Summary of findings 4. Summary of findings table 4.
| ITS versus no intervention for preventing leishmaniasis | ||||||
|
Patient or population: People at risk of CL or VL Settings: CL or VL endemic areas Intervention: ITS Comparison: No intervention | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trials) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| No intervention | ITS | |||||
| Vector density | ‐ | ‐ | ‐ | (1 trial) | ⊕⊝⊝⊝ very low1,2,3,4 | No data post‐intervention. |
|
CL cases > 12 months follow‐up |
52 per 1000 | 18 per 1000 (10 to 30) | RR 0.34 (0.20 to 0.57) | 2784 (1 trial) |
⊕⊕⊝⊝ low2,5,6 | ‐ |
|
VL cases > 2 years follow‐up |
‐ | ‐ | ‐ | (0 trials) | ‐ | ‐ |
| *The basis for the assumed risk is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio; CL: cutaneous leishmaniasis; VL: visceral leishmaniasis; ITS: insecticide treated bedsheet. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1One trial evaluated the effects of hanging ITS near to a chicken shed. 2Downgraded by 1 for serious risk of bias: Trials are at high or unclear risk of selection bias and reporting bias. 3Downgraded by 2 for very serious indirectness: This is a single trial and does not directly assess the effects of ITS. 4The trial authors state that "the abundance in sheds was approximately 50% below that expected on the first day falling to about 80% at week 12 ‐ the only time the difference was statistically significant". 5The assumed risk of CL over 12 months follow‐up is taken from the control group of Reyburn 2000 AFG. This trial was conducted in Afghanistan from 1997 to 1998. 6Downgraded by 1 for serious indirectness: This trial was conducted in urban areas of Afghanistan using ITS treated with permethrin (1 g/m²). Further trials from different settings would increase confidence in this result.