***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: Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design Background Tanzania has a well-developed network of commercial ITN retailers . In 2004 , the government introduced a voucher subsidy for pregnant women and , in mid 2005 , helped distribute free nets to under-fives in small number of districts , including Rufiji on the southern coast , during a child health campaign . Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed . Methods Cross-sectional household survey in 6,331 members of r and omly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district , Southern Tanzania was conducted in 2006 . A question naire was administered to every consenting respondent about net use , treatment status and delivery mechanism . Findings Net use was 62.7 % overall , 87.2 % amongst infants ( 0 to1 year ) , 81.8 % amongst young children ( > 1 to 5 years ) , 54.5 % amongst older children ( 6 to 15 years ) and 59.6 % amongst adults ( > 15 years ) . 30.2 % of all nets had been treated six months prior to interview . The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy ( 41.8 % ) . Half of nets used by young children ( 50.0 % ) and over a third of those used by older children ( 37.2 % ) were obtained free of charge through the vaccination campaign . The largest source of nets amongst the population overall was commercial purchase ( 45.1 % use ) and was the primary means for protecting adults ( 60.2 % use ) . All delivery mechanisms , especially sale of nets at full market price , under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets . Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population . Each of them reached their relevant target group and free nets only temporarily suppressed the net market , illustrating that in this setting that these are complementary rather than mutually exclusive approaches Insecticide-treated nets ( ITNs ) are effective in substantially reducing malaria transmission . Still , ITN coverage in sub-Saharan Africa ( SSA ) remains extremely low . Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage . Little is known , however , on the comparative costs of alternative ITN distribution strategies . This paper aim ed to fill this gap in knowledge by developing such a comparative cost analysis , looking at the cost per ITN distributed for two alternative interventions : subsidized sales supported by social marketing and free distribution to pregnant women through antenatal care ( ANC ) . The study was conducted in rural Burkina Faso , where the two interventions were carried out alongside one another in 2006/07 . Cost information was collected prospect ively to derive both a financial analysis adopting a provider 's perspective and an economic analysis adopting a societal perspective . The average financial cost per ITN distributed was US$ 8.08 and US$ 7.21 for sales supported by social marketing and free distribution through ANC , respectively . The average economic cost per ITN distributed was US$ 4.81 for both interventions . Contrary to common belief , costs did not differ substantially between the two interventions . Due to the district 's ability to rely fully on the use of existing re sources , financial costs associated with free ITN distribution through ANC were in fact even lower than those associated with the social marketing campaign . This represents an encouraging finding for SSA governments and points to the possibility to invest in programmes to favour free ITN distribution through existing health facilities . Given restricted budgets , however , free distribution programmes are unlikely to be feasible OBJECTIVE To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania , compared with no net use . METHODS Project cost data were collected prospect ively from accounting records . Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey . FINDINGS The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted . These figures fell to 1018 US dollars and 37 US dollars , respectively , when the costs and consequences of untreated nets were taken into account . CONCLUSION The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria Background Insecticide-impregnated bed nets ( ITNs ) have been shown to be a highly effective tool against malaria in the endemic regions of sub-Saharan Africa ( SSA ) . There are however different opinions about the role of ITN social marketing and ITN free distribution in the roll-out of ITN programmes . The objective of this study was to evaluate the effects of free ITN distribution through antenatal care services in addition to an ITN social marketing programme in an area typical for rural SSA . Methods A cluster-r and omised controlled ITN trial took place in the whole Kossi Province in north-western Burkina Faso , an area highly endemic for malaria . Twelve clusters were assigned to long-term ITN ( Serena br and ) social marketing plus free ITN ( Serena br and ) distribution to all pregnant women attending governmental antenatal care services ( group A ) , and 13 clusters to ITN social marketing only  ( group B ) . The intervention took place during the rainy season of 2006 and thereafter . The trial was evaluated through a representative household survey at baseline and after one year . Serena ITN household ownership was the primary outcome measure . Findings A total of 1052 households were visited at baseline in February 2006 and 1050 at follow-up in February 2007 . Overall Serena ITN household ownership increased from 16 % to 28 % over the study period , with a significantly higher increase in group A ( 13 % to 35 % ) than in group B ( 18 % to 23 % ) ( p<0.001 ) . Interpretation The free distribution of ITNs to pregnant women through governmental antenatal care services in addition to ITN social marketing substantially improved ITN household ownership in rural Burkina Faso . Trial registration Controlled-Trials.com IS RCT This study compared the costs and effects of insecticide (permethrin)-treated bed net ( ITN ) use in children less than five years of age in an area of intense , perennial malaria transmission in western Kenya . The data were derived from a group-r and omized controlled trial of ITNs conducted between 1996 and 1999 . The annual net cost per life-year gained was 34 U.S. dollars and the net annual cost per all-cause sick child clinic visit averted was 49 U.S. dollars . After taking into account a community effect ( protection from malaria afforded to non-ITN users who lived within 300 meters from users ) these estimates decreased to 25 U.S. dollars and 38 U.S. dollars , respectively . This study provides further evidence that ITNs are a highly cost-effective use of scarce health care re sources OBJECTIVES In December 2005 and March 2006 , Niger conducted nationwide integrated campaigns to distribute polio vaccine and long lasting insecticide-treated nets ( LLINs ) to children < 5 years of age . We evaluated the campaign effectiveness , net retention , insecticide-treated net ( ITN ) ownership , and usage . METHODS Two nationwide cross-sectional surveys in January 2006 ( dry season ) and September 2006 ( rainy season ) , using a stratified two-stage cluster sampling design . We mapped selected communities , selected households by simple r and om sampling , and administered question naires by interviewers using personal digital assistants . RESULTS The first survey showed that ITN ownership in all households was 6.3 % prior to the campaign , increasing to 65.1 % after the campaign in the second survey . The second survey also showed that 73.4 % of households with children < 5 received an LLIN and that 97.7 % of households that received > or = one LLIN retained it . The wealth equity ratio for ITN ownership in households with children < 5 increased from 0.17 prior to the campaign to 0.79 afterward . During the dry season , 15.4 % of all children < 5 and 11.3 % of pregnant women  slept under an ITN , while during rainy season , 55.5 % of children < 5 and 48.2 % of pregnant women slept under an ITN . CONCLUSIONS Free distribution during the integrated campaign rapidly increased ITN ownership and decreased inequities between those in the highest and lowest wealth quintiles . Retention of ITNs was very high , and usage was high during malaria transmission season . However , ITN ownership and usage by vulnerable groups continues to fall short of RBM targets , and additional strategies are needed to increase ownership and usage 
    Output:
    
Strategies achieving high ownership among households and use among children < 5 delivered ITNs free through campaigns .
Costs were largely comparable across strategies ; ITNs were the main cost .
Cost-effectiveness estimates were most sensitive to the assumed net lifespan and leakage .
Common barriers to delivery included cost , stock-outs and poor logistics .
Common facilitators were staff training and supervision , cooperation across departments or ministries and stakeholder involvement .
There is a broad taxonomy of strategies for delivering ITNs at scale