTC)

Done (removed the tag). EMsmile (talk) 10:17, 6 July 2017 (UTC)

"Preventative chemotherapy" listed at Redirects for discussion

The redirect Preventative chemotherapy has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at Wikipedia:Redirects for discussion/Log/2024 March 25 § Preventative chemotherapy until a consensus is reached. ‑‑Neveselbert (talk · contribs · email) 21:57, 25 March 2024 (UTC)