***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: 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 Artemether is an efficacious antimalarial drug that also displays antischistosomal properties . Laboratory studies have found that artemether curtails the development of adult worms of Schistosoma japonicum , S. mansoni and S. haematobium , and thus prevents morbidity . These findings have been confirmed in clinical trials for the former two parasites ; administered orally once every 2 - 3 weeks , artemether significantly reduced the incidence and intensity of patent infections . Here , we present the first r and omized , double-blind , placebo-controlled trial of artemether against S. haematobium , done in a highly endemic area of Côte d'Ivoire . Urine specimens from 440 schoolchildren were examined over 4 consecutive days , followed by two systematic praziquantel treatments 4 weeks apart . S. haematobium-negative children were r and omized to receive 6 mg/kg artemether ( N = 161 ) or placebo ( N = 161 ) . Medication was administered orally for a total of six doses once every 4 weeks . Adverse events were assessed 72 hours after medication , and perceived illness episodes were monitored throughout the study period . Incidence and intensity of S. haematobium infections , and microhematuria and macrohematuria were assessed 3 weeks after the final dosing . We also monitored malaria parasitemia and treated positive cases with sulfadoxine-pyrimethamine ( SP ) . Oral artemether was well tolerated . The incidence of patent S. haematobium infections in artemether recipients was significantly lower than in placebo recipients ( 49 % versus 65 % , protective efficacy : 0.25 , 95 % CI : 0.08 - 0.38 , P = 0.007 ) . The geometric mean infection intensity in the artemether group was less than half that of the placebo recipients ( 3.4 versus 7.4 eggs/10 mL urine , P < 0.001 ) . Heavy S. haematobium infections , microhematuria and macrohematuria , and the incidence of malaria parasitemia were all significantly lower in artemether recipients . In conclusion , previous findings of efficacy of artemether against S. japonicum and S. mansoni were confirmed for S. haematobium , although the protective efficacy was considerably lower . These findings enlarge the scope and potential of artemether and further contribute to discussion s of its role as an additional tool for integrated schistosomiasis control Recently , artemisinin derivatives have been shown to be efficacious in chemoprophylaxis of and chemotherapy for Schistosoma japonicum and S. mansoni infections . Therefore , a double-blind , r and omized , placebo-controlled study was carried out to investigate the efficacy and tolerability of artesunate plus placebo and the combination of artesunate and praziquantel in the treatment of S. haematobium infections in Gabon . The 300 infected schoolchildren included in the study were r and omized to receive artesunate plus placebo ( n=90 ) , praziquantel plus placebo ( n=90 ) , artesunate and praziquantel ( n=90 ) , or only placebo ( n=30 ) . End points were efficacy , assessed as cure on day 56 , and tolerability . All treatment regimens were well tolerated . The praziquantel plus placebo-treated group attained a cure rate of 73 % , artesunate plus placebo a rate of 27 % , the combination of artesunate and praziquantel a rate of 81 % , and placebo alone a rate of 20 % . In summary , earlier findings of efficacy of artemisinin derivitives against S. mansoni and S. japonicum could not be confirmed in S. haematobium infections OBJECTIVE To study the preventive effect of oral artemether ( Art ) against schistosomal infection in the field . METHODS In Minglang District of Yiyang City , Hunan Province , there is an islet with embankment type endemic area in the southern Dongting Lake region . From August to October 1994 the residents who frequently contacted the infested water were selected for study and allocated to the Art group and the control group . About one month before the preventive Art administration , all the residents understudied were examined by  stool hatching technique  , and then treated orally with praziquantel at a single dose of 40 mg/kg in stool egg-negative residents and 50 mg/kg in stool egg-positive ones . In the Art group , the first dose of 6 mg/kg was given at the end of August , followed by 3 repeated doses every 15 days . Placebo ( starch ) was given to the control group at the same time as in the Art group . The preventive efficacy was evaluated by stool examination 25 - 32 days after the last medication . RESULTS In the Art group , 20 out of 365 studied residents became stool positive with an infection rate of 5.5 % , while in the control group , 51 out of 376 studied residents were stool positive with an infection rate of 13.6 % . The egg count per gram of feces ( EPG ) determined by the Kato-Katz method was 122 + /- 79 in the Art group and 681 + /- 909 in the control group . Meanwhile , two cases of acute schistosomiasis were found in the control group , but none was observed in the Art group . No apparent adverse side effect was seen during the treatment with Art . CONCLUSION Oral Art exhibited apparent preventive effect on the residents who contacted the infested water in schistosomiasis endemic area OBJECTIVE To study the preventive effect of artemether ( Art ) in protecting the people from schistosome infection during flood fighting in schistosomiasis endemic area of Poyang Lake , Jiangxi Province . METHODS From mid July to mid August in 1996 , the water level in Poyang Lake rose due to torrential rains and 2 embankments , Zhedi and Jiangtongdi , which appeared in dangerous situation and were selected as the pilot spots . After those who went to fight against flood arrived at the pilots their sera were collected within 48 hours and were examined with indirect hemagglutination test ( IHA ) , enzyme-linked immunosorbent assay ( ELISA ) and McAb-ELISA . Individuals with negative outcome in the 3 tests were then selected as the study subjects and were allocated r and omly to the Art or the control group . The first dose of Art given to the individuals contacted with the infested water within 11 - 15 days was 6 mg/kg . If the individual continually contacted the infested water , the same dose of Art was given once every 15 days . After the individuals withdrew from the pilot , one more dose of 
    Output:
    
/ SIGNIFICANCE This meta- analysis confirms that artemisinin derivatives used in combination with praziquantel have the potential to increase the cure rates in schistosomiasis treatment , but not artesunate alone .
It is also confirmed that repeated doses of artemisinin derivatives play a prophylactic role , significantly reducing the incidence of Schistosoma japonicum infections compared with placebo