Samnotra 1980 IND

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
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
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
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)
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
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.