***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 More than a third of the world 's children are infected with intestinal nematodes . Current control approaches emphasise treatment of school age children , and there is a lack of information on the effects of deworming preschool children . Methodology We studied the effects on the heights and weights of 3,935 children , initially 1 to 5 years of age , of five rounds of anthelmintic treatment ( 400 mg albendazole ) administered every 6 months over 2 years . The children lived in 50 areas , each defined by precise government boundaries as urban slums , in Lucknow , North India . All children were offered vitamin A every 6 months , and children in 25 r and omly assigned slum areas also received 6-monthly albendazole . Treatments were delivered by the State Integrated Child Development Scheme ( ICDS ) , and height and weight were monitored at baseline and every 6 months for 24 months ( trial registration number NCT00396500 ) . p Value calculations are based only on the 50 area-specific mean values , as r and omization was by area . Findings The ICDS infrastructure proved able to deliver the interventions . 95 % ( 3,712/3,912 ) of those alive at the end of the study had received all five interventions and had been measured during all four follow-up surveys , and 99 % ( 3,855/3,912 ) were measured at the last of these surveys . At this final follow up , the albendazole-treated arm exhibited a similar height gain but a 35 ( SE 5 ) % greater weight gain , equivalent to an extra 1 ( SE 0.15 ) kg over 2 years ( 99 % CI 0.6–1.4 kg , p = 10−11 ) . Conclusions In such urban slums in the 1990s , five 6-monthly rounds of single dose anthelmintic treatment of malnourished , poor children initially aged 1–5 years results in substantial weight gain . The ICDS system could provide a sustainable , inexpensive approach to the delivery of anthelmintics or micronutrient supplements to such population s. As , however , we do not know the control parasite burden , these results are difficult to generalize . Trial Registration Clinical Trials.gov 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 Tribendimidine is an anthelminthic drug with a broad spectrum of activity . In 2004 the drug was approved by Chinese authorities for human use . The efficacy of tribendimidine against soil-transmitted helminths ( Ascaris lumbricoides , hookworm , and Trichuris trichiura ) has been established , and new laboratory investigations point to activity against cestodes and Strongyloides ratti . Methodology /Principal Findings In an open-label r and omized trial , the safety and efficacy of a single oral dose of albendazole or tribendimidine ( both drugs administered at 200 mg for 5- to 14-year-old children , and 400 mg for individuals ≥15 years ) against soil-transmitted helminths , Strongyloides stercoralis , and Taenia spp . were assessed in a village in Yunnan province , People 's Republic of China . The analysis was on a per- protocol basis and the trial is registered with controlled-trials.com ( number IS RCT N01779485 ) . Both albendazole and tribendimidine were highly efficacious against A. lumbricoides and , moderately , against hookworm . The efficacy against T. trichiura was low . Among 57 individuals who received tribendimidine  , the prevalence of S. stercoralis was reduced from 19.3 % to 8.8 % ( observed cure rate 54.5 % , p = 0.107 ) , and that of Taenia spp . from 26.3 % to 8.8 % ( observed cure rate 66.7 % , p = 0.014 ) . Similar prevalence reductions were noted among the 66 albendazole recipients . Taking into account “ new ” infections discovered at treatment evaluation , which were most likely missed pre-treatment due to the lack of sensitivity of available diagnostic approaches , the difference between the drug-specific net Taenia spp . cure rates was highly significant in favor of tribendimidine ( p = 0.001 ) . No significant adverse events of either drug were observed . Conclusions / Significance Our results suggest that single-dose oral tribendimidine can be employed in setting s with extensive intestinal polyparasitism , and its efficacy against A. lumbricoides and hookworm was confirmed . The promising results obtained with tribendimidine against S. stercoralis and Taenia spp . warrant further investigations . In a next step , multiple-dose schedules should be evaluated Significance Chronic helminth infections are accompanied by profound immune regulation . In humans , helminth-induced immune reactivity has not been thoroughly investigated in trial setting s. We assessed the effect of anthelmintic treatment on immune responses in a whole community in a placebo-controlled r and omized controlled trial . We show increased immune responses to helminth-specific as well as unrelated antigens , in parallel with decreased expression of cytotoxic T lymphocyte-associated antigen 4 ( CTLA-4 ) , which is a molecule involved in putting the brake on immune activation . Deworming seems to lead to decreased immunoregulation and increased immune responsiveness . These findings are of importance regarding the suboptimal vaccine responses in helminth-endemic areas and also in anticipating the future rise in inflammatory diseases when helminth infections are increasingly controlled . In cross-sectional studies , chronic helminth infections have been associated with immunological hyporesponsiveness that can affect responses to unrelated antigens . To study the immunological effects of deworming , we conducted a cluster-r and omized , double-blind , placebo-controlled  trial in Indonesia and assigned 954 households to receive albendazole or placebo once every 3 mo for 2 y. Helminth-specific and nonspecific whole-blood cytokine responses were assessed in 1,059 subjects of all ages , whereas phenotyping of regulatory molecules was undertaken in 121 school-aged children . All measurements were performed before and at 9 and 21 mo after initiation of treatment . Anthelmintic treatment result ed in significant increases in proinflammatory cytokine responses to Plasmodium falciparum-infected red blood cells ( PfRBCs ) and mitogen , with the largest effect on TNF responses to PfRBCs at 9 mo — estimate [ 95 % confidence interval ] , 0.37 [ 0.21–0.53 ] , P value over time ( Ptime ) < 0.0001 . Although the frequency of regulatory T cells did not change after treatment , there was a significant decline in the expression of the inhibitory molecule cytotoxic T lymphocyte-associated antigen 4 ( CTLA-4 ) on CD4 + T cells of albendazole-treated individuals , –0.060 [ –0.107 to –0.013 ] and –0.057 [ –0.105 to –0.008 ] at 9 and 21 mo , respectively ; Ptime = 0.017 . This trial shows the capacity of helminths to up-regulate inhibitory molecules and to suppress proinflammatory immune responses in humans . This could help to explain the inferior immunological responses to vaccines and lower prevalence of inflammatory diseases in low- compared with high-income countries Background : Helminth infestations are associated with T-helper cell type 2 ( Th2 ) immune responses , leading to suppression of Th1 responses required to control Mycobacterium tuberculosis infection . We hypothesized that deworming after documented M. tuberculosis exposure might improve Th1 immune responses . Methods : This was a r and omized controlled trial comparing the effect of early versus delayed ( after 3 months ) deworming on tuberculin skin testing ( TST ) and Quantiferon-Gold-in-tube responses among children from a setting with a known high burden of M. tuberculosis and helminth co-infection in Cape Town , South Africa . Children aged 6 to 15 years with documented M. tuberculosis exposure were enrolled . Ascaris lumbricoides status was measured by Ascaris-specific IgE and stool microscopy . Results : A total of 250 children ( mean age , 9.6 years ) were enrolled ; 11.9 % ( 27/227 ) were Ascaris stool microscopy positive and 54.2 % ( 135/249 ) were Ascaris stool and /or IgE positive ( Ascaris status ) . In univariable analysis , deworming at enrollment was not associated with a negative TST at 3 months ( odds ratio , 0.61 ; 95 % confidence interval , 0.35–1.07 ; P = 0.08 ) . In stratified analysis , children with a positive Ascaris status were more likely to be TST negative at 3 months if dewormed early ( odds ratio , 0.49 ; 95 % confidence interval , 0.23–1.04 ; P = 0.06 ) . In multivariable analysis , deworming was not associated with TST status ( adjusted odds ratios , 0.62 ; 95 % confidence interval , 0.34–1.10 ; P = 0.10 ) . There was no association between deworming and Quantiferon-Gold-in-tube status . Conclusions : Deworming in children with recent M. tuberculosis exposure is associated with a trend toward a negative TST result . Timing of deworming might influence interpretation of TST in setting s with high burdens of tuberculosis and helminths 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. tr 
    Output:
    
There was little or no effect in studies conducted in low and intermediate worm burden groups .
Thus we conclude that we do not know if repeated doses of deworming drugs impact on average weight , with a fewer older studies showing large gains , and studies since 2000 showing little or no average gain .
Authors ' conclusions Public health programmes to regularly treat all children with deworming drugs do not appear to improve height , haemoglobin , cognition , school performance , or mortality .
Studies conducted in two setting s over 20 years ago showed large effects on weight gain , but this is not a finding in more recent , larger studies .