***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 In the present study , Interceptor ® , long-lasting polyester net , 75 denier and bursting strength of minimum 250 kPa coated with alpha-cypermethrin @ 200 mg/m2 was evaluated for its efficacy in reducing the mosquito density , blood feeding inhibition and malaria incidence in a tribal dominated malaria endemic area in Chhattisgarh state , central India . Its durability , washing practice s and usage pattern by the community was also assessed up to a period of three years . Methods The study was carried out in two phases . In the first phase ( September 2006 to August 2007 ) , 16 malaria endemic villages in district Kanker were r and omized into three groups , viz . Interceptor net ( LN ) , untreated polyester net ( 100 denier ) and without net . Malaria cases were detected by undertaking fortnightly surveillance by home visits and treated as per the national drug policy . Mosquito collection s were made by h and catch and pyrethrum space spray methods from human dwellings once every month . Slide positivity rate ( SPR ) and malaria incidence per 1000 population ( PI ) were compared between the three study arms to assess the impact of use of Interceptor nets . Simultaneously , wash resistance studies were carried out in the laboratory by doing cone bioassays on Interceptor LNs washed up to 20 times . Activities undertaken in second Phase ( April 2008 to October 2009 ) after an interval of about 18 months post-net distribution included question naire based surveys at every six months , i.e. 18 , 24 , 30 and 36 months to observe durability , usage pattern of LNs and washing practice s by the community . After 36 months of field use , 30 nets were retrieved and sample d destructively for chemical analysis . Results Interceptor nets were found effective in reducing the density , parity rate and blood feeding success rate of main malaria vector Anopheles culicifacies as compared to that in untreated net and no net villages . SPR in LN villages was 3.7 % as compared to 6.5 % in untreated and 11 % in no net villages . PI in LN villages was 16.4 in comparison to 24.8 and 44.2 in untreated polyester net and no net villages respectively . In surveys carried out after three years of initial distribution , 78.7 % ( 737/936 ) nets were still in possession with the households , of which 68 % were used every night . An . culicifacies mortality was > 80 % in cone bioassays done on LNs washed up to 20 times in laboratory . Mean alpha-cypermethrin content was 43.5 ± 31.7 mg/m2 on Interceptor LNs withdrawn after three years of household use against the baseline specification of 200 mg/m2 . A gradual increase in the proportion of holed nets was observed with the increased period of usage . Conclusion Interceptor nets were highly effective in reducing vector densities as well as malaria incidence in the study villages . Availability of 78 % nets with the households in usable condition clearly indicated durability of Interceptor LNs up to three years in the rural setting of India . The nets were found to contain an effective concentration of alpha-cypermethrin against malaria vector after three years of household use Objective Systematic review s can include cluster-r and omised controlled trials ( C- RCTs ) , which require different analysis compared with st and ard individual-r and omised controlled trials . However , it is not known whether review authors follow the method ological and reporting guidance when including these trials . The aim of this study was to assess the method ological and reporting practice of Cochrane review s that included C- RCTs against criteria developed from existing guidance . Methods Criteria were developed , based on method ological literature and personal experience supervising review production and quality . Criteria were grouped into four themes : identifying , reporting , assessing risk of bias , and analysing C- RCTs . The Cochrane Data base of Systematic Review s was search ed ( 2nd December 2013 ) , and the 50 most recent review s that included C- RCTs were retrieved . Each review was then assessed using the criteria . Results The 50 review s we identified were published by 26 Cochrane Review Groups between June 2013 and November 2013 . For identifying C- RCTs , only 56 % identified that C- RCTs were eligible for inclusion in the review in the eligibility criteria . For reporting C- RCTs , only eight ( 24 % ) of the 33 review s reported the method of cluster adjustment for their included C- RCTs . For assessing risk of bias , only one review assessed all five C- RCT -specific risk-of-bias criteria . For analysing C- RCTs , of the 27 review s that presented unadjusted data , only nine ( 33 % ) provided a warning that confidence intervals may be artificially narrow . Of the 34 review s that reported data from unadjusted C- RCTs , only 13 ( 38 % ) excluded the unadjusted results from the meta-analyses . Conclusions The method ological and reporting practice s in Cochrane review s incorporating C- RCTs could be greatly improved , particularly with regard to analyses . Criteria developed as part of the current study could be used by review authors or editors to identify errors and improve the quality of published systematic review s incorporating C- RCTs Malaria vector mosquitoes belonging to the Anopheles gambiae complex were studied in four hamlets in The Gambia . All inhabitants were given bednets treated either with a placebo ( milk ) in two hamlets or with the pyrethroid insecticide permethrin ( 500 mg/m2 ) in two other hamlets . Malaria transmission occurred mainly during a few weeks of the rainy season , in September and October 1987 . The indoor resting densities of mosquitoes in permethrin-treated hamlets were reduced , and we estimated over 90 % reduction in biting on man by An . gambiae Giles sensu stricto in these hamlets . No mosquitoes were found under permethrin-treated bednets compared with eighty-one recovered from placebo-treated bednets . Mosquitoes exited more readily from rooms where permethrin-treated bednets were used than from rooms with placebo-treated nets . The annual mean probability that a child would receive an infective bite was estimated to be 0.09 in hamlets with insecticide-treated bednets , compared with 1.9 where placebo-treated bednets were used . Permethrin-treated bednets are therefore recommended as a means of effectively reducing the risk of exposure to malaria transmission , particularly in areas of low seasonal transmission A group-r and omized controlled trial of insecticide (permethrin)-treated bed nets ( ITNs ) was conducted in an area of high perennial malaria transmission in western Kenya to test the effect of ITNs on  all-cause mortality in children 1 - 59 months of age . Child deaths were monitored over a two-year period by biannual household census in Asembo ( 1997 - 1998 ) and in Gem ( 1998 - 1999 ) . Overall , 1,722 deaths occurred in children 1 - 59 months followed for 35,932 child-years .  Crude mortality rates/1,000  child-years were 51.9 versus 43.9 in control and ITN villages in children 1 - 59 months old . The protective efficacy ( PE ) ( 95 % confidence interval ) adjusted for age , study year , study site , and season was 16 % ( 6 - 25 % ) . Corresponding figures in 1 - 11- and 12 - 59-month-old children in control and ITN villages were 133.3 versus 102.3 , PE = 23 % ( 11 - 34 % ) and 31.1 versus 28.7 , PE = 7 % ( -6 - 19 % ) . The numbers of lives saved/1,000 child-years were 8 , 31 , and 2 for the groups 1 - 59 , 1 - 11 , and 12 - 59 months old , respectively . Stratified analysis by time to insecticide re-treatment showed that the PE of  ITNs  re-treated per study protocol ( every six months ) was 20 % ( 10 - 29 % ) , overall and 26 % ( 12 - 37 % ) and 14 % ( -1 - 26 % ) in 1 - 11- and 12 - 59-month-old children , respectively . ITNs prevent approximately one in four infant deaths in areas of intense perennial malaria transmission , but their efficacy is compromised if re-treatment is delayed beyond six months A field trial was conducted on the efficacy of Interceptor nets-a long-lasting insecticidal net ( LLN ) factory treated with alphacypermethrin 0.667 % ( w/w ) corresponding to 200mg/m(2 ) , against malaria vectors Anopheles culicifacies and Anopheles fluviatilis in one of the highly endemic areas of Orissa . The study area comprised 19 villages which were r and omized into three clusters and design ated as Interceptor net cluster , untreated net cluster , and no net cluster . Baseline studies showed that both the vector species An . culicifacies and An . fluviatilis were 100 % susceptible to alphacypermethrin . Results of wash-resistance and bio-efficacy of Interceptor nets showed 100 % mortality in An . culicifacies and An . fluviatilis even after 20 washings . Bioassays on the Interceptor nets while in use in the field conditions showed a knockdown effect on 70 - 90 % mosquitoes during different months of intervention after 3 min of exposure and 100 % mortality was recorded after 24h of recovery period . The median knockdown time for these species ranged between 4.10 - 5.25 min and 4.00 - 5.00 min respectively during intervention period . In Interceptor net study area , there was a significant reduction of 88.9 , 96.3 and 90.6 % in the entry rate of An . culicifacies , An . fluviatilis and other anopheline species respectively with an over all reduction of 87.5 % in total mosquitoes . The overall feeding success rate of mosquitoes in the trial villages was only 12.8 % in comparison to 35.0 and 78.8 % in villages with untreated nets and no nets respectively . A significant reduction was also recorded in parity rate and human blood index of vector species in Interceptor net area . The results of the study showed that Interceptor nets are effective against the malaria vectors and may be used as a suitable intervention strategy in high-risk areas Spatial analyses of the effect of insecticide (permethrin)-treated bed nets ( ITNs ) on nearby households both with and without ITNs was performed in the context of a large-scale , group-r and omized , controlled mortality trial in Asembo , western Kenya . Results illustrate a protective effect of ITNs on compounds lacking ITNs located within 300 meters of compounds with ITNs for child mortality , moderate anemia , high-density parasitemia , and hemoglobin levels . This community effect on nearby compounds without nets is approximately as strong as the effect observed within villages with ITNs . This implies that in areas with intense malaria transmission with high ITN coverage , the primary effect of insecticide-treated nets is via area-wide effects on the mosquito population and not , as commonly supposed , by simple imposition of a physical barrier protecting individuals from biting . The strength of the community effect depended upon the proportion of nearby compounds with treated nets . To maximize their public health impact , high coverage with treated nets is essential Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The efficacy of nets treated with lambda-cyhalothrin , a pyrethroid insecticide , on  malaria infection and disease  was assessed for the first time at the community level in Anopheles gambiae pyrethroid resistance areas . The study was carried out in northern Côte d'Ivoire , which is an area of kdr resistance . Four pairs of villages were selected and matched according to demographic , sociological , and ecological criteria . Among each pair , a village was r and omly allocated to receive mosquito nets . More than 80 % of beds were covered with nets treated with lambda-cyhalothrin and retreated after 6 months . In each village , 54 children aged 0 - 59 months were r and omly selected and clinical ly monitored for 8 periods of 7 days throughout the year . Results showed that the efficacy of treated nets was maintained with a reduction of the prevalence of asymptomatic malaria infection by 12 % and an estimated protective efficacy against malaria disease of 56 % New tools to prevent malaria morbidity and mortality are needed to improve child survival in sub-Saharan Africa .  Insecticide treated bednets ( ITBN ) have been shown , in one setting ( The Gambia , West Africa ) , to reduce childhood mortality . To assess the impact of ITBN on child survival under different epidemiological and cultural conditions we conducted a community r and omized , controlled trial of permethrin treated bednets ( 0.5 g/m2 ) among a rural population on the Kenyan Coast . Between 1991 and 1993 continuous community-based demographic surveillance linked to hospital-based in-patient surveillance identified all mortality and severe malaria morbidity events during a 2-year period among a population of over 11000 children under 5 years of age . In July 1 
    Output:
    
Authors ' conclusions Although there is some evidence that insecticide resistance frequency has some effects on mosquito mortality , it is unclear how quantitatively important this is .