***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: This prospect i ve study was design ed to look for and describe urologic and nephrologic consequences of urinary bilharziosis due to schistosoma haematobium in a hyperendemic hotbed in the middle west of Madagascar . Methodology included clinical examination , kidney and bladder ultrasonography , urine dipsticks and creatininemia . Amongst a population of 574 persons aged 5 years ore more , 436 ( 76 % ) had bilharziosis ova in the urine ( filtration method ) . From the clinical point of view , 257 patients ( 58.9 % ) had microscopic hematuria , 178 ( 40.8 % ) had presently an hematuria ;  111 patients ( 25.5 % ) suffered from  dysuria  ; 18 patients ( 4.1 % ) had limb oedema  when 3 patients had present oedema ( 0.7 % ) . Among 436 checked people , 267 ( 61.2 % ) had an ultrasonography abnormality . In 252 , it was bladder wall abnormalities ( 57.8 % ) . They were wall irregularities in 182 cases ( 41.7 % ) ; vesico-ureteral reflux in 22 cases ( 5.3 % ) ; ureteral dilatations in 22 cases ( 5.3 % ) and pyelocalyceal dilatations in 61 cases ( 13.9 % ) . Prevalence of proteinuria 75.2 % ( 316 amongst 420 checked people ) of whom 5.7 % ( 24 cases ) had 5 g/l or more . Hematuria was found in 352 patients ( 83.8 % ) of whom 238 ( 56.7 % ) had more than 250 erythrocytes per microliter . Prevalence of leucocyturia was 56.7 % ( 238 cases ) . Creatininemia was measured in 140 people with positive filtration ; it was normal in all except two patients . This study highlights the parallel evolution between parasitic infection and uronephrological manifestations of the disease UNLABELLED An earlier reported laboratory assay , performed in The Netherl and s , to diagnose Schistosoma infections by detection of the parasite antigen CAA in serum was converted to a more user-friendly format with dry reagents . The improved assay requires less equipment and allows storage and worldwide shipping at ambient temperature . Evaluation of the new assay format was carried out by local staff at Ampath Laboratories , South Africa . The lateral flow ( LF ) based assay utilized fluorescent ultrasensitive up-converting phosphor ( UCP ) reporter particles , to be read by a portable reader ( UPlink ) that was also provided to the laboratory . Over a period of 18 months , about 2000 clinical sample s were analyzed prospect ively in parallel with a routinely carried out CAA-ELISA . LF test results and ELISA data correlated very well at CAA concentrations above 300 pg/mL serum . At lower concentrations the UCP-LF test indicates a better performance than the ELISA . The UCP-LF strips can be stored as a permanent record as the UCP label does not fade . At the end of the 18 months testing period , LF strips were shipped back to The Netherl and s where scan results obtained in South Africa were vali date d with different UCP scanning equipment including a novel , custom developed , small lightweight UCP strip reader ( UCP-Quant ) , well suited for testing in low re source setting s. CONCLUSION The dry format UCP-LF assay was shown to provide a robust and easy to use format for rapid testing of CAA antigen in serum . It performed at least as good as the ELISA with respect to sensitivity and specificity , and was found to be superior with respect to speed and simplicity of use . Worldwide shipping at ambient temperature of the assay reagents , and the availability of small scanners to analyze the CAA UCP-LF strip , are two major steps towards point-of-care ( POC ) applications in remote and re source poor environments to accurately identify low ( 30 pg CAA/mL serum ; equivalent to about 10 worm pairs ) to heavy Schistosoma infections Quantitative parasitological assessment and quantitative analysis of proteinuria , hematuria , and leukocyturia were carried out in 182 Sudanese schoolboys with mixed urinary and intestinal schistosomiasis .  Pathological proteinuria was found in 73 % of patients ( median = 380 , 95 % confidence limits = 200 to 500 mg/liter ) . The median protein/creatinine ratio was 0.54 . SDS polyacrylamide gel electrophoresis showed an excretion of albumin , transferrin , and IgG consistent with a postrenal pattern of proteinuria . Pathological erythrocyturia occurred in 84 % of patients ( median = 255 , 95 % CL = 95 to 629 cells/microliter ) and leukocyturia in 77 % of patients ( median = 148 , 95 % CL = 93 to 246 cells/microliter ) . Phase contrast microscopy revealed intact erythrocytes , suggestive of postrenal hemorrhage . Proteinuria , erythrocyturia , and leukocyturia correlated significantly with the ova excretion in the urine , but not with egg excretion in the stool . Oxamniquine reduced ova excretion in the stool but did not influence pathological urine findings . In patients treated effectively with Praziquantel or Metrifonate , pathological PU , EU , and LU decreased markedly 1 month post treatment . PU in severely proteinuric patients reached physiological values 5 months post therapy . We suggest that the proteinuria , erythrocyturia , and leukocyturia in mixed schistosomiasis were of postrenal origin Health question naires and parasitologic examinations of urine and stool were performed upon a stratified r and om sample of 7,710 individuals from 1,109 households in 21 rural communities in Fayoum Governorate , Egypt in 1992 to investigate the prevalence of , risk factors for , and changing pattern of , infection with Schistosoma sp. in the governorate . A subset , every fifth household , or 1,038 subjects , had physical and ultrasound examinations  to investigate prevalence of , and risk factors for , morbidity . The prevalence of S. haematobium ranged from 0 % to 27.1 % and averaged 13.7 % . The geometric mean egg count ( GMEC ) was 10.0 eggs/10 ml of urine . Age-stratified prevalence and intensity of infection were 18 - 25 % and 10 - 15 eggs/10 ml of urine in those 5 - 25 years of age . Schistosoma mansoni were detected in inhabitants of 13 communities , but 78.5 % of the infections were focally present in a group of 4 satellite hamlets around a single village . The overall prevalence of S. mansoni in the governorate was 4.3 % and the GMEC was 44.0 ova/g of stool . Risk factors for infection with either species were male gender , an age < 20 years , living in smaller communities , and exposures to canal water by males . Histories of burning micturation , blood in the urine , or prior schistosomiasis and reagent strip-detected hematuria and proteinuria were risks for S. haematobium , but not for S. mansoni . Both urinary tract and higher grade s of hepatic morbidity were rare . Obstructive uropathy was present in 6.3 % of the subjects and was more common in males and older people . Ultrasonography-detected bladder lesions were present in 5.2 % and correlated with S. haematobium only in younger subjects and in those with hematuria and proteinuria . The prevalences of hepatomegaly , splenomegaly , and periportal fibrosis ( PPF ) were associated with each other and increased with age and in males . Ultrasonography-detected hepatomegaly and splenomegaly were weakly associated with S. mansoni infections only in children . The prevalence of PPF was greater in the 4 communities with > 25 % S. mansoni infection rates in comparison with the 17 other villages and ezbas . Transmission of S. mansoni is focally well established in Fayoum , which also has the highest prevalence of S. haematobium in the governorates surveyed by the Epidemiology 1 , 2 , 3 Project . However , both urinary tract and hepatic morbidity are relatively rare in the governorate . This probably results from the long-st and ing schistosomiasis control program in Fayoum , which suppressed intensity more than prevalence of infection , leading to less community morbidity Using Hansel 's stain , eosinophiluria greater than 5 % of total urinary white blood cells was found in 59 % of a r and omly selected population sample in an area endemic for schistosomiasis hematobium . The prevalence and mean level of eosinophiluria were significantly higher in infected subjects than in noninfected subjects ( P less than 0.05 ) . The sensitivity ( 80 % ) , specificity ( 86 % ) , and positive predictive value ( 82 % ) of eosinophiluria as a diagnostic index for schistosomiasis hematobium were significantly higher ( Youdin index 0.66 ; P less than 0.05 ) than those of proteinuria , hematuria , and leukocyturia taken singly or in combination . However , unlike the latter three measurements , this method involves microscopy . There is a great need for a chemical method for measuring eosinophiluria Schistosomiasis is a public health problem in Nigeria . Although there is a national programme for its control , there is the need for reliable and simple means of rapidly diagnosing communities to provide a detailed map on the distribution of the disease in the country , in order to prioritize control activities , as well as to monitor the effectiveness of control operations . A rapid assessment technique using school question naires was tested in Borgu Local Government Area ( LGA ) , Niger State , north-western Nigeria . Following a series of focus group discussion s , the question naires were adapted before they were administered through the school system to 60 primary schools in Borgu LGA . Correctly completed question naires were returned from 58 schools ( 97 % ) within 4 weeks . Question naires were vali date d by reagent stick tests performed by trained teachers . Their results proved to be reliable compared to those obtained by our research team in 20 r and omly selected schools . Overall prevalences of microhaematuria at 1 + and 2 + levels were 45.7 % and 27 . 1 % , respectively . Highly significant correlations were obtained between school prevalence of microhaematuria and reported schistosomiasis , as well as reported blood in urine . The diagnostic performance of the question  naires at the 2 + level of microhaematuria was very good . The design of our study also allowed data analysis on an individual level , and multivariate analysis revealed highly significant odds ratios for reported schistosomiasis and reported blood in urine to detect an individual with urinary schistosomiasis . Our results are in good agreement with reports from other African countries , and question naires can be recommended for rapid identification of communities at highest risk of urinary schistosomiasis in Nigeria , so that scarce re sources of the national control programme can be used most effectively To determine the effect of targeted field administration of oral chemotherapeutic agents on the prevalence , intensity , and morbidity of Schistosoma haematobium infections , we initiated a long-term school-based program in the Msambweni area of Kwale District , Coast Province , Kenya . Prior to treatment , 69 % of the children examined ( ages 4 - 21 , n = 2,628 ) were infected ; 34 % had moderate or heavy infections ( greater than 100 eggs/10 ml urine ) . Infected individuals were r and omized to receive , during one year , either metrifonate ( 10 mg/kg x 3 doses ) or praziquantel , ( 40 mg/kg x 1 dose ) . At the end of the first year , prevalence of infection fell to 19 % ; only 2 % of the pupils remained in the moderately and heavily infected groups . Corresponding decreases in the prevalence of hematuria ( 54 % in 1984 vs. 16 % in 1985 ) and proteinuria ( 56 % in 1984 vs. 26 % in 1985 ) were noted . These were associated with significant declines in bladder thickening and irregularities noted during ultrasound examinations , but not with decreases in hydronephrosis . There was no significant difference in the post-treatment prevalence or intensity of infection after treatment with metrifonate as compared with praziquantel . These results demonstrate that field-applied chemotherapy with either agent offers a practical strategy for the control of S. haematobium infection and its associated morbidity We evaluated the ability of circulating anodic antigen ( CAA ) to identify infection with Schistosoma mansoni in a prospect i ve cohort study of 257 Egyptian men , 147 with infection diagnosed by repeated Kato thick smears , and 110 without detectable infection . The  CAA  levels were obtained and the stool examinations were performed two weeks and one , two , four , and six months after praziquantel therapy for infected men . A CAA enzyme-linked immunosorbent assay was repeated twice on subjects who were otherwise negative for schistosomiasis . Circulating anodic antigen was detected in 117 cases , with an overall test sensitivity before treatment of 0.8 . Sensitivity was related to the intensity 
    Output:
    
Authors ' conclusions Among the evaluated tests for S. haematobium infection , microhaematuria correctly detected the largest proportions of infections and non‐infections identified by microscopy .
The CCA POC test for S. mansoni detects a very large proportion of infections identified by microscopy , but it misclassifies a large proportion of microscopy negatives as positives in endemic areas with a moderate to high prevalence of infection , possibly because the test is potentially more sensitive than microscopy .