***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 determine whether nutritional status , anaemia and geohelminth infections were related to school achievement and attendance in Jamaican children . Design : A cross-sectional study using a r and omly selected sample .Subjects : Eight hundred children aged 9–13 y r and omly selected from those enrolled in grade 5 in 16 primary schools in rural Jamaica . Results : The mean height-for-age of the children was −0.37 z-score±1.0 s.d . with 4.9 % having heights-for-age < −2 s.d . of the NCHS references . Anaemia ( Hb<11 ; g/dl ) was present in 14.7 % of the children , 38.3 % were infected with Trichuris trichiura and 19.4 % with Ascaris lumbricoides . Achievement levels on the Wide Range Achievement Test were low , with children performing at grade 3 level . In multilevel analyses , controlling for socioeconomic status , children with Trichuris infections had lower achievement levels than uninfected children in spelling , reading and arithmetic ( P<0.05 ) . Children with Ascaris infections had lower scores in spelling and reading ( P<0.05 ) Height-for-age ( P<0.01 ) was positively associated with performance in arithmetic . Ascaris infection ( P<0.001 ) and anaemia ( P<0.01 ) predicted poorer school attendance . Conclusion : Despite mild levels , undernutrition and geohelminth infections were associated with achievement , suggesting that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children . Sponsorship : Funding was provided by the Commonwealth Caribbean Medical Research Council and the Inter-American Development Bank Background Appropriate health and nutrition interventions to prevent long-term adverse effects in children are necessary before two years of age . One such intervention may include population -based deworming , recommended as of 12 months of age by the World Health Organization in soil-transmitted helminth (STH)-endemic areas ; however , the benefit of deworming has been understudied in early preschool-age children . Methodology /Principal Findings A r and omized , double-blind , placebo-controlled trial was conducted to determine the effect of  deworming ( 500 mg single-dose crushed mebendazole tablet ) on growth in one-year-old children in Iquitos , Peru . Children were enrolled during their routine 12-month growth and development clinic visit and followed up at their 18 and 24-month visits . Children were r and omly allocated to : Group 1 : deworming at 12 months and placebo at 18 months ; Group 2 : placebo at 12 months and deworming at 18 months ; Group 3 : deworming at both 12 and 18 months ; or Group 4 : placebo at both 12 and 18 months ( i.e. control group ) . The primary outcome was weight gain at the 24-month visit . An intention-to-treat approach was used . A total of 1760 children were enrolled between September 2011 and June 2012 . Follow-up of 1563 children ( 88.8 % ) was completed by July 2013 . STH infection was of low prevalence and predominantly light intensity in the study population . All groups gained between 1.93 and 2.05 kg on average over 12 months ; the average difference in weight gain ( kg ) compared to placebo was : 0.05 ( 95 % CI : -0.05 , 0.17 ) in Group 1 ; -0.07 ( 95%CI : -0.17 , 0.04 ) in Group 2 ; and 0.04 ( 95%CI : -0.06 , 0.14 ) in Group 3 . There was no statistically significant difference in weight gain in any of the deworming intervention groups compared to the control group . Conclusions Overall , with one year of follow-up , no effect of deworming on growth could be detected in this population of preschool-age children . Low baseline STH prevalence and intensity and /or access to deworming drugs outside of the trial may have diluted the potential effect of the intervention . Additional research is required to overcome these challenges and to contribute to strengthening the evidence base on deworming . Trial Registration Clinical Trials.gov ( NCT01314937 The effects of treating Trichuris trichiura infections were investigated in 407 Jamaican children age 6 to 12 y. The children were r and omly assigned to receive treatment ( albendazole ) or a placebo . The outcome variables included growth , tests of reading , spelling and arithmetic , and school attendance . After 6 mo of treatment , there was no significant main effect on any of the outcomes . However , there were significant treatment-by-infection intensity interactions with spelling ( P < 0.05 ) and body mass index ( P < 0.01 ) , and a significant treatment-by-stunting interaction with school attendance ( P < 0.01 ) . In spelling , the children with heavy infections showed improvements with treatment that approached significance ( P = 0.06 ) , whereas those with lower intensities did not . However , the children with lower infection intensities had increased body mass index with treatment ( P = 0.02 ) , although there was no difference in children with heavy infections . In school attendance , the stunted children improved with treatment ( P < 0.04 ) , whereas there was no difference in the nonstunted children . These findings suggest that in the sample of Jamaican children examined , the treatment of T. trichiura was more likely to benefit school performance in children of poor nutritional status and those with heavy infections , and to improve weight gain in children with lighter infection intensities Soil-transmitted helminth ( STH ) infections are a leading cause of disability and disease burden in school-age children of worm-endemic regions . Their effect on school absenteeism , however , remains unclear . The World Health Organization currently recommends delivering mass deworming and health hygiene education through school-based programs , in an effort to control STH-related morbidity . In this cluster- RCT , the impact of a health hygiene education intervention on absenteeism was measured . From April to June 2010 , all Grade 5 students at 18 schools in a worm-endemic region of the Peruvian Amazon were dewormed . Immediately following deworming , nine schools were r and omly assigned to the intervention arm of the trial using a matched-pair design . The Grade 5 students attending intervention schools ( N = 517 ) received four months of health hygiene education aim ed at increasing knowledge of STH prevention .  Grade 5 students from the other nine schools ( N = 571 ) served as controls . Absenteeism was measured daily through teachers ' attendance logs . After four months of follow-up , overall absenteeism rates at intervention and control schools were not statistically significantly different . However , post-trial non-r and omized analyses have shown that students with moderate-to-heavy Ascaris infections and light hookworm infections four months after deworming had , respectively , missed 2.4 % ( 95 % CI : 0.1 % , 4.7 % ) and 4.6 % ( 95 % CI : 1.9 % , 7.4 % ) more schooldays during the follow-up period than their uninfected counterparts . These results provide empirical evidence of a direct effect of STH infections on absenteeism in school-age children A double-blind placebo trial was conducted to determine the effect of moderate to high loads of Trichuris trichiura ( whipworm ) infection on the cognitive functions of 159 school children ( age 9 - 12 years ) in Jamaica . Infected children were r and omly assigned to Treatment or Placebo groups . A third group of r and omly selected uninfected children were assigned to a Control for comparative purpose s. The improvement in cognitive function was evaluated using a stepwise multiple linear regression , design ed to control for any confounding variables . The expulsion of worms led to a significant improvement in tests of auditory short-term memory ( P less than 0.02 ; P less than 0.01 ) , and a highly significant improvement in the scanning and retrieval of long-term memory ( P less than 0.001 ) . After 9 weeks , treated children were no longer significantly different from an uninfected Control group in these three tests of cognitive function . The removal of T. trichiura was more important than Ascaris lumbricoides in determining this improvement . The results suggest that whipworm infection has an adverse effect on certain cognitive functions which is reversible by therapy Introduction : Helminth ( worm ) infections cause morbidity among poor communities worldwide . An influential study conducted in Kenya in 1998–99 reported that a school-based drug- and -educational intervention had benefits for worm infections and school attendance . Methods : In this statistical replication , we re-analysed data from this cluster quasi-r and omized stepped-wedge trial , specifying two co- primary outcomes : school attendance and examination performance . We estimated intention-to-treat effects using year-stratified cluster- summary analysis and observation-level r and om-effects regression , and combined both years with a r and om-effects model accounting for year . The participants were not blinded to allocation status , and other interventions were concurrently conducted in a sub-set of schools . A protocol guiding outcome data collection was not available . Results : Quasi-r and omization result ed in three similar groups of 25 schools . There was a substantial amount of missing data . In year-stratified cluster- summary analysis , there was no clear evidence for improvement in either school attendance or examination performance . In year-stratified regression models , there was some evidence of improvement in school attendance [ adjusted odds ratios ( aOR ) : year 1 : 1.48 , 95 % confidence interval ( CI ) 0.88–2.52 , P = 0.147 ; year 2 : 1.23 , 95 % CI 1.01–1.51 , P = 0.044 ] , but not examination performance ( adjusted differences : year 1 : −0.135 , 95 % CI −0.323–0.054 , P = 0.161 ; year 2 : −0.017 , 95 % CI −0.201–0.166 , P = 0.854 ) . When both years were combined , there was strong evidence of an effect on attendance ( aOR 1.82 , 95 % CI 1.74–1.91 , P < 0.001 ) , but not examination performance ( adjusted difference −0.121 , 95 % CI −0.293–0.052 , P = 0.169 ) . Conclusions : The evidence supporting an improvement in school attendance differed by analysis method . This , and various other important limitations of the data , caution against over-interpretation of the results . We find that the study provides some evidence , but with high risk of bias , that a school-based drug-treatment and health-education intervention  improved school attendance and no evidence of effect on examination performance Tested 47 first-year primary school children at a mission school in rural Zaire for cognitive ability with the Kaufman Assessment Battery for Children ( K-ABC ) adopted to the language of Kituba . Within a day of this test , each child was evaluated for blood hemoglobin ( Hgb ) level and the presence of intestinal parasites . Half of the children received an iron supplement ( 20 mg Fe ) for 30 days and those children positive for the intestinal parasites of ankylostome or ascaris were r and omly selected to receive either a vermifuge treatment or placebo . All of the children were again evaluated medically and cognitively 4 weeks after the initiation of treatment . Using discriminant analysis , performance on the Mental Processing Composite of the K-ABC 1 month after treatment in combination with increases in blood Hgb result ed in the successful classification of 74 % in terms whether a child had received both iron supplement and vermifuge treatment ( p = .007 ) . With respect to our home evaluation for each child , factors related to the nutritional and economic well-being of the home environment proved a reliable marker for Simultaneous Processing ability . However , the present findings also suggest that over the short-term , changes in blood Hgb that accompany both vermifuge and iron supplement treatment together can improve certain aspects of cognitive ability , perhaps by means of heightened attentional capacity Background The Schistosomiasis Consortium for Operational Research and Evaluation ( SCORE ) was established in 2008 to answer strategic questions about schistosomiasis control . For programme managers , a high-priority question is : what are the most cost-effective strategies for delivering preventive chemotherapy ( PCT ) with praziquantel ( PZQ ) ? This paper describes the process SCORE used to transform this question into a harmonized research protocol , the study design for answering this question , the village eligibility assessment s and data result ing from the first year of the study . Methods Beginning in 2009 , SCORE held a series of meetings to specify empirical questions and design studies related to different schedules of PCT for schistosomiasis control in communities with high ( gaining control studies ) and moderate ( sustaining control studies ) prevalence of Schistosoma infection among school-aged children . Seven studies are currently being implemented in five African countries . During the first year , villages were screened for eligibility , and data were collected on prevalence and intensity of infection prior to r and omisation and the implementation of different schemes of PZQ intervention strategies . Results These studies of different treatment schedules with PZQ will provide the most comprehensive data thus far on the optimal frequency and continuity of PCT for schistosomiasis infection and morbidity control . Conclusions We expect that the study outcomes will provide data for decision-making for country programme 
    Output:
    
INTERPRETATION We provide evidence of superior performance in five of six educational and cognitive domains assessed for STH uninfected/dewormed versus STH infected/not-dewormed school-aged children from helminth endemic regions .
Notwithst and ing , this synthesis provides empirical support for a cognitive and educational benefit of deworming .
The benefit of deworming will be enhanced by strategically employing , integrated interventions .