Methods |
Trial design: Controlled before‐and‐after trial Type of cluster: Town Cluster size: Intervention arm 92,000 individuals; control arm 5000 individuals Number of clusters in each arm: One Adjusted for clustering? n/a |
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Participants |
Age: Any Sex: Any Co‐morbidities and pregnancy: Any Primary outcome sample size (Malaria incidence): Intervention arm: 92,000; control arm: 5000 Secondary outcome sample size (Adult mosquito density (measures other than human biting rate)): 80 sentinel sites |
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Interventions |
Intervention: Habitat manipulation with larviciding Details of the intervention: Habitat manipulation: attempts to persuade householders to remove domestic water storage containers made with limited success Larviciding: Larval habitats (excluding stored domestic water) were treated with pirimiphos‐methyl (applied at 12.5g active ingredient/ha, with knapsack sprayers) Frequency of application: Weekly Duration of intervention period: 15 months Who was responsible for LSM? Study staff were responsible for larviciding. Attempts were made to persuade the local community to conduct habitat modification Co‐interventions: Case management (active case detection): presumptive treatment of all fever cases with chloroquine (coverage not stated) Co‐interventions equal in each arm? Yes |
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Outcomes |
1. Malaria incidence (measured with continuous community surveillance) 2. Parasite prevalence (measured with community surveys) 3. Adult mosquito density (measures other than human biting rate): (measured with weekly indoor resting collections using an aspirator, at sentinel sites. 16 of 80 sentinel sites visited each week day) |
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Notes |
Continent: Asia Country: India Ecosystem: Desert fringe Urban or rural: Urban Extensive or localized larval habitats: Localized Primary larval habitats: Containers, wells, rainwater pools, canals, stagnant pools in drains Transmission intensity: Low Transmission season(s): May to September Primary and secondary vector:An. culicifacies, An. stephensi Primary malaria parasite:P. falciparum Source of funding: Haryana State Health Authorities; Alkali and Chemical Corporation of India Ltd; ICI Plant Protection Division |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Not randomly chosen. |
Allocation concealment (selection bias) | High risk | Not randomly chosen. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | No information given as to blinding of those seeing patients and reading blood slides. |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Impossible to blind implementers or inhabitants to intervention. |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Individual patients not followed up therefore not possible to measure percentage loss to follow‐up. |
Selective reporting (reporting bias) | Unclear risk | Outcomes not specified. |
Baseline characteristics | Unclear risk | Baseline characteristics not stated; intervention town much larger than control town. |
Contamination | Low risk | 8 km between control and intervention towns. |
Incorrect analysis | Unclear risk | Cluster adjustment not applicable. |
Other bias | High risk | High risk of confounding. |