Costa 2007 BRA.

Methods	Trial design: Cluster‐RCT. Unit of randomization: Geographic area. Number of clusters: 34 geographic areas. Entomological data collection: Not done. Clinical data collection: Immunological tests by ELISA in blood samples to detect antigen from Leishmania chagasi, at one year. Length of follow‐up: 6 to 12 months. Analysis: Analysed at cluster level.
Participants	The central area of Teresina (Brazil) was divided in 34 geographic areas (blocks) randomly allocated to the 4 types of interventions (367 inhabitants; 213 seronegatives/154 seropositives at the beginning). Endemic disease: VL caused by L. infantum (L. chagasi).
Interventions	Spraying houses and animals pens with insecticide. Spraying houses and eliminating infected dogs. Combination of spraying houses and animal pens and eliminating infected dogs. Spraying houses (considered as no treatment in the publication). Description of spraying: Pyrethroid insecticide in internal walls (all of 3 m height walls were sprayed) of houses (household spraying) and outdoors close to the houses. The elimination of infected dogs was decided if indirect immunofluorescence test was more or equalled 1:40.
Outcomes	Cases of seropositivity by ELISA assessed at one year.
Notes	Country: Brazil (Teresina, Itararé quarter). Trial dates: 1995 to 1996. Trial sponsor: No source of funding reported. Sample size: Not calculated. Compliance assessment: Not reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient detail was reported about the method used to generate the allocation sequence. "Os lotes foram alocados aleatoriamente a 4 tipos de intervenção".
Allocation concealment (selection bias)	Unclear risk	Not reported.
Blinding (performance bias and detection bias) participants	Unclear risk	Not reported.
Blinding (performance bias and detection bias) investigators	Unclear risk	Not reported.
Blinding (performance bias and detection bias) Assessors	Unclear risk	Not reported.
Incomplete outcome data (attrition bias) All outcomes	High risk	No information on loss of clusters. There were 44% of lost of participants to follow‐up (93/213) although the authors did not specify to which group these people belonged.
Selective reporting (reporting bias)	Low risk	All outcomes mentioned in the methods were reported in the results.
Baseline measurements	High risk	The prevalence of seropositivity at baseline were similar in the intervention areas but was significantly lower in the control area (only IRS). Groups were not comparable at baseline. Prevalence of infection was similar within the three treatments, but not between the treatments and the control group (lower prevalence in control group).
Statistical adjustment for clustering	Low risk	Cluster adjustment was performed as the model considered the effect of aggregation of individuals in batches and used robust variance estimates.
Other bias	Unclear risk	Trial authors did not provide a conflict of interest declaration.