Summary of findings 7. Summary of findings table 7.
| IRS versus ITNs for preventing leishmaniasis | ||||||
|
Patient or population: People at risk of CL or VL Settings: CL or VL endemic areas Intervention: IRS Comparison: ITNs | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trials) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| ITNs | IRS | |||||
| Vector density | ‐ | ‐ | Not pooled | ‐ (2 trials) |
⊕⊕⊝⊝ low1,2,3 | One trial found a reduction in vector numbers post‐intervention and one trial did not. |
|
CL cases > 12 months follow‐up |
15 per 1000 | 30 per 1000 |
RR 1.90 (0.98 to 3.69) |
1655 (1 trial) |
⊕⊕⊝⊝ low1,4,5,6 | ‐ |
|
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. | ||||||
| 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. | ||||||
1Downgraded by 1 for serious risk of bias: Trials are at high or unclear risk of selection bias and reporting bias. 2Downgraded by 1 for serious inconsistency: Chowdhury 2011 BGD reports a statistically significant difference in total vector numbers over 12 months follow‐up, Joshi 2009 ASIA found no difference in mean number of vectors per household. 3No serious indirectness: The trials used insecticides shown to be effective in the trial area. Trials were from India, Bangladesh and Nepal.
4Downgraded by 1 for serious indirectness: There is a single trial from a particular geographical area. 5No serious indirectness: This trial was conducted in urban areas of Afghanistan using lambdacyhalothrin at a target rate of 30 mg/m². Further studies from different settings would increase confidence in this result. 6Downgraded by 1 for serious imprecision: The 95% CI is wide and includes clinically important effects and no real difference.