. 2018 Nov 29;2018(11):CD012776. doi: 10.1002/14651858.CD012776.pub2

Summary of findings 4. ‘Summary of findings' table 4.

Pyrethroid‐piperonyl butoxide (PBO) nets compared to long‐lasting insecticidal nets (LLIN) for malaria control where mosquitoes are susceptible
Patient or population:Anopheles gambiae complex or Anopheles funestus group  Setting: areas of insecticide‐susceptible mosquitoes 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
Outcomes	Risk with LLIN	Risk with pyrethroid‐PBO nets	Relative effect  (95% CI)	Number of mosquitoes  (experimental hut trials)	Certainty of the evidence  (GRADE)	Comments
Mosquito mortality (unwashed nets)	392 per 1000^a	471 per 1000  (251 to 887)^a	RR 1.20  (0.64 to 2.26)	2791  (2 trials, 2 comparisons)	⊕⊕⊝⊝  LOW^b due to imprecision	There may be little or no difference in the effect of unwashed pyrethroid‐PBO nets on mosquito mortality compared to standard unwashed LLINs in areas of no insecticide resistance.
Mosquito mortality (washed nets)	457 per 1000^a	489 per 1000  (420 to 571)^a	RR 1.07  (0.92 to 1.25)	2644  (2 trials, 2 comparisons)	⊕⊕⊝⊝  LOW^b due to imprecision	There may be little or no difference in the effect of washed pyrethroid‐PBO nets on mosquito mortality compared to standard washed LLINs in areas of no insecticide resistance.
Blood‐feeding success (unwashed nets)	57 per 1000^a	29 per 1000  (6 to 132)^a	RR 0.50  (0.11 to 2.32)	2791  (2 trials, 2 comparisons)	⊕⊝⊝⊝  VERY LOW^b,c 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 no insecticide resistance.
Blood‐feeding success (washed nets)	64 per 1000^a	82 per 1000  (52 to 131)^a	RR 1.28  (0.81 to 2.04)	2644  (2 trials, 2 comparisons)	⊕⊕⊝⊝  LOW^b due to imprecision	There may be little or no difference in the effect of washed pyrethroid‐PBO nets on mosquito blood‐feeding success compared to standard washed LLINs in areas of no 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 use the effective sample size. Note that cluster adjustments do not change the point estimate of the effect size, just the standard error.  ^bDowngraded by two for imprecision due to extremely wide CIs.  ^cDowngraded by one for inconsistency due to unexplained heterogeneity.