***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: Background Malaria control in Africa is most tractable in urban settlements yet most research has focused on rural setting s. Elimination of malaria transmission from urban areas may require larval control strategies that complement adult mosquito control using insecticide-treated nets or houses , particularly where vectors feed outdoors . Methods and Findings Microbial larvicide ( Bacillus thuringiensis var . israelensis ( Bti ) ) was applied weekly through programmatic , non-r and omized community-based , but vertically managed , delivery systems in urban Dar es Salaam , Tanzania . Continuous , r and omized cluster sampling of malaria infection prevalence and non-r and om programmatic surveillance of entomological inoculation rate ( EIR ) respectively constituted the primary and secondary outcomes surveyed within a population of approximately 612,000 residents in 15 fully urban wards covering 55 km2 .  Bti application for one year in 3 of those wards ( 17 km2 with 128,000 residents ) reduced crude annual transmission estimates ( Relative EIR [ 95 % Confidence Interval ] = 0.683 [ 0.491–0.952 ] , P = 0.024 ) but program effectiveness peaked between July and September ( Relative EIR [ CI ] = 0.354 [ 0.193 to 0.650 ] , P = 0.001 ) when 45 % ( 9/20 ) of directly observed transmission events occurred . Larviciding reduced malaria infection risk among children ≤5 years of age ( OR [ CI ] = 0.284 [ 0.101 to 0.801 ] , P = 0.017 ) and provided protection at least as good as personal use of an insecticide treated net ( OR [ CI ] = 0.764 [ 0.614–0.951 ] , P = 0.016 ) . Conclusions In this context , larviciding reduced malaria prevalence and complemented existing protection provided by insecticide-treated nets . Larviciding may represent a useful option for integrated vector management in Africa , particularly in its rapidly growing urban centres The study was conducted in eight adjacent villages in central Sri Lanka where there are many shallow pits dug by gem miners that fill with water . These become breeding places of the main malarial vector Anopheles culicifacies , and of the second most important vector Anopheles subpictus , but not of Anopheles varuna , the third most important vector . With the help of local volunteers , data on the adult population s of these three species was collected by various st and ard methods , and data on the incidence of malaria cases was collected by two clinics set up for the project and through the existing hospitals . Prevalence of malaria infection in symptom-less people was investigated by mass blood surveys . On the basis of a year 's pre-intervention data the villages were stratified into four with high levels of malaria transmission and four with lower transmission . Within each stratum two villages were r and omly assigned for mosquito control by treating all the gem pits , as well as river bed pools , with a granular formulation of the insect growth regulator pyriproxyfen at a target dose of 0.01 mg a.i./litre . The intervention caused significant reductions in the adult population s of An . culicifacies and An . subpictus . Similarly , incidence of malaria was reduced in the intervention villages to about 24 % ( 95 % c.l . 20 - 29 % ) of that in the controls . Prevalence of parasitaemia also declined significantly . It is concluded that in this situation where , with active community participation , the breeding sites of the main vectors could be located ; vector control by a highly active and persistent insect growth regulator can be a very effective means of malaria control The relationship between malaria transmission intensity and efficiency is important for malaria epidemiology , for the design of r and omized control trials that measure transmission or incidence as end points , and for measuring and modelling malaria transmission and control . Five kinds of studies published over the past century were assembled and reanalysed to quantify malaria transmission efficiency and describe its relation to transmission intensity , to underst and the causes of inefficient transmission and to identify functions suitable for modelling mosquito-borne disease transmission . In this study , we show that these studies trace a strongly nonlinear relationship between malaria transmission intensity and efficiency that is parsimoniously described by a model of heterogeneous biting . When many infectious bites are concentrated on a few people , infections and parasite population structure will be highly aggregated affecting the immunoepidemiology of malaria , the evolutionary ecology of parasite life history traits and the measurement and stratification of transmission for control using entomological and epidemiological data An evaluation of pyriproxyfen as a larval control agent with the aim of reducing malaria vector population s and incidence of malaria was conducted in 12 villages in an irrigated settlement scheme in the dry zone of central Sri Lanka . In these villages , there are many pools in the beds of rivers , streams , and irrigation ditches during the dry season of the year . These are the major breeding places of the malaria vectors Anopheles culicifacies and An . subpictus . Collection s of adult mosquitoes were carried out by using st and ard methods and parasitological data were collected by daily malaria clinics set up for the project and through the 2 government hospitals . All villages in the study area were under residual house spraying with lambdacyhalothrin water-dispersible powder . Using the 1st year 's baseline data collection , the villages were stratified into 6 villages with high malaria incidence and 6 villages with low incidence . Within each group , 3 villages were r and omly assigned for larval control by treating all the pools in the beds of rivers , streams , and irrigation ditches and agricultural wells with a granular formulation of the insect growth regulator pyriproxyfen at the rate of 0.01 mg active ingredient/liter . The field bioassays indicated that a single treatment of pyriproxyfen effectively inhibited the emergence of adult mosquitoes in the riverbed pools for a period of 190 days . The treatment caused significant reduction of the adult population s of An . culicifacies ( 78 % ) and An . subpictus ( 72 % ) . Similarly , incidence of malaria was reduced in the treatment villages by about 70 % ( 95 % confidence interval 58 - 78 % ) compared with the controls . The conclusion is made that pyriproxyfen can be a very effective means of malaria control if all possible vector breeding places in the area can be located 
    Output:
    
In Africa and Asia , LSM is another policy option , alongside LLINs and IRS , for reducing malaria morbidity in both urban and rural areas where a sufficient proportion of larval habitats can be targeted .