title: Benefit of insecticide-treated nets, curtains and screening on vector borne diseases, excluding malaria: a systematic review and meta-analysis.
abstract: BACKGROUND
  Insecticide-treated nets (ITNs) are one of the main interventions used for malaria control. However, these nets may also be effective against other vector borne diseases (VBDs). We conducted a systematic review and meta-analysis to estimate the efficacy of ITNs, insecticide-treated curtains (ITCs) and insecticide-treated house screening (ITS) against Chagas disease, cutaneous and visceral leishmaniasis, dengue, human African trypanosomiasis, Japanese encephalitis, lymphatic filariasis and onchocerciasis.
  
  
  METHODS
  MEDLINE, EMBASE, LILACS and Tropical Disease Bulletin databases were searched using intervention, vector- and disease-specific search terms. Cluster or individually randomised controlled trials, non-randomised trials with pre- and post-intervention data and rotational design studies were included. Analysis assessed the efficacy of ITNs, ITCs or ITS versus no intervention. Meta-analysis of clinical data was performed and percentage reduction in vector density calculated.
  
  
  RESULTS
  Twenty-one studies were identified which met the inclusion criteria. Meta-analysis of clinical data could only be performed for four cutaneous leishmaniasis studies which together showed a protective efficacy of ITNs of 77% (95%CI: 39%-91%). Studies of ITC and ITS against cutaneous leishmaniasis also reported significant reductions in disease incidence. Single studies reported a high protective efficacy of ITS against dengue and ITNs against Japanese encephalitis. No studies of Chagas disease, human African trypanosomiasis or onchocerciasis were identified.
  
  
  CONCLUSIONS
  There are likely to be considerable collateral benefits of ITN roll out on cutaneous leishmaniasis where this disease is co-endemic with malaria. Due to the low number of studies identified, issues with reporting of entomological outcomes, and few studies reporting clinical outcomes, it is difficult to make strong conclusions on the effect of ITNs, ITCs or ITS on other VBDs and therefore further studies be conducted. Nonetheless, it is clear that insecticide-treated materials such as ITNs have the potential to reduce pathogen transmission and morbidity from VBDs where vectors enter houses.
authors.affiliation: School of Biological and Biomedical Sciences, Durham University, Stockton Road, Durham, United Kingdom.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Wilson
authors.affiliation: National Institute of Malaria Research (ICMR), New Delhi, India.
authors.forename: Ramesh C
authors.initials: RC
authors.lastname: Dhiman
authors.affiliation: Department of Environmental Sciences, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Uriel
authors.initials: U
authors.lastname: Kitron
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America; Department of Entomology and Nematology, University of California, Davis, California, United States of America.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.affiliation: Laboratory of Entomology, Wageningen University, Wageningen, Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: van den Berg
authors.affiliation: School of Biological and Biomedical Sciences, Durham University, Stockton Road, Durham, United Kingdom.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Lindsay
mesh_terms: D000818:Animals; D001179:Arthropod Vectors; D003715:Dengue / Q000517:prevention & control; D004605:Elephantiasis, Filarial / Q000517:prevention & control; D004672:Encephalitis, Japanese / Q000517:prevention & control; D006801:Humans; D007159:Immunologic Tests; D057148:Insecticide-Treated Bednets; D007306:Insecticides / Q000494:pharmacology*; D007896:Leishmaniasis / Q000517:prevention & control; D008288:Malaria / Q000453:epidemiology; D009032:Mosquito Control / Q000379:methods*
chemical_list: D007306:Insecticides