Summary of findings 3. ‘Summary of findings' table 3.
| Pyrethroid‐piperonyl butoxide (PBO) nets compared to long‐lasting insecticidal nets (LLIN) for malaria control where insecticide resistance is low | ||||||
| Patient or population:Anopheles gambiae complex or Anopheles funestus group Setting: areas of low insecticide resistance Intervention: pyrethroid‐PBO nets Comparison: LLIN | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of mosquitoes (experimental hut trials) | Certainty of the evidence (GRADE) | Comments | |
| Risk with LLIN | Risk with pyrethroid‐PBO nets | |||||
| Mosquito mortality (unwashed nets) | 871 per 1000a | 958 per 1000 (914 to 1000)a | RR 1.10 (1.05 to 1.16) | 708 (1 trial, 2 comparisons) | ⊕⊕⊕⊝
MODERATEb due to imprecision |
There is probably little or no difference in the effect of unwashed pyrethroid‐PBO nets on mosquito mortality compared to standard unwashed LLINs in areas of low insecticide resistance. |
| Mosquito mortality (washed nets) | 620 per 1000a | 719 per 1000 (514 to 1000)a | RR 1.16 (0.83 to 1.63) | 878 (1 trial, 2 comparisons) | ⊕⊝⊝⊝
VERY LOWc,d due to imprecision and inconsistency |
We do not know if pyrethroid‐PBO nets have an effect on mosquito mortality in areas of low insecticide resistance when the nets have been washed. |
| Blood‐feeding success (unwashed nets) | 72 per 1000a | 48 per 1000 (4 to 529)a | RR 0.67 (0.06 to 7.37) | 708 (1 trial, 2 comparisons) | ⊕⊝⊝⊝
VERY LOWc,d due to imprecision and inconsistency |
We do not know if unwashed pyrethroid‐PBO nets have an effect on mosquito blood‐feeding success in areas of low insecticide resistance. |
| Blood‐feeding success (washed nets) | 149 per 1000a | 223 per 1000 (132 to 377)a | RR 1.50 (0.89 to 2.54) | 878 (1 trial, 2 comparisons) | ⊕⊕⊝⊝
LOWd due to inconsistency |
Mosquito blood‐feeding success may decrease with washed pyrethroid‐PBO nets compared to standard washed LLINs in areas of low insecticide resistance. |
| *The risk in the intervention group (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). Abbreviations: CI: confidence interval; LLIN: long‐lasting insecticidal nets; PBO: pyrethroid‐piperonyl butoxide; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aOriginal numbers used in this table, however in pooled analysis events and total numbers were generated from cluster adjusted results which uses the effective sample size. Note that cluster adjustments do not change the point estimate of the effect size, just the standard error. bDowngraded by one for imprecision due to wide CIs. cDowngraded by one for inconsistency due to unexplained heterogeneity. dDowngraded by two for imprecision due to extremely wide CIs.