***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: Praziquantel , a new antischistosomal compound , was tested for tolerance and efficacy against placebo in two double-blind clinical trials in Philippine patients infected with Schistosoma japonicum . The compound was given orally at a dose of 3 x 20 mg/kg at intervals of 4 hours to a total of 82 patients -some without advanced disease and some with hepatosplenic involvement . A total of 43 patients received placebo .  In a single-blind trial , 42 patients were given a single oral dose of 50 mg/kg . Monitoring of vital organ functions included comprehensive laboratory tests and serial electrocardiograms . In 38 patients with hepatosplenic involvement due to advanced stages of infection , serial electroencephalograms were additionally recorded . No toxic effects were observed in any of these examinations . Undesirable side effects occurred in 53 % of the patients given 3 x 20 mg/kg and in 70 % after a dose of 1 x 50 mg/kg . They consisted mainly of abdominal discomfort , fever , sweating , and occasionally giddiness , but in general were transient and mild . At 6 months post-treatment , 60 of 75 patients treated with 3 x 20 mg/kg and 29 of 41 treated with 1 x 50 mg/kg were completely negative for eggs . At 12 months post-treatment , 25 of 33 and 14 of 26 patients in the two treatment groups were cured . Thus the divided dosage gave a superior therapeutic result . Praziquantel proved to be free of major toxicity , and was well tolerated , highly effective , and easy to administer . Confirmation of results in extended trials may soon permit large-scale treatment 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 The efficacy of the antischistosomal drugs praziquantel and oxamniquine was tested on four groups of Ethiopian sugar estate workers . The cure rates , determined by the absence of eggs in stools , were 96 , 93 and 74 % at one , three and six months post-treatment for patients receiving a single dose ( 40 mg kg-1 body weight ) of praziquantel , and 82 , 78 and 78 % for patients on a single dose ( 15 mg kg-1 body weight ) of oxamniquine . When split doses of these drugs were used , praziquantel achieved cure rates of 96 , 95 and 89 % , while the corresponding cure rates for oxamniquine were 98 , 96 and 88 % at one , three and six months post-treatment . In general , there were no statistically significant differences within the single and split doses of each drug , nor between the two drugs except that single doses of praziquantel had significantly higher cure rates than oxamniquine at one and three months post-treatment . Although both drugs produced mild and transient side-effects such as dizziness , abdominal discomfort and diarrhoea , serious side-effects such as seizures were seen only among patients on oxamniquine . As praziquantel is also effective against other forms of schistosomiasis as well as against cestodes , we recommended the use of this drug in mass chemotherapy and in the ambulatory treatment of schistosomiasis in Ethiopia OBJECTIVE To evaluate the safety and efficacy of combining artemether ( AM ) and praziquantel ( PZQ ) in different regimens for treating acute schistosomiasis japonica . METHODS We undertook a r and omized , double-blind , placebo-controlled trial within four specialized schistosomiasis hospitals in the Dongting Lake region , Hunan province , China , between May 2003 and December 2005 . Study participants were r and omized into one of four treatment regimes : group A received 60 mg/kg PZQ + 6 mg/kg AM ;  group B received 60 mg/kg PZQ + AM placebo ;  group C received 120 mg/kg PZQ + 6 mg/kg AM ; and group D  received 120 mg/kg PZQ + AM placebo . All participants were followed up over a 45-day period . The primary endpoint of the trial was human infection status ( determined by positive stool examination ) . Secondary endpoints involved clinical observations and blood biochemistry , including monitoring haemoglobin and alanine aminotransferase levels over time . FINDINGS Treatment efficacies of the four different treatment regimens were 98.0 % , 96.4 % , 97.7 % and 95.7 % for group A , B , C , and D respectively ( P > 0.05 ) . The group B had a greater treatment efficacy ( 96.4 % ) than the group D ( 95.7 % ) ( P > 0.05 ) . Group A treatment was better for clearance of fever ( P < 0.05 ) and result ed in a shorter hospitalization time ( P < 0.05 ) . CONCLUSION This is the first report of a r and omized , double-blind , placebo-controlled trial for evaluating combined chemotherapy with AM and two different dosages ( 60 mg/kg and 120 mg/kg ) of PZQ in the treatment of acute schistosomiasis japonica in China . The combination of AM and PZQ chemotherapy did not improve treatment efficacy compared with PZQ alone . PZQ given as a dosage of 60 mg/kg ( 1 day , 3 x 20 mg/kg doses at 4 - 5 hour intervals ) may be as effective as a dosage of 120 mg/kg ( 6 days , 20 mg/kg for each day split into 3 doses at 4 - 5 hour intervals ) 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 Schistosomiasis is an important parasitic disease in Kenya . Decreasing susceptibility of schistosomes to praziquantel , the major drug used to reduce disease morbidity , has made assessment of new antischistosomal drugs a priority . We aim ed to assess the safety and efficacy of an artesunate-based combination drug in the treatment of schistosomiasis . METHODS In this open-label r and omised trial in Rarieda district of western Kenya , we enrolled school children ( aged 6 - 15 years ) who had Schistosoma mansoni infection according to duplicate Kato-Katz thick smears from a stool sample . Computer-generated block r and omisation was used to assign children ( 1:1 ) to receive artesunate ( 100 mg ) with sulfalene ( also known as sulfamethoxypyrazine ; 250 mg ) plus pyrimethamine ( 12.5 mg ) as one dose every 24 h for 3 days or one dose of praziquantel ( 40 mg/kg per day ) . The primary efficacy endpoint was the number of participants cured 28 days after treatment . Analysis was by intention to treat . This trial is registered with Clinical Trials.gov , number NCT01054651 . RESULTS Between October and December , 2009 , 212 children were enrolled and assigned to receive artesunate with sulfalene plus pyrimethamine ( n=106 ) or praziquantel ( n=106 ) . 69 patients ( 65 % ) were cured in the praziquantel treatment group compared with 15 ( 14 % ) in the artesunate with sulfalene plus pyrimethamine treatment group ( p<0.0001 ) . Adverse events were less common in patients taking artesunate with sulfalene plus pyrimethamine than in those taking praziquantel ( 22 % [ n=23 ] vs 49 % [ n=52 ] , p<0.0001 ) , and no drug-related serious adverse events occurred . INTERPRETATION The st and ard treatment with praziquantel is more effective than artesunate with sulfalene plus pyrimethamine in the treatment of children with S mansoni infection in western Kenya . Whether artemisinin-based combination therapy has a role in the treatment of schistosomiasis is unclear A r and omized double-blind study comparing the therapeutic efficacy of single dose of levo-praziquantel and mixed isomer praziquantel was carried out on 139 matched pairs of patients with schistosomiasis japonica . A single dose of either levo-praziquantel ( 20 mg/kg ) or praziquantel ( 40 mg/kg ) was given to each patient . Four and six months after treatment , the stool ova negative conversion rates were 94.85 % and 96.27 % for the levo-praziquantel group , and 97.06 % and 94.03 % for the praziquantel group , respectively ; there was no statistically significant difference between the two treatments ( P greater than 0.05 ) . For lightly and moderately infected patients , a single 20 mg/kg dose of levo-praziquantel was as efficacious as 40 mg/kg of praziquantel . Moreover , levo-praziquantel produced fewer side effects than praziquantel . These results suggest that levo-praziquantel is the component of the mixed isomer preparation that is antihelminthic . Levo-praziquantel could be used therapeutically at half the current dose of the mixed isomer drug 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 , expl 
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/ SIGNIFICANCE The large number of subjects allows generalizable conclusions despite the inherent limitations of aggregated- data meta-analyses .
The choice of praziquantel dose of 40 mg/kg is justified as a reasonable compromise for all species and ages , although in a proportion of sites efficacy may be lower than expected and age effects could not be fully explored