***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omized single blind stratified study involving 153 patients with mixed S. mansoni and S. haematobium infection showed that 2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino[2,1-a]isoquinolin-4-one ( praziquantel , EMBAY 8440 , Biltricide ) is effective in giving high cure rates in each infection separately , 66 % ( 64 patients ) and 77 % ( 94 patients ) , respectively . The complete clearance of both infections ( i.e. , no eggs whether dead or alive ) 6 months after treatment was 29 % ( 43 patients ) . The side effects of the drug were minimal and transient , the most common being gastrointestinal ones . The assessment of the objective tolerability by clinical , haematological and biochemical tests showed also that the drug was very safe . It is thus concluded that the drug is a promising useful tool in the control of schistosomiasis in general and the treatment of the individual The shortage of available information on the impact of low doses of praziquantel was remedied by a trial of 0 , 10 , 20 , 30 and 40 mg kg-1 against double infections of Schistosoma haematobium and S. mansoni in a rural area of Zimbabwe . No significant differences were found in egg reduction between 20 - 40 mg kg-1 for S. haematobium and between 30 - 40 mg kg-1 for S. mansoni . It is suggested that morbidity control can be achieved with lower dosages of praziquantel than currently recommended Relationships of S. haematobium , hookworm and malarial infections to growth 6 months after metrifonate treatment were studied in Kenyan primary school children in an area where poor growth , S. haematobium and hookworm were common and malaria was endemic . All children with light-moderate S. haematobium infections ( 1 - 500 eggs/10 ml adj ) in 4 schools were examined ( Exam 1 ) , allocated at r and om to either placebo ( MIP , n = 198 ) or metrifonate treatment ( MIT , n = 201 ) groups , treated , and examined again 6 months later ( Exam 2 ) . An additional 19 heavily infected children ( HIT group greater than 500 eggs/10 ml adj ) were treated immediately after Exam 1 and also followed . The MIT and HIT groups exhibited more rapid growth between Exam 1 and 2 than did the placebo group . The MIT group gained significantly ( P less than 0.001 ) more than the MIP group in weight ( 0.8 kg ) , percent weight for age ( 2.3 percentage points ) , weight for height squared ( 0.04 units ) , arm circumference ( 0.4 cm ) , percent arm circumference for age ( 1.7 percentage points ) and in triceps and subscapular skinfold thicknesses . In addition , the placebo group showed statistically significant decreases between exams in percentage weight for age , percent arm circumference for age , both skinfold thicknesses for age and no significant increase in percent height for age while the MIT group exhibited highly significant increases in all anthropometric parameters . ( ABSTRACT TRUNCATED AT 250 WORDS Praziquantel administered in a single oral dose of 30 mg kg-1 to subjects infected with Schistosoma haematobium produced minimal side effects and was more effective than established regimes of niridazole and metrifonate . Praziquantel should prove a major tool in schistosomiasis control programmes Abstract The efficacy and tolerability of oral artesunate for the treatment of urinary schistosomiasis was assessed among schoolchildren aged 5–18 years in Adim community , Nigeria . Overall , 500 children , r and omly selected from those attending the Presbyterian primary school , were each invited to provide two consecutive urine sample s. Using st and ard parasitological procedures , Schistosoma haematobium ova were found in the sample s from 145 ( 29.0 % ) of the subjects . Most ( 87 ) of the infected subjects were then treated orally with artesunate , using two doses , each of 6 mg/kg , given 2 weeks apart . When the treated children were re-examined 4 weeks after the second dose of artesunate , 61 ( 70.1 % ) appeared egg-negative and were therefore considered cured . Post-treatment , the geometric mean egg count ( GMEC ) for the treated subjects who were not cured was significantly lower than the pre-treatment GMEC for all the treated subjects , with log10[(eggs/10 ml urine ) + 1 ] values of 0.9 v. 1.75 ( t = 4.45 ; P < 0.05 ) . The cure ' rate ' for the subjects aged ≥ 10 years was slightly higher than that among the younger subjects . It was lowest for the heavier subjects ( 70 % for those weighing 41–50 kg ) and highest ( 79 % ) for the subjects who weighed 31–40 kg . The artesunate was well tolerated . This observation of a therapeutic effect  of artesunate against S. haematobium in Nigeria confirms recent observations from Senegal . In the Adim community at least , it would be more cost-effective to treat urinary schistosomiasis with artesunate than with praziquantel . The wide-spread use of artesunate against schistosomiasis has to be considered carefully , however , if it is not to compromise the efficacy of the drug as an antimalarial , by increasing the risk of resistance developing in local Plasmodium The effectiveness of the new schistosomicide praziquantel was assessed in African schoolchildren infected with Schistosoma haematobium . They were stratified according to the severity of their infection and were then r and omly allocated to treatment with two single-dose regimens ( 30 and 40 mg/kg ) and a split regimen of two doses of 20 mg/kg given four hours apart . All three regimens were highly effective and produced few side effects .  Children who initially had very high pretreatment egg loads showed a poorer therapeutic response at all dose levels , and further investigations are necessary to find the optimum dose . Because of its effectiveness in a single dose and lack of toxicity , praziquantel may prove to be the ideal schistosomicide Artemether is an efficacious antimalarial drug that also displays antischistosomal properties . Laboratory studies have found that artemether curtails the development of adult worms of Schistosoma japonicum , S. mansoni and S. haematobium , and thus prevents morbidity . These findings have been confirmed in clinical trials for the former two parasites ; administered orally once every 2 - 3 weeks , artemether significantly reduced the incidence and intensity of patent infections . Here , we present the first r and omized , double-blind , placebo-controlled trial of artemether against S. haematobium , done in a highly endemic area of Côte d'Ivoire . Urine specimens from 440 schoolchildren were examined over 4 consecutive days , followed by two systematic praziquantel treatments 4 weeks apart . S. haematobium-negative children were r and omized to receive 6 mg/kg artemether ( N = 161 ) or placebo ( N = 161 ) . Medication was administered orally for a total of six doses once every 4 weeks . Adverse events were assessed 72 hours after medication , and perceived illness episodes were monitored throughout the study period . Incidence and intensity of S. haematobium infections , and microhematuria and macrohematuria were assessed 3 weeks after the final dosing . We also monitored malaria parasitemia and treated positive cases with sulfadoxine-pyrimethamine ( SP ) . Oral artemether was well tolerated . The incidence of patent S. haematobium infections in artemether recipients was significantly lower than in placebo recipients ( 49 % versus 65 % , protective efficacy : 0.25 , 95 % CI : 0.08 - 0.38 , P = 0.007 ) . The geometric mean infection intensity in the artemether group was less than half that of the placebo recipients ( 3.4 versus 7.4 eggs/10 mL urine , P < 0.001 ) . Heavy S. haematobium infections , microhematuria and macrohematuria , and the incidence of malaria parasitemia were all significantly lower in artemether recipients . In conclusion , previous findings of efficacy of artemether against S. japonicum and S. mansoni were confirmed for S. haematobium , although the protective efficacy was considerably lower . These findings enlarge the scope and potential of artemether and further contribute to discussion s of its role as an additional tool for integrated schistosomiasis control Recently , artemisinin derivatives have been shown to be efficacious in chemoprophylaxis of and chemotherapy for Schistosoma japonicum and S. mansoni infections . Therefore , a double-blind , r and omized , placebo-controlled study was carried out to investigate the efficacy and tolerability of artesunate plus placebo and the combination of artesunate and praziquantel in the treatment of S. haematobium infections in Gabon . The 300 infected schoolchildren included in the study were r and omized to receive artesunate plus placebo ( n=90 ) , praziquantel plus placebo ( n=90 ) , artesunate and praziquantel ( n=90 ) , or only placebo ( n=30 ) . End points were efficacy , assessed as cure on day 56 , and tolerability . All treatment regimens were well tolerated . The praziquantel plus placebo-treated group attained a cure rate of 73 % , artesunate plus placebo a rate of 27 % , the combination of artesunate and praziquantel a rate of 81 % , and placebo alone a rate of 20 % . In summary , earlier findings of efficacy of artemisinin derivitives against S. mansoni and S. japonicum could not be confirmed in S. haematobium infections Quantitative parasitological assessment and quantitative analysis of proteinuria , hematuria , and leukocyturia were carried out in 182 Sudanese schoolboys with mixed urinary and intestinal schistosomiasis .  Pathological proteinuria was found in 73 % of patients ( median = 380 , 95 % confidence limits = 200 to 500 mg/liter ) . The median protein/creatinine ratio was 0.54 . SDS polyacrylamide gel electrophoresis showed an excretion of albumin , transferrin , and IgG consistent with a postrenal pattern of proteinuria . Pathological erythrocyturia occurred in 84 % of patients ( median = 255 , 95 % CL = 95 to 629 cells/microliter ) and leukocyturia in 77 % of patients ( median = 148 , 95 % CL = 93 to 246 cells/microliter ) . Phase contrast microscopy revealed intact erythrocytes , suggestive of postrenal hemorrhage . Proteinuria , erythrocyturia , and leukocyturia correlated significantly with the ova excretion in the urine , but not with egg excretion in the stool . Oxamniquine reduced ova excretion in the stool but did not influence pathological urine findings . In patients treated effectively with Praziquantel or Metrifonate , pathological PU , EU , and LU decreased markedly 1 month post treatment . PU in severely proteinuric patients reached physiological values 5 months post therapy . We suggest that the proteinuria , erythrocyturia , and leukocyturia in mixed schistosomiasis were of postrenal origin A field trial was conducted in Sudan to evaluate the acceptability and efficacy of praziquantel given to schoolchildren aged 7 - 11 years who were all infected with both Schistosoma mansoni and S. haematobium . Two dosage regimes were compared , a single dose of 40 mg/kg bodyweight , and a divided dose 2 X 20 mg/kg given 4 - 6 h apart . When interviewed 24 h after treatment , 80 % of the children complained of drug-induced abdominal pain , diarrhoea , nausea or vomiting . However none of the side-effects persisted beyond the day of treatment . More children complained of side-effects from the divided dose than from the single dose . The cure rate in the divided-dose group was slightly better than in the single-dose group but the differences were not significant at any follow-up , nor when results were expressed in terms of cumulative failures . The initial cure rates were 66.3 % and 61.8 % at 1 month , and 73.2 % and 64.7 % at 3 months for the divided and single doses respectively . After 12 months there had apparently been considerable reinfection with S. mansoni and 73 % of the children were passing eggs . Reinfection with S. haematobium was negligible The impact of albendazole ( 400 mg ) and praziquantel ( 40 mg/kg body weight ) treatment of schoolchildren was compared with placebo according to the presence of anaemia ( haemoglobin concentration < 11 . 0 g/dl ) and heavy ( > 5000 epg ) or light ( < 5000 epg ) hookworm egg load . The study was conducted in rural Tanga . Medication was administered in September 1994 and children were followed-up in January 1995 . Overall , anthelminthic treatment reduced the fall in haemoglobin concentration compared with that 
    Output:
    
The review confirmed that both the st and ard recommended doses of PZQ ( single 40 mg/kg oral dose ) and metrifonate ( 3x7.5 - 10 mg/kg oral doses administered fortnightly ) are efficacious and safe in treating urinary schistosomiasis , but there is no study comparing these two regimens head-to-head .