***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: Background Helminth infections are proposed to have immunomodulatory activities affecting health outcomes either detrimentally or beneficially . We evaluated the effects of albendazole treatment , every three months for 21 months , on STH , malarial parasitemia and allergy . Methods and Findings A household-based cluster-r and omized , double-blind , placebo-controlled trial was conducted in an area in Indonesia endemic for STH . Using computer-aided block r and omization , 481 households ( 2022 subjects ) and 473 households ( 1982 subjects ) were assigned to receive placebo and albendazole , respectively , every three months . The treatment code was concealed from trial investigators and participants . Malarial parasitemia and malaria-like symptoms were assessed in participants older than four years of age while skin prick test ( SPT ) to allergens as well as reported symptoms of allergy in children aged 5–15 years . The general impact of treatment on STH prevalence and body mass index ( BMI ) was evaluated . Primary outcomes were prevalence of malarial parasitemia and SPT to any allergen . Analysis was by intention to treat . At 9 and 21 months post-treatment 80.8 % and 80.1 % of the study subjects were retained , respectively . The intensive treatment regiment result ed in a reduction in the prevalence of STH by 48 % in albendazole and 9 % in placebo group . Albendazole treatment led to a transient increase in malarial parasitemia at 6 months post treatment ( OR 4.16(1.35–12.80 ) ) and no statistically significant increase in SPT reactivity ( OR 1.18(0.74–1.86 ) at 9 months or 1.37 ( 0.93–2.01 ) 21 months ) . No effect of anthelminthic treatment was found on BMI , reported malaria-like- and allergy symptoms . No adverse effects were reported . Conclusions The study indicates that intensive community treatment of 3 monthly albendazole administration for 21 months over two years leads to a reduction in STH . This degree of reduction appears safe without any increased risk of malaria or allergies . Trial Registration Controlled-Trials.com IS RCT Background Some studies have suggested that helminth infections increase the risk of malaria infection and are associated with increased number of malaria attacks and anaemia . Thus interventions to control helminth infections may have an impact on incidence of clinical malaria and anaemia . The current study assessed the impact of two anthelmintic treatment approaches on malaria infection and on anaemia in school and pre-school children in Magu district , Tanzania . Methods A total of 765 children were enrolled into a prospect i ve r and omized anthelmintic intervention trial following a baseline study of 1546 children . Enrolled children were r and omized to receive either repeated treatment with praziquantel and albendazole four times a year ( intervention group , 394 children ) or single dose treatment with praziquantel and albendazole once a year ( control group , 371 children ) . Follow up examinations were conducted at 12 and 24 months after baseline to assess the impact of the intervention . Stool and urine sample s were collected and examined for schistosome and soil transmitted helminth infections . Blood sample s were also collected and examined for malaria parasites and haemoglobin concentrations . Monitoring of clinical malaria attacks was performed at each school during the two years of the intervention . Results Out of 1546 children screened for P. falciparum , S. mansoni , S. haematobium , hookworm and T. Trichiura at baseline , 1079 ( 69.8 % ) were infected with at least one of the four parasites . There was no significant difference in malaria infection ( prevalence , parasite density and frequency of malaria attacks ) and in the prevalence of anaemia between the repeated and single dose anthelmintic treatment groups at 12 and 24 months follow up ( p > 0.05 ) . However , overall , there was significant improvement in mean haemoglobin concentrations ( p < 0.001 ) from baseline levels of 122.0g/L and 123.0g/L to 136.0g/L and 136.8g/L for the repeated and single dose treatment groups , respectively , at 24 months follow-up which result ed in significant reduction in prevalence of anaemia . Conclusions These results suggest that repeated anthelmintic treatment did not have an impact on malaria infection compared to single dose treatment . However , both treatment approaches had overall impact in terms of improvements of haemoglobin levels and hence reductions in prevalence of anaemia Background To control soil-transmitted helminth ( STH ) infections , the World Health Organization recommends school-based deworming programs with a health hygiene education component . The effect of such health hygiene interventions , however , has not been adequately studied . The objective of the present study was to determine the effectiveness of a health hygiene education intervention on the occurrence of STH re-infection four months post-de-worming . Methodology /Principal Findings An open-label pair-matched cluster-r and omized trial was conducted in Grade 5 schoolchildren of 18 primary schools ( 9 intervention and 9 control ) in the Peruvian Amazon . Baseline assessment included interview with a pre-tested question naire and collection of single stool specimens that were examined using the single Kato-Katz thick smear . All schoolchildren were then treated with single-dose albendazole ( 400 mg ) . Schoolchildren in intervention schools then received 1 ) an initial one hour in-class activity on health hygiene and sanitation and 30-minute refresher activities every two weeks over four months ; and 2 ) a half-day workshop for teachers and principals , while children in control schools did not . Four months later , STH infection was re-assessed in all schools by laboratory technologists blinded to intervention status . From April 21–October 20 , 2010 , a total of 1,089 schoolchildren ( 518 and 571 from intervention and control schools , respectively ) participated in this study . Intervention children scored significantly higher on all aspects of a test of STH-related knowledge compared with control children ( aOR = 18·4 ; 95 % CI : 12·7 to 26·6 ) . The intensity of Ascaris lumbricoides infection at follow-up was statistically significantly lower ( by 58 % ) in children in intervention schools compared with children in control schools ( aIRR = 0·42 ; 95 % CI = 0·21 to 0·85 ) . No significant changes in hookworm or Trichuris trichiura intensity were observed . Conclusions / Significance A school-based health hygiene education intervention was effective in increasing STH knowledge and in reducing Ascaris lumbricoides infection . The benefits of school-based periodic deworming programs are likely to be enhanced when a sustained health hygiene education intervention is integrated into school curricula BACKGROUND School-based deworming programmes have been promoted as a cost-effective strategy for control of nematode infection in developing countries . While numerous efficacy studies have been conducted , there is little information on actual programme effectiveness in areas of intense transmission . METHODS A r and omized trial of a  school-based deworming programme  was conducted in 12 primary schools on Pemba Isl and , Zanzibar . Four schools each were r and omized to control , twice a year deworming with single dose mebendazole or three times a year deworming . Baseline and 12-month follow-up data on helminth infection using the Kato-Katz technique , demographic information and nutritional status were collected on 3028 children from March 1994 to May 1995 . RESULTS Intensity of infection measured as eggs per gram of faeces ( epg ) declined significantly for Ascaris lumbricoides , Trichuris trichiura and hookworm infections in both treatment groups . A. lumbricoides infection intensity declined 63.1 % and 96.7 % in the twice and three times per year treatment groups compared to the controls . T. trichiura infection intensity declined 40.4 % and 75.9 % respectively and hookworm intensity declined 35.3 % and 57.2 % respectively compared to control schools . CONCLUSIONS These results suggest that school-based programmes can be a cost-effective approach for controlling the intensity of intestinal helminth infection even in environments where transmission is high Background There is considerable debate on the health impacts of soil-transmitted helminth infections . We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan , People 's Republic of China , where soil-transmitted helminthiasis is highly endemic . Methodology The double-blind , r and omized , placebo-controlled trial was conducted between October 2011 and May 2012 . Children , aged 9–12 years , were treated with either triple-dose albendazole or placebo , and monitored for 6 months post-treatment . The Kato-Katz and Baermann techniques were used for the diagnosis of soil-transmitted helminth infections . Physical fitness was assessed with a 20-m shuttle run test , where the maximum  aerobic capacity within 1 min of exhaustive exercise ( VO2 max estimate ) and the number of 20-m laps completed were recorded . Physical strength was determined with grip strength and st and ing broad jump tests . Body height and weight , the sum of skinfolds , and hemoglobin levels were recorded as secondary outcomes . Principal Findings Children receiving triple-dose albendazole scored slightly higher in the primary and secondary outcomes than placebo recipients , but the difference lacked statistical significance . Trichuris trichiura-infected children had 1.6 ml kg−1 min−1 ( P = 0.02 ) less increase in their VO2 max estimate and completed 4.6 ( P = 0.04 ) fewer 20-m laps than at baseline compared to non-infected peers . Similar trends were detected in the VO2 max estimate and grip strength of children infected with hookworm and Ascaris lumbricoides , respectively . In addition , the increase in the VO2 max estimate from baseline was consistently higher in children with low-intensity T. trichiura and hookworm infections than in their peers with high-intensity infections of all soil-transmitted helminths ( range : 1.9–2.1 ml kg−1 min−1 ; all P<0.05 ) . Conclusions / Significance We found no strong evidence for significant improvements in physical fitness and anthropometric indicators due to deworming over a 6-month follow-up period . However , the negative effect of T. trichiura infections on physical fitness warrants further investigation Abstract Soil-transmitted helminths ( STHs ) infect over one billion people worldwide . There is concern that chronic infection with STHs among school-aged children may detrimentally affect their development , including their health , cognition , and education . However , two recent Cochrane review s examining the impact of deworming drugs for STH on nutrition , hemoglobin , and school performance found that r and omized controlled trials ( RCTs ) in the literature provide an insufficient evidence base to draw reliable conclusions . This study uses a cluster- RCT to add to existing evidence by assessing the impact of a deworming intervention on nutrition , cognition , and school performance among schoolchildren in rural China . The intervention , implemented by local health practitioners in a setting with a baseline infection prevalence of 41.9 % ( 95 % confidence interval [ CI ] = 39.8 % , 43.9 % ) and infection intensity of 599.5 eggs per gram of feces among positive-tested schoolchildren ( 95 % CI = 473.2 , 725.8 ) , consisted of distributing a 400-mg dose of albendazole accompanied with educational training about STH infection , treatment , and prevention . The intervention was conducted twice over the course of the study -at baseline in May 2013 and later in November 2013 . We found that the deworming intervention reduced both infection prevalence and infection intensity , but these declines in infection were not accompanied by an impact on outcomes of nutrition , cognition , or school performance . Our interpretation is that the impact of deworming was attenuated by the light infection intensity in our sample population . Evidence from future RCTs is needed to assess the effect of deworming on key outcomes in areas with moderate and severe worm infections We evaluated the effects of the  Zanzibar school-based deworming program  on the iron status of primary school children . Parasitologic and nutritional assessment s were carried out at baseline , 6 mo , and 12 mo in 4 nonprogram schools ( n = 1002 ) , 4 schools in which students received twice-yearly deworming ( n = 952 ) , and 4 schools in which students received thrice-yearly deworming ( n = 970 ) with 500 mg generic mebendazole .  Schools were r and omly selected for evaluation and allocated to program groups . Relative to no treatment , thrice-yearly deworming caused significant decreases in protoporphyrin concentrations and both deworming regimens caused marginally significant increases in serum ferritin concentrations . The average annual changes in protoporphyrin concentrations were -5.9 and -23.5 micromol/mol heme in the control and thrice-yearly deworming groups , respectively ( P < 0.001 ) . The average changes in ferritin concentration were 2.8 and 4.5 microg/L , respectively ( P = 0.07 ) . Deworming had no 
    Output:
    
Conclusions Mass deworming probably reduces the prevalence of soil-transmitted helminth infections but may have little or no effect on anaemia and iron-deficiency in adolescent girls and non-pregnant women in comparison to no intervention or placebo .
We are uncertain about the effect on severe anaemia .