Antimalarial artesunate-mefloquine versus praziquantel in African children with schistosomiasis: an open-label, randomized controlled trial.

Name: Αlpha¹ Rigor Record — Antimalarial artesunate-mefloquine versus praziquantel in African children with schistosomiasis: an open-label, randomized controlled trial.
Item: Antimalarial artesunate-mefloquine versus praziquantel in African children with schistosomiasis: an open-label, randomized controlled trial.
Rating: 100
Author: Αlpha¹

Bottieau E, Mbow M, Brosius I, Roucher C, Gueye CT, Mbodj OT, Faye BT, De Hondt A, Smekens B, Arango D, Burm C, Tsoumanis A, Paredis L, Van Herrewege Y, Potters I, Richter J, Rosanas-Urgell A, Cissé B, Mboup S, Polman K

Paper source

Read full text (PMC)

Embed this Rigor badge

Αlpha¹ Rigor Review — 3.5★ (Adequate), 0 critical, 0 high issues for “Antimalarial artesunate-mefloquine versus praziquantel in African children with schistosomiasis: an open-label, randomized controlled trial.”

Links back to this Rigor Record.

Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 16, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

3.5 / 5

Adequate — real issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern−0.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 1 reported mean was read, and its group size is not stated where the value is printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.

Problems surfaced4 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions3

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed
Conclusions only partially backed by the presented evidenceAssessed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

This is a well-conducted and transparently reported randomized noninferiority trial. The paper demonstrates strong methodological rigor across all eight dimensions, with clear ethics approvals, detailed statistical reporting, and exemplary data/code sharing. The only issues are minor copyedit inconsistencies, notably a discrepancy in the reported confidence interval for the primary outcome between the abstract and results.

This is an interventional study (randomized controlled trial). Both reviewers agreed on the study type. The evaluation covered all eight dimensions; sub-criteria not applicable to a clinical trial (e.g., cell line authentication, housing conditions) were marked as not applicable. The statistics verification component recomputed only 2 tests (both consistent); other statistics were not machine-verified and should not be assumed correct beyond what was checked.

7 major claims checked against the paper's own evidence: 2 only partially supported (evidence backs part of the claim; gaps or caveats remain); the rest adequately supported.

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

Recomputed 2 tests: 2 consistent, 0 inconsistent; 2 via agent-written checks.

1 integrity concern flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites prior work on praziquantel's limitations (e.g., activity on juvenile worms, reinfections, potential decreased susceptibility) and on artemisinin derivatives and mefloquine's in vitro and clinical activity, including two exploratory trials with equivocal results. The rationale for the trial follows logically from the need for alternative treatments and the inconclusive prior evidence. The paper acknowledges limitations of prior research (e.g., small exploratory trials, equivocal results) and addresses them by conducting a larger, adequately powered trial.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise: praziquantel is the only treatment, with limitations, and prior evidence on artesunate–mefloquine is inconclusive, justifying the trial.

Evidence

paraphrase[Introduction, paragraphs 1-3]

“However, praziquantel has little activity on juvenile worms, and reinfections remain an unsolved challenge, especially in high-transmission areas such as sub-Saharan Africa.”

direct quote[Introduction, paragraph 4]

“So far, evidence of a potential clinical activity of artesunate–mefloquine against Schistosoma infection remains inconclusive, although the need of a backup treatment for praziquantel is pressing.”