***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 field trial was conducted in the Gezira , Sudan , to evaluate the acceptability and efficacy of praziquantel , a new schistosomicide . In one Arab village 350 patients with Schistosoma mansoni were r and omly assigned to two treatment groups and given 1 X 40 mg kg-1 ( Group A ) or 2 X 20 mg kg-1 given four to six hours apart ( Group B ) . In two small settlements ( camps ) 2 km distant from the Arab village 38 patients with S. mansoni and 43 with concurrent S. mansoni and S. haematobium infections were given 1 X 40 mg kg-1 . Side effects were mild and limited to the first 24 hours after treatment . The main complaints were abdominal pain , diarrhoea , urticaria and /or vomiting and were most common in the camp residents ( 79 % ) with 60 % of Group A and 45 % of Group B having one or more side effects . One month after treatment ' cure ' rates were : Camps 63 % , Group A 84 % and Group B 96 % , and the reduction in egg output was over 95 % . After 12 months re-infection was greater in the camps . As there was no significant difference in the egg output reduction between the two treatment regimes , praziquantel is recommended for mass chemotherapy in Gezira at the logistically simpler regimen of 1 X 40 mg kg-1 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 Abstract In Dar es Salaam , 576 African school-children , age-distribution seven to sixteen years , began a course of niridazole ( ' Ambilhar ' , Ciba 32,644-Ba ) to treat their urinary schistosomiasis ; 488 ( 84·7 % ) completed treatment . Of these 475 ( 97·3 % ) completed satisfactory monthly follow-up urine tests for four months . 25 mg . per kg . of niridazole was given daily for seven days . Half the children were treated with a daily dose and the other half with a split dose administered twice a day . 13·5 % of the children complained of minor symptoms but serious side-effects were not encountered during treatment . After four months ' follow-up 92·6 % of the children on a daily dose were classed as " cured " as against 98·6 % on a twice-daily dose . Failure occurred chiefly in boys on the daily dose ( 17 out of the total of 22 failures in both boys and girls who were on a daily or twice-daily dose ) . The cure-rate in boys ( 94·2 % ) was lower than in girls ( 98·5 % ) . The results showed a significant difference in the higher cure-rate of those on a twice-daily dose . Because the number who failed to complete treatment was higher in those on a twice-daily dose ( 21·0 % ) as against those on a daily dose ( 9·7 % ) , a daily dose should be used for outpatient or mass-treatment of children . A twice-daily dose , with a somewhat higher cure-rate , should be used for inpatient treatment and also for outpatient treatment when it can be reasonably ensured that the child will take the dose twice a day . Since other workers have encountered serious neuropsychiatric side-effects in some patients who were treated with niridazole , particularly in adults with Schistosoma mansoni infections , caution in the use of this drug is advocated until the contraindications have been further eluci date d. Nevertheless , niridazole is a very valuable and well-tolerated drug for the ambulatory treatment of children with urinary schistosomiasis 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 Background This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy ( ACT ) artesunate + sulfamethoxypyrazine/pyrimethamine ( As+SMP ) , administered in doses used for malaria , to treat Schistosoma haematobium in school aged children . Methodology /Principal Findings The study was conducted in Djalakorodji , a peri-urban area of Bamako , Mali , using a double blind setup in which As+SMP was compared with praziquantel ( PZQ ) . Urine sample s were examined for Schistosoma haematobium on days −1 , 0 , 28 and 29 . Detection of haematuria , and haematological and biochemical exams were conducted on day 0 and day 28 . Clinical exams were performed on days 0 , 1 , 2 , and 28 . A total of 800 children were included in the trial .  The cure rate obtained without viability testing was 43.9 % in the As+SMP group versus 53 % in the PZQ group ( Chi2 = 6.44 , p = 0.011 ) . Egg reduction rates were 95.6 % with PZQ in comparison with 92.8 % with As+SMP , p = 0.096 . The proportion of participants who experienced adverse events related to the medication was 0.5 % ( 2/400 ) in As+SMP treated children compared to 2.3 % ( 9/399 ) in the PZQ group ( p = 0.033 ) . Abdominal pain and vomiting were the most frequent adverse events in both treatment arms . All adverse events were categorized as mild . Conclusions / Significance The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium . However , the safety and tolerability profile of As+SMP was similar to that seen with PZQ . Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections . Trial Registration Clinical Trials.gov BACKGROUND Morbidity control of schistosomiasis relies on a single drug , praziquantel . The antimalarial drug mefloquine possesses interesting antischistosomal properties , yet no clinical studies have been performed . METHODS We conducted a r and omized , exploratory open-label trial to assess the efficacy and safety of mefloquine ( 25 mg/kg ) , artesunate ( 3 doses of 4 mg/kg ) , mefloquine-artesunate ( 3 doses of 100 mg artesunate plus 250 mg mefloquine ) , and praziquantel ( 40 mg/kg ) against Schistosoma haematobium . The effects on Schistosoma mansoni , malaria parasitemia , soil-transmitted helminths , and intestinal protozoa were also determined . RESULTS A total of 83 S. haematobium-infected schoolchildren were included in the study . Cure rates of  mefloquine , artesunate , mefloquine-artesunate , and praziquantel against S. haematobium at day 26 after treatment were 21 % , 25 % , 61 % , and 88 % , respectively . Both mefloquine-artesunate and praziquantel result ed in egg reduction rates > 95 % . Significantly lower egg reduction rates were seen in the artesunate ( 85 % ) and mefloquine groups ( 74 % ) . In children coinfected with S. mansoni , praziquantel and mefloquine-artesunate , but not mefloquine and artesunate alone , result ed in high cure rates and egg reduction rates .  Mefloquine , artesunate , and mefloquine-artesunate completely cured infections due to Plasmodium falciparum . No effects were found against soil-transmitted helminths and intestinal protozoa . Abdominal pain was the most frequent adverse event , with a higher incidence among children treated with mefloquine ( 89 % ) , mefloquine-artesunate ( 83 % ) , and artesunate ( 60 % ) than among children treated with praziquantel ( 46 % ) . CONCLUSIONS The high efficacy of mefloquine-artesunate against S. haematobium warrants further investigation . Individuals coinfected with Plasmodium and Schistosoma who were treated with a mefloquine-artesunate combination against malaria might have a dual benefit : clearance of malaria parasitemia and reduction of schistosomiasis-related morbidity . CLINICAL TRIALS REGISTRATION Current Controlled Trials identifier : IS RCT N06498763 We studied the growth of comparable groups of children with light to moderate Schistosoma haematobium infections who received a single dose of metrifonate ( MT , 10 mg/kg ) , praziquantel ( PR , 40 mg/kg ) , or a placebo ( PL ) . Children were re-examined 8 months later . The MT and PR groups gained significantly more than the placebo group in weight , percent weight for age , percent weight for height , arm circumference , and in triceps and subscapular skinfold thicknesses . The MT and PR groups did not differ significantly from each other . The placebo group showed statistically significant decreases or no change between exams in percent weight for age , percent weight for height , percent arm circumference , and both skinfold thicknesses ; the MT and PR groups exhibited highly significant increases in these parameters ( P less than 0.0002 ) . The intensity of S. haematobium infection had decreased significantly in both the MT and PR groups , but especially in the PR group . Multiple regression analyses showed that a decrease in the intensity of S. haematobium infection was by far the most important predictor of growth rate after treatment for all 5 anthropometric measures tested ; decreases in the intensity of hookworm infection was also significant for 2 of the 5 measures Summary We have carried out an open clinical study in Somalia to evaluate the efficacy and safety of a simplified dosage schedule of metrifonate in the treatment of Schistosoma haematobium infection . The doses used were : I.10 mg · kg−1 once daily for 3 daysII.5 mg · kg−1 thrice daily for one dayIII.7.5 mg · kg−1 thrice daily for one day . We screened a total of 550 subjects in four villages for egg excretion in urine , and selected patients with more than 200 eggs per 10 ml of urine . In the initial phase of the study eight patients were assigned to each of the three dose schedules . In an extended study 38 additional patients were treated with regimen II which gave the best outcome in the initial study .Dosage Schedules I and III turned out to be toxic , and none of the patients was treated with all three doses . Adverse effects , such as abdominal colic , nausea , salivation , dizziness , and headache , were seen in almost all the patients in those two groups . Two patients from Group I reported that they fainted within 2 h after the second dose . None of the patients in Group II reported adverse effects . After 4–6 weeks follow-up , egg reduction was 96–100 % for Groups I and II and the cure rate was around 60%.This study has shown that a shorter course of treatment with metrifonate might be equally effective and safer than the recommended dosage schedule with three doses of 7.5–10 mg · kg−1 fortnightly A CAJM article on the control of bilharzia-sis  in Zimbabwean ( Rhodesian ) African children 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 
    Output:
    
Authors ' conclusions Praziquantel 40 mg/kg is the most studied drug for treating urinary schistosomiasis , and has the strongest evidence base .
Potential strategies to improve future treatments for schistosomiasis include the combination of praziquantel with metrifonate , or with antimalarial drugs with antischistosomal properties such as artesunate and mefloquine .