Kaneko 2000 VUT.

Methods	Dates of study: 1991‐1999 Location of study: Vanuatu Malaria endemicity (prevalence): Intervention group 1 (January ‐ September 1991): 15.7% in all ages; Comparison group 1 (May 1990): 28.8% in all ages [Moderate]. Transmission season: December to April Malaria species:P. falciparum, P. vivax Vector species: A. farauti Study design: Non‐randomized controlled study Evaluation design: Cross‐sectional surveys
Participants	Age groups included: All ages Sample size Intervention group 1 (mean): 718 Comparison group 1 (mean): 19,289
Interventions	Intervention group 1: MDA administered to all persons in Aneityum weekly for nine weeks with chloroquine 600 mg and sulfadoxine‐pyrimethamine 1500 mg/75 mg and primaquine 45 mg once a week in weeks 1, 5, and 9; chloroquine 300 mg and primaquine 45 mg once a week in weeks 2, 3, 4, 6, 7, and 8 in September 1991 to November 1991. Coverage 79 to 92%. Co‐intervention with larvivorous fish in several identified breeding sites and universal coverage with insecticide treated bed nets (about 0.94 nets per villager). Comparison group 1: Persons living in Malakula Island. Co‐intervention with bed nets (approximately 20% coverage).
Outcomes	Parasitaemia prevalence No adverse event surveillance conducted Adverse events reported: Some villagers reported vomiting after taking the tablets.
Notes	Another village on Futana island was included in the study for comparison; however, because no parasitaemia was detected in the two surveys on Futuna, it was excluded from the meta‐analysis. The meta‐analysis only included data from Aneityum for the months of January and September 1991 (before MDA) and March 1998 (post‐MDA).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Non‐randomized controlled study
Allocation concealment (selection bias)	High risk	Non‐randomized controlled study
Baseline imbalance (selection bias)	Low risk	According to investigators, "the parasite rates were initially similar on Aneityum and Malakula islands and in general, decreased with age".
Contamination protection	Low risk	The comparison group was a village from Malakula, an adjacent island; therefore, it is unlikely that the comparison group received the intervention.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not blinded, but unclear if this impacted outcomes
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not blinded, but unclear if this impacted outcomes
Incomplete outcome data (attrition bias) All outcomes	Low risk	Only 7.9% of doses unable to be administered and only 3.8% doses were not properly reported and could not be confirmed. The overall calculated compliance rate of the remaining doses was 88.3%.
Selective reporting (reporting bias)	High risk	Of the 13 surveys, two covered only school children whereas the other 11 surveys covered the entire population of Aneityum.
Other bias	Low risk	No other bias detected