***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: 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 Abstract Background : Documents from advocacy and fund-raising organizations for child mass deworming programmes in low- and middle-income countries cite unpublished economic studies cl aim ing long-term effects on health , schooling and economic development . Methods : To summarize and appraise these studies , we search ed for and included all long-term follow-up studies based on cluster-r and omized trials included in a 2015 Cochrane review on deworming . We used Cochrane methods to assess risk of bias , and appraised the credibility of the main findings . Where necessary we contacted study authors for clarifications . Results : We identified three studies ( Baird 2016 , Ozier 2016 and Croke 2014 ) evaluating effects more than 9 years after cluster-r and omized trials in Kenya and Ug and a. Baird and Croke evaluate short additional exposures to deworming programmes in setting s where all children were dewormed multiple times . Ozier evaluates potential spin-off effects to infants living in areas with school-based deworming . None of the studies used pre-planned protocol s nor blinded the analysis to treatment allocation . Baird 2016 has been presented online in six iterations . The work is at high risk of reporting bias and selective reporting , and there are substantive changes between versions . The main cited effects on secondary school attendance and job sector allocation are from post hoc subgroup analyses , which the study was not powered to assess . The study did not find any evidence of effect on nutritional status , cognitive tests or school grade s achieved , but these are not reported in the abstract s. Ozier 2016 has been presented online in four iterations , without substantive differences between versions . Higher cognitive test scores were associated with deworming , but the appropriate analysis was underpowered to reliably detect these effects . The size of the stated effect seems inconsistent with the short and indirect nature of the exposure to deworming , and a causal pathway for this effect is unclear . Croke 2014 uses a data set unrelated to the base trial , to report improvements in English and maths test scores . The analysis is at high risk of attrition bias , due to loss of clusters , and is substantially underpowered to assess these effects . Conclusions : In the context of reliable epidemiological methods , all three studies are at risk of substantial method ological bias . They therefore help in generating hypotheses , but should not be considered to provide reliable evidence of effects Abstract Objective : To measure the effects of iron supplementation and anthelmintic treatment on iron status , anaemia , growth , morbidity , and development of children aged 6–59 months . Design : Double blind , placebo controlled r and omised factorial trial of iron supplementation and anthelmintic treatment . Setting : Community in Pemba Isl and , Zanzibar . Participants : 614 preschool children aged 6–59 months . Main outcome measures : Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups . Results : Before intervention , anaemia was prevalent and severe , and geohelminth infections were prevalent and light — Plasmodium falciparum infection was nearly universal . Iron supplementation significantly improved iron status , but not haemoglobin status . Iron supplementation improved language development by 0.8 ( 95 % confidence interval 0.2 to 1.4 ) points on the 20 point scale . Iron supplementation also improved motor development , but this effect was modified by baseline haemoglobin concentrations ( P=0.015 for interaction term ) and was apparent only in children with baseline haemoglobin concentrations < 90 g/l . In children with a baseline haemoglobin concentration of 68 g/l ( one st and ard deviation below the mean value ) , iron treatment increased scores by 1.1 ( 0.1 to 2.1 ) points on the 18 point motor scale . Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura , but not by hookworms . Mebendazole  increased development scores by 0.4 ( −0.3 to 1.1 ) points on the motor scale and 0.3 ( −0.3 to 0.9 ) points on the language scale . Conclusions : Iron supplementation improved motor and language development of preschool children in rural Africa . The effects of iron on motor development were limited to children with more severe anaemia ( baseline haemoglobin concentration < 90 g/l ) . Mebendazole had a positive effect on motor and language development , but this was not statistically significant . What is already known on this topic Iron is needed for development and functioning of the human brain Anaemic children show developmental delays , but it is not yet clear whether iron deficiency causes these deficits or whether iron supplementation can reverse them Helminth infections in schoolchildren are associated with cognitive deficits , but few studies have been made of helminth infection and early child development What this study adds Low doses of oral iron supplementation given daily improved language development in children aged 1–4 years in Zanzibar Iron supplementation improved motor development , but only in children with initial haemoglobin concentrations below 90 g/l The effects of routine anthelmintic treatment on motor and language milestones were positive , but non-significant , with our sample Objective : The study was conducted to assess the effectiveness of six monthly albendazole ( ABZ ) for improving the weight and height of preschool children when initia ted at 0.5–1 year of age in population s with a high transmission rate of intestinal roundworm , Ascaris lumbricoides . It was a cluster r and omized trial in the urban slums of Lucknow , North India . Methods : Control children received 2 ml ( 1 ml to infants ) of Vitamin A every six month whereas those in the ABZ areas received , in addition , 400 mg of ABZ suspension ( Zentel , SKB ) every six month . Sixty-three and sixty-one slum areas were r and omized to albendazole ( ABZ ) or to control  groups , respectively . Children aged 0.5–1 year were recruited in April 1996 and followed up for 1.5 years . Of 1022 children recruited from control and 988 from ABZ areas , the loss to follow-up at 1.5 year was 15.6 % and 14.6 % respectively . Mean ( ±SE ) weight gain in Kg in control versus ABZ areas was 3.04 ( 0.03 ) versus 3.22 ( 0.03 ) , ( p=0.01 ) . Results : After controlling for the presence of weight-for age z-score < -2.00 at enrollment in the ordinary least square ’s regression model , the extra weight gain in 1.5 years in those who received ABZ plus vitamin A was 0.13 Kg ( 95 % Cl:0.004 to 0.26 Kg . , p value=0.043 ) when compared to those who received only vitamin A ; underweight children at enrollment benefiting more than the normal ones . Conclusion : It was concluded that there was an improvement in weight with six monthly ABZ over 1.5 years . However , a much larger trial would be needed to determine whether there is any net effect of improvement in weight on under five mortality rate The study examines the effect of moderate to high worm burdens of Trichuris trichiura infection  on the cognitive functions  of 159 school children ( age 9–12 years ) in Jamaica , using a double-blind placebo-controlled protocol . Results were evaluated by using a forward-stepwise multiple linear regression . Removal of worms led to a significant improvement in tests of auditory short-term memory ( p < 0.017 ; p < 0.013 ) , and scanning and retrieval of long-term memory ( p < 0.001 ) . Nine weeks after treatment , there were no longer significant differences between the treated children and an uninfected Control group in these three tests of cognitive function . It is concluded that whipworm infection has an adverse effect on certain cognitive functions which is reversible by therapy The effects of mild to moderate infections of Trichuris trichiura on cognitive functions were investigated in Jamaican children aged 7 to 10 years . In all , 189 infected children and 100 uninfected classmates were studied . The infected children were r and omly assigned to receive treatment ( albendazole ) or a placebo . All children were given cognitive tests on enrolment and 14 weeks later . These included verbal fluency ( generation of ideas ) , digit span ( working memory ) , number choice ( speed of processing of visual stimuli ) , visual search ( sustained attention ) and a French Vocabulary test ( paired-associate learning ) . At baseline , the infected children had lower scores than the uninfected ones in fluency ( P = 0.01 ) , search ( P = 0.02 ) and French ( P = 0.01 ) . Treatment effects were examined among infected children and there was no significant treatment effect for any of the tests . However , there was a significant treatment by weight-for-age interaction in fluency ( P < 0.05 ) . The children with low weight-for-age ( Z-score < -1 ) improved with treatment while there was no improvement with treatment among the other children . We concluded that treatment of children with mild to moderate T. trichiura infections using albendazole produces little benefit in cognition if they are adequately nourished ; however , undernourished children are more likely to benefit OBJECTIVE To determine the prevalence and intensity of intestinal helminth species among school children in southern Ug and a. DESIGN A cross-sectional survey using a r and omly selected sample . SETTING Eighteen districts of southern Ug and a. SUBJECT Two thous and and four school children aged two to twenty years ( 93.3 % , aged 5 - 10 years ) selected from classes 1 and 2 in 26 r and omly selected primary schools . RESULTS Overall , 55.9 % of children were infected with either  hookworm , Ascanis lumbricoides or Trichuris trichiura . The prevalence of A. lumbricoides was 17.5 % ( range 0 - 66.7 % by school ) , T. trichiura was 7.3 % ( 0 - 45.0 % ) and hookworm 44.5 % ( 15.6 - 86.0 % ) . The prevalence of A. lumbricoides and T. trichiura was greatest in western districts while hookworm infection was more evenly distributed across the country . CONCLUSION Mass antihelminthic treatment of school children was warranted in 13 of the 18 districts as more than 50 % of the children were infected with an intestinal nematode . It is likely that pre-school children are similarly infected Abstract Objective To estimate the effectiveness of delivering an anthelmintic through a community child health programme on the weight gain  of preschool children in Ug and a. Design Cluster r and omised controlled trial . Setting Eastern Ug and a. Participants 48 parishes participating in a new programme for child health : 24 offered children an additional service of anthelmintic treatment . The outcome is based on measurements from 27 995 children . Intervention Treatment of children aged between 1 and 7 years with 400 mg albendazole added to st and ard services offered during child health days over a three year period . Main outcome measure Weight gain . Results The provision of periodic anthelmintic treatment as a part of child health services in Ug and a result ed in an increase in weight gain of about 10 % ( 166 g per child per year , 95 % confidence interval 16 to 316 ) above expected weight gain when treatments were given twice a year , and an increase of 5 % when the treatment was given annually . Conclusion Deworming of preschool children in Ug and a as part of regularly scheduled health services seems practical and associated with increased weight gain 
    Output:
    
There are significant differences in program impact by gender , with numeracy and literacy differentially positively affected for girls , and by age , with treatment effects larger for the primary school aged sub sample .
There are also significant treatment interactions for those living in households with more treatment-eligible children .
There is no evidence of differential treatment effects on age at program eligibility or number of years of program eligibility .
Mass deworming of preschool aged children in high prevalence communities in Ug and a result ed in no statistically significant gains in numeracy or literacy 7 - 12 years after program completion .
Point estimates were positive but imprecise ; the study lacked sufficient power to rule out substantial positive effects or more modest negative effects .
However , there is suggestive evidence that deworming was relatively more beneficial for girls , primary school aged children , and children living in households with other treated children .