***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: Filariasis control programmes are moving towards a strategy of repeated single-dose mass treatment of endemic population s. Using a combination , such as albendazole ( ALB ) to diethylcarbamazine ( DEC ) gives both macrofilaricidal and anti-helmintic activity . However , the safety of the combination versus DEC alone should be established in field studies in large population s prior to incorporation into national programmes . The present study compared the safety , tolerability , and efficacy of single doses of DEC 6 mg/kg + ALB placebo with DEC 6 mg/kg + ALB 400 mg in population s living in two filariasis endemic villages in the district of Wardha in western India . The study was double blind , parallel group , and r and omized . Safety and tolerability study were studied in males and females older than 5 years .  Safety was assessed by monitoring if adverse events ( AEs ) over 5 days affected daily acivities . Subjects in the 2 treatment groups experienced insignificantly different effects on daily activities and the combination was shown to be safe . Efficacy was evaluated by microfilaraemia ( Mf ) , immunochromatographic test ( ICT ) and ultrasonography ( USG ) at 0 , 3 , 6 , and 12 months of follow up . The efficacy study enrolled 103 male patients ( aged 18 - 50 years ) in microfilariae positive , clinical disease and asymptomatic , amicrofilaremic groups . There was no significant difference in efficacy between groups at 12 months . Within the Mf positive group , significant differences were seen in microfilaraemia ( P < 0.001 ) with both treatments , and in USG ( P < 0.001 and P < 0.004 respectively ) , at 12 months . The present field study has shown the combination of DEC + ALB  to be as safe as the single drug DEC and thus the combination can be put in use in the national filariasis control programmes . Both drugs were adequately absorbed . The study at present does not provide evidence for the greater efficacy of the combination at 12 months follow up . While the safety of the combination has been ascertained , the incorporation or otherwise of ALB into national programmes for greater efficacy must await results of studies with longer follow up Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more This r and omized , placebo-controlled trial investigated the efficacy and nutritional benefit of combining chemotherapeutic treatment for intestinal helminths ( albendazole ) and lymphatic filariasis ( ivermectin ) . Children were infected with Ascaris ( 29.2 % ) , Trichuris ( 42.2 % ) , and hookworm ( 6.9 % ) , with 54.7 % of children having one or more of these parasites . Wuchereria bancrofti microfilaria were found in 13.3 % of the children . Children were r and omly assigned to treatment with placebo , albendazole , ivermectin , or combined therapy . Combination treatment reduced the prevalence of Trichuris infections significantly more than either drug alone . Combination therapy also significantly reduced the prevalence and density of W. bancrofti microfilaremia compared with placebo or ivermectin alone . Only combination therapy result ed in significantly greater gains in height ( hookworm-infected children ) or weight ( Trichuris-infected children ) compared with the placebo group . Combined  albendazole and ivermectin  was a more efficacious treatment for intestinal helminth and W. bancrofti infections  in children and result ed in nutritional benefits not found with either drug alone Although current programmes to eliminate lymphatic filariasis have made significant progress it may be necessary to use different approaches to achieve the global goal , especially where compliance has been poor and ‘ hot spots ’ of continued infection exist . In the absence of alternative drugs , the use of higher or more frequent dosing with the existing drugs needs to be explored . We examined the effect of higher and /or more frequent dosing with albendazole with a fixed 300 mg dose of diethylcarbamazine in a Wuchereria bancrofti endemic area in Odisha , India . Following screening , 104 consenting adults were r and omly assigned to treatment with the st and ard regimen annually for 24 months ( S1 ) , or annually with increased dose ( 800 mg albendazole)(H1 ) or with increased frequency ( 6 monthly ) with either st and ard ( S2 ) or increased ( H2 ) dose . Pre-treatment microfilaria counts ( GM ) ranged from 348 to 459 mf/ml . Subjects were followed using microfilaria counts , OG4C3 antigen levels and ultrasound scanning for adult worm nests . Microfilarial counts tended to decrease more rapidly with higher or more frequent dosing at all time points . At 12 months , Mf clearance was marginally greater with the high dose regimens , while by 24 months , there was a trend to higher Mf clearance in the arm with increased frequency and 800 mg of albendazole ( 76.9 % ) compared to other arms , ( S1:64 % , S2:69.2 % & H1:73.1 % ) . Although higher and /or more frequent dosing showed a trend towards a greater decline in antigenemia and clearance of “ nests ” , all regimens demonstrated the potential macrofilaricidal effect of the combination . The higher doses of albendazole did not result in a greater number or more severe side effects . The alternative regimens could be useful in the later stages of existing elimination programmes or achieving elimination more rapidly in areas where programmes have yet to start Background Chronic parasitic infections are associated with active immunomodulation which may include by-st and er effects on unrelated antigens . It has been suggested that pre-natal exposure to parasitic infections in the mother impacts immunological development in the fetus and hence the offspring ’s response to vaccines , and that control of parasitic infection among pregnant women will therefore be beneficial . Methodology /Principal findings We used new data from the Entebbe Mother and Baby Study , a trial of anthelminthic treatment during pregnancy conducted in Ug and a , to further investigate this hypothesis . 2705 mothers were investigated for parasitic infections and then r and omised to albendazole ( 400 mg ) versus placebo and praziquantel ( 40mg/kg ) during pregnancy in a factorial design . All mothers received sulfadoxine/pyrimethamine for presumptive treatment of malaria . Offspring received Exp and ed Programme on Immunisation vaccines at birth , six , 10 and 14 weeks . New data on antibody levels to diphtheria toxin , three pertussis antigens , Haemophilus influenzae type B ( HiB ) and Hepatitis B , measured at one year ( April 2004 –May 2007 ) from 1379 infants were analysed for this report . Additional observational analyses relating maternal infections to infant vaccine responses were also conducted . Helminth infections were highly prevalent amongst mothers ( hookworm 43.1 % , Mansonella 20.9 % , Schistosoma mansoni 17.3 % , Strongyloides 11.7 % , Trichuris 8.1 % ) and 9.4 % had malaria at enrolment . In the trial analysis we found no overall effect of either anthelminthic intervention on the measured infant vaccine responses . In observational analyses , no species was associated with suppressed responses . Strongyloidiasis was associated with enhanced responses to pertussis toxin , HiB and Hep B vaccine antigens . Conclusions / Significance Our results do not support the hypothesis that routine anthelminthic treatment during pregnancy has a benefit for the infant ’s vaccine response , or that maternal helminth infection has a net suppressive effect on the offspring ’s response to vaccines . Trial Registration IS RCT N.com IS RCT The efficacy of two strategies for control of Bancroftian filariasis using selective rather than community-wide diethylcarbamazine ( DEC ) chemotherapy was evaluated and compared in two endemic communities of north-eastern Tanzania , with pretreatment microfilariae ( mf ) prevalences of 22 % and 38 % , and geometric mean intensities ( GMIs ) of 668 mf/ml and 735 mf/ml of blood . All mf-positive cases in the first community were offered treatment with 6 mg of DEC/kg of body weight a day for 12 days ( group 1 ) , and those in the second community were offered treatment with two doses of 6 mg of DEC/kg of body weight at an interval of six months ( group 2 ) . The effect of treatment was followed both among those treated and at the community level . In treated individuals , there was a rapid decrease in the mf load that was significantly greater among those receiving the 12-day st and ard dose . One year after the start of treatment , the mf clearance rates were 59 % and 39 % and the GMIs were reduced by 99 % and 97 % among treated individuals in groups 1 and 2 , respectively . However , at the community level , the mf prevalences were 16.3 % and 27.9 % ( reduced by 27 % and 26 % ) and the GMIs were 129 mf/ml and 224 mf/ml ( reduced by 81 % and 70 % ) one year after the start of treatment with the two regimens , respectively , suggesting that transmission continued at a significant level in the villages after treatment . The limitations of selective chemotherapy are discussed , and it is argued that strategies based on mass DEC chemotherapy would be more effective in reducing the microfilarial load in the community and thereby in reducing transmission Forty male Polynesian W. bancrofti carriers with mf counts greater than or equal to 20/ml were treated with a single ivermectin 50 , 100 , 150 or 200 mcg/kg dose . Following therapy , mf levels fell to less than 1 % of pretreatment levels in the carriers treated with the 3 highest doses . After one month , negativation rate was 40 % in patients treated with a 50 mcg/kg dose , significantly lower than in patients treated with higher doses . Recurrence of microfilaremia was observed by 3 months , mf recurrence percentages were significantly lower in patients treated with the 3 highest doses than in patients treated with a 50 mcg/kg dose . At 6 months , mf recurrence percentages reached 49.8 , 12.6 , 14 and 5.4 % of pretreatment levels in carriers treated with 50 , 100 , 150 and 200 mcg/kg , respectively . No significant difference was observed between mf levels by group at 6 and 12 months . With respect to efficacy , a dose greater than or equal to 100 mcg/kg appeared superior to 50 mcg/kg dose ; no significant difference between the 3 highest doses was observed . Some patients developed headache , myalgia and fever within 24 hours following therapy , none of adverse reactions were considered serious . In vector Ae . polynesiensis fed on carriers 6 months after treatment , average numbers of mf ingested and average numbers of L3 cephalic larvae were lower than those observed in mosquitoes fed on non-treated carriers with comparable mf counts . ( ABSTRACT TRUNCATED AT 250 WORDS Integrated chemotherapy of neglected tropical diseases ( NTD ) through mass drug administration given as a single dose would increase treatment coverage and cost-effectiveness . This study reports on the safety of a combination of albendazole , ivermectin and praziquantel in the treatment of lymphatic filariasis ( LF ) , schistosomiasis and soil-transmitted helminthiasis ( STH ) in infected children . In this r and omised , controlled , single-blinded clinical trial conducted in 235 primary school children aged 5 - 18 years in Yumbe District in Northern Ug and a , the triple combination therapy was compared with the current NTD programme regimen . Liver function testing was performed for all children who received combined therapy . The study included 48 children with LF alone , 60 children with schistosomiasis ( Schistosoma mansoni ) , 41 children with STH , 49 children with schistosomiasis + LF and 37 children with all three types of infection . Children were closely monitored by a paediatrician for any adverse reactions for 7 days . No serious adverse events were experienced . However , 4 of 18 children in the test group and 2 of 3 children in the control group who did not report any ill conditions before treatment developed adverse drug reactions . The combined and conventional therapies were found to be equally safe . The efficacies of both therapies were comparable and satisfactory . [ Clinical Trials.gov identifier : NCT01050517 ] Background Once interruption of transmission of lymphatic filariasis is achieved , morbidity prevention and management becomes more important . A study in Brugia malayi filariasis from India has shown sub- clinical lymphatic pathology with potential reversibility . We studied a Wuchereria bancrofti infected population , the major contributor to LF globally . Methods Children aged 5–18 years from Odisha , India were screened for W. bancrofti infection and disease . 102 infected children , 50 with filarial disease and 52 without symptoms were investigated by lymphoscintigraphy and then r and omized to receive a supervised single oral dose of DE 
    Output:
    
For mf density there is no trend , with some trials reporting a greater reduction in mf density  with albendazole and others a greater reduction with the control group .
This finding is consistent in trials evaluating albendazole alone , or added to DEC or ivermectin .
The review raises questions over whether albendazole has any important contribution to the elimination of lymphatic filariasis .