***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Visceral leishmaniasis ( VL ) is a deadly vector-borne disease that causes an estimated 500 000 new cases a year . In India , Nepal and Bangladesh , VL is caused by Leishmania donovani , which is transmitted from man to man by the s and fly Phlebotomus argentipes . In 2005 , these three countries signed a memor and um of underst and ing to eliminate VL from the region . Integrated vector management is one of the pillars of this elimination strategy , alongside early case detection and treatment . We review ed the evidence of effectiveness of different vector control methods , to examine the potential role of insecticide treated bednets ( ITNs ) . Indoor residual spraying has shown poor impact for various reasons and resistance to DDT is emerging in Bihar . Environmental management performed poorly compared to insecticide based methods . ITNs could give individual protection but this still needs to be proven in r and omized trials . Given the constraints of indoor residual spraying , it is worthwhile to further explore the use of ITNs , in particular long lasting ITNs , as an additional tool in the VL elimination initiative INTRODUCTION American cutaneous leishmaniasis is endemic in Colombia , where approximately 6.000 new cases are reported every year . Current prevention and control measures are restricted to the diagnosis and treatment of cases . OBJECTIVE To evaluate the efficacy of a multifaceted intervention to prevent the transmission of Leishmania in the endemic focus of Tumaco , on the Pacific Coast of Colombia . MATERIAL S AND METHODS A group-r and omized trial was conducted . Twenty villages were matched according to prevalence of Leishmania infection , number of inhabitants and level of community participation , and then r and omly assigned to intervention or control . The intervention included deltamethrin-impregnated bednets , repellent ( 20 % diethyltoluamide and 0.5 % permethrin ) , modification of s and fly resting sites , and health education . Villages were under surveillance for one year and the use of the intervention measures monitored . The incidence of American cutaneous leishmaniasis and Leishmania infection in the two groups were compared , adherence to the intervention and adverse events were monitored , and the results were adjusted for village intraclass correlation . RESULTS Ten cases of American cutaneous leishmaniasis were confirmed in the intervention and 23 in the control group , OR = 0.42 , 95 % CI 0.14 - 1.26 . The intervention had a greater effect in children < 10 years old , in people living on the periphery of the village and in villages with a prevalence of infection in small children > 1 % . Adverse events associated with the use of the bednets and the repellent were reported in 2 % of the participants and were always mild . CONCLUSION Incident cases of American cutaneous leishmaniasis were reduced by 58 % in the intervention group . However , the small number of cases renders the effect estimate imprecise and precludes us to cl aim a protective effect for the intervention . Specific population s could be the targets of simpler and more cost-effective interventions in the future A large-scale intervention field trial of the effect of Olyset long-lasting insecticide-treated bednets on transmission of cutaneous leishmaniasis was carried out in 2 cities in the Islamic Republic of Iran from October 2003 to July 2005 . We enrolled 8620 individuals in 3000 households in 6 pairs of sectors in each city . Epidemiological and entomological surveys were carried out pre- and post-intervention . In both cities a statistically significant reduction was found in the incidence of new cases in intervention sectors who received bednets compared with control areas . Entomological surveys showed a reduction in numbers of female Phlebotomus sergenti captured indoors in intervention sectors Objective To test the effectiveness of large scale distribution of longlasting nets treated with insecticide in reducing the incidence of visceral leishmaniasis in India and Nepal . Design Paired cluster r and omised controlled trial design ed to detect a 50 % reduction in incidence of Leishmania donovani infection . Setting Villages in Muzaffarpur district in India and Saptari , Sunsari , and Morang districts in Nepal . Participants 13 intervention and 13 control clusters . 12 691 people were included in the analysis of the main outcome ( infection ) , and 19 810 were enrolled for the secondary ( disease ) end point . Intervention Longlasting insecticidal nets ( treated with deltamethrin ) were distributed in the intervention clusters in December 2006 . Main outcome measures Infection was determined by direct agglutination test at 12 and 24 months after the intervention in those who had negative results ( titre < 1:1600 ) at baseline . The effect estimate was computed as the geometric mean of the risk ratios for seroconversion for each cluster pair ( net/no net ) , with its 95 % confidence interval . Formal tests of effect of no intervention were obtained with a paired t test . Results There was no significant difference in the risk of seroconversion over 24 months in intervention ( 5.4 % ; 347/6372 ) compared with control ( 5.5 % ; 345/6319 people ) clusters ( risk ratio 0.90 , 95 % confidence interval 0.49 to 1.65 ) nor in the risk of clinical visceral leishmaniasis ( 0.99 , 0.46 to 1.40 ) . Adjustment for covariates did not alter these conclusions . Conclusions There is no evidence that large scale distribution of longlasting insecticidal nets provides additional protection against visceral leishmaniasis compared with existing control practice in the Indian subcontinent . The observed effect was small and not significant , though the confidence intervals did not exclude a 50 % change in either direction . Trial registration Clinical Trials NCT 2005 - 015374 Abstract Objective : To measure the impact on transmission of leishmaniasis of curtains impregnated with insecticide . Design : Cluster r and omised controlled trial : household interview survey , observational study of people 's behaviour , entomological study with light trap captures of s and flies inside houses . Setting : 14 urban sectors in Trujillo , Venezuela . Participants : 2913 inhabitants of 569houses . Intervention : Sectors were paired according to their 12month cumulative incidence of cutaneous leishmaniasis , one sector in each pair was r and omly allocated to receive polyester curtains impregnated with lambdacyhalothrin ( intervention group ) while the other sector received curtains without insecticide or no curtains ( control groups ) . After 12 months a follow up household survey was conducted . Main outcome measures : Reduction in abundance of s and flies indoors and 12 month incidence of clinical cases of cutaneous leishmaniasis . Results : Transmission of cutaneous leishmaniasis occurred mainly in the domestic setting , with the incidence over 12 months of 4 % . The mean number of s and flies per trap per night was 16.After follow up the 12 month incidence of cutaneous leishmaniasis was 0 % in the intervention group and 8 % in the six pairs in the control group that received unimpregnated curtains ( mean difference 8 , 95 % confidence interval 4.22 to 11.78 ; P=0.001 ) . There were significantly fewer s and flies in the intervention group ( 2 v 15,mean difference 13 s and flies per trap ; 9 to 17 ; P<0.001 ) . Conclusion : Curtains impregnated with insecticide provide a high degree of protection against indoor transmission of cutaneous leishmaniasis Background Bangladesh , India and Nepal are working towards the elimination of visceral leishmaniasis ( VL ) by 2015 . In 2005 the World Health Organization/Training in Tropical Diseases launched an implementation research programme to support integrated vector management for the elimination of VL from Bangladesh , India and Nepal . The programme is conducted in different phases , from proof-of-concept to scaling up intervention . This study was design ed in order to evaluate the efficacy of the three different interventions for VL vector management : indoor residual spraying ( IRS ) ; long-lasting insecticide treated nets ( LLIN ) ; and environmental modification ( EVM ) through plastering of walls with lime or mud . Methods Using a cluster r and omized controlled trial we compared three vector control interventions with a control arm in 96 clusters ( hamlets or neighbourhoods ) in each of the 4 study sites : Bangladesh ( one ) , India ( one ) and Nepal ( two ) . In each site four villages with high reported VL incidences were included . In each village six clusters and in each cluster five households were r and omly selected for s and fly collection on two consecutive nights . Control and intervention clusters were matched with average pre-intervention vector densities . In each site six clusters were r and omly assigned to each of the following interventions : indoor residual spraying ( IRS ) ; long-lasting insecticide treated nets ( LLIN ) ; environmental management ( EVM ) or control . All the houses ( 50 - 100 ) in each intervention cluster underwent the intervention measures . A reduction of intra-domestic s and fly densities measured in the study households by overnight US Centres for Disease Prevention and Control light trap captures ( that is the number of s and flies per trap per night ) was the main outcome measure . Results IRS , and to a lesser extent EVM and LLINs , significantly reduced s and fly densities for at least 5 months in the study households irrespective of type of walls or whether or not people shared their house with cattle . IRS was effective in all sites but LLINs were only effective in Bangladesh and India . Mud plastering did not reduce s and fly density ( Bangladesh study ) ; lime plastering in India and one Nepali site , result ed in a significant reduction of s and fly density but not in the second Nepali site . ConclusionS and fly control can contribute to the regional VL elimination programme ; IRS should be strengthened in India and Nepal but in Bangladesh , where vector control has largely been ab and oned during the last decades , the insecticide treatment of existing bed nets ( coverage above 90 % in VL endemic districts ) could bring about an immediate reduction of vector population s ; operational research to inform policy makers about the efficacious options for VL vector control and programme performance should be strengthened in the three countries The efficacy of insecticide-treated window curtains ( ITCs ) for dengue vector control was evaluated in Thail and in a cluster-r and omized controlled trial . A total of 2,037 houses in 26 clusters was r and omized to receive the intervention or act as control ( no treatment ) . Entomological surveys measured Aedes infestations ( Breteau index , house index , container index , and pupae per person index ) and oviposition indices ( mean numbers of eggs laid in oviposition traps ) immediately before and after intervention , and at 3-month intervals over 12 months . There were no consistent statistically significant differences in entomological indices between intervention and control clusters , although oviposition indices were lower ( P < 0.01 ) in ITC clusters during the wet season . It is possible that the open housing structures in the study reduced the likelihood of mosquitoes making contact with ITCs . ITCs deployed in a region where this house design is common may be unsuitable for dengue vector control Abstract Objectives To measure the impact on the  dengue vector population  ( Aedes aegypti ) and disease transmission of window curtains and water container covers treated with insecticide . Design Cluster r and omised controlled trial based on entomological surveys and , for Trujillo only , serological survey . In addition , each site had a non-r and omised external control . Setting 18 urban sectors in Veracruz ( Mexico ) and 18 in Trujillo ( Venezuela ) . Participants 4743 inhabitants ( 1095 houses ) in Veracruz and 5306 inhabitants ( 1122 houses ) in Trujillo . Intervention Sectors were paired according to entomological indices , and one sector in each pair was r and omly allocated to receive treatment . In Veracruz , the intervention comprised curtains treated with lambdacyhalothrin and water treatment with pyriproxyfen chips ( an insect growth regulator ) . In Trujillo , the intervention comprised curtains treated with longlasting deltamethrin ( PermaNet ) plus water jar covers of the same material . Follow-up surveys were conducted at intervals , with the final survey after 12 months in Veracruz and nine months in Trujillo . Main outcome measures Reduction in entomological indices , specifically the Breteau and house indices . Results In both study sites , indices at the end of the trial were significantly lower than those at baseline , though with no significant differences between control and intervention arms . The mean Breteau index dropped from 60 % ( intervention clusters ) and 113 % ( control ) to 7 % ( intervention ) and 12 % ( control ) in Veracruz and from 38 % to 11 % ( intervention ) and from 34 % to 17 % ( control ) in Trujillo . The pupae per person and container indices showed similar patterns . In contrast , in nearby communities not in the trial the entomological indices followed the rainfall pattern . The intervention reduced mosquito population s in neighbouring control clusters ( spill-over effect ) ; and houses closer to treated houses were less likely to have infestations than those further away . This created a community effect whereby mosquito numbers were reduced throughout the study site . The observed effects were probably associated with the use of material s treated with insecticide at both sites because in Veracruz , people did not accept and use the pyriproxyfen chips . Conclusion Window curtains and domestic water container covers treated with insecticide can reduce densities of dengue vectors to low levels and potentially affect dengue transmission Background Visceral leishmaniasis ( VL ) control in the Indian subcontinent is currently based on case detection and treatment , and on vector control using indoor residual spraying ( IRS ) . The use of long-lasting insecticidal 
    Output:
    
There are likely to be considerable collateral benefits of ITN roll out on cutaneous leishmaniasis where this disease is co-endemic with malaria .
Nonetheless , it is clear that insecticide-treated material s such as ITNs have the potential to reduce pathogen transmission and morbidity from VBDs where vectors enter houses