Twenty studies were included: nine were double-blind, two single-blind, two non-blinded, and no information was provided for seven.
Fourteen studies assessed albendazole, of which 2 RCTs were of the highest quality (score 5) and two nearly so (score 4); the other 10 studies were of varying quality (score 1 to 3). There was significant heterogeneity between the studies and the results of the Egger and/or Begg's tests indicated publication bias. For the treatment of A. lumbricoides there were 557 individuals (10 RCTs), for T. trichiura 735 individuals (9 RCTs), and for hookworm infection 742 individuals (14 RCTs). The pooled RRs for albendazole treatment against the various infections, relative to placebo, were as follows: 0.12 (95% CI: 0.07, 0.21, p<0.001) for A. lumbricoides infection, 0.72 (95% CI: 0.61, 0.87, p=0.001) for T. trichiura infection and 0.28 (95% CI: 0.19, 0.41, p=0.001) for hookworm infection (both species).
Six studies assessed mebendazole, of which one RCT was of the highest quality (score 5); the other 5 studies were of varying quality (score 2 to 3). For all infections there was significant heterogeneity between the studies. For the treatment of A. lumbricoides there were 309 individuals, for T. trichiura 685 individuals (3 RCTs), and for hookworm infection 853 individuals (6 RCTs). The pooled RRs for mebendazole treatment against the various infections, relative to placebo, were as follows: 0.05 (95% CI: 0.03, 0.09, p<0.001) for A. lumbricoides infection, 0.64 (95% CI: 0.49, 0.84, p=0.001) for T. trichiura infection and 0.85 (95% CI: 0.73, 0.99; p=0.01) for hookworm infection (both species).
Four studies assessed pyrantel pamoate; all RCTs were of varying quality (score 1 to 3). The pooled RR for pyrantel pamoate treatment, relative to placebo, was 0.12 (95% CI: 0.07, 0.21, p<0.001) against A. lumbricoides infection (3 RCT, 131 individuals) and 0.69 (95% CI: 0.58, 0.81, p<0.001) against hookworm infection (both species).
No placebo-controlled RCTs were identified that assessed levamisole at the currently recommended dose.