Submicroscopic malaria infections analyses IPD Aggregated data 609 items identified through database searching (search update Nov 10, 2021) Country Location 0 additional items identified through other Africa sources including contact with researchers Cottrell et al (2015) Benin Come Central 11•75 Cottrell et al (2015) Benin Akodeha 12•69 Denoeud-Ndam et al (2013) Cottrell et al (2015) Benin 609 items after removal of duplicates Porto Novo Benin Ouedeme-Pedah 16•03 16•41 Accrombessi et al (2018) Benin Soava and Akassato 20•55 Denoeud-Ndam et al (2013)* Benin Cotonou 22•38 Williams et al (2016)* Kattenberg et al (2012) Burkina Faso 609 items screened for eligibility Ziniare Burkina Faso Nanoro 47•29 63•07 Leke et al (2010) Ntoumi et al (2016)* Matangila et al (2014)* Tadesse et al (2020)* Williams et al (2016)* Quakyi et al (2019)* Quakyi et al (2019)* Nwaefuna et al (2015) Lamptey et al (2018) Cameroon Congo (Brazzaville) DR Congo Ethiopia The Gambia Ghana Ghana Ghana Ghana Ngali II Madibou Kinshasa Kafa zone Basse Maamobi Kpone on-Sea Central Ghana Asutsuare 67•99 409 items excluded 18•30 31 not in pregnant women 12•74 92 PCR for immunology, genetics, or other infection 1•09 95 drug efficacy or pharmacokinetics 7•86 38 comment, review, or proposal 17•19 104 specific group, case report, or series 17•19 42 no PCR or only PCR 22•20 7 not enough information (conference abstracts) 27•75 Mockenhaupt et al (2000) Williams et al (2016)* Desai et al (2015)* Ghana 200 items further evaluated* Agogo Ghana Navrongo 87 studies eligible for IPD Kenya Lwak 36•28 60•65 11•17 Desai et al (2015)* Desai et al (2015)* Desai et al (2015)* Daud et al (2014)* Samuels et al et al (2019) Madanitsa et al et al (2016)* Madanitsa et al (2016)* Kapito-Tembo (2010)* Madanitsa et al (2016)* Kenya Kenya Kenya Kenya Kenya Malawi Malawi Malawi Malawi Madiany Siaya Bondo Chulaimbo Siaya Chikwawa Chikwawa Thyolo Mpemba 13•49 42 studies for which IPD were not provided 13•71 (34 734 participants) 16•77 1 no email address 20•28 9 no email response 38•15 4 could not find data 11•35 4 data not available 11•35 20 responded positive but not data provided 15•42 4 responded positive but data not usable 17•98 Madanitsa et al (2016)* Malawi Mpemba 17•98 Madanitsa et al (2016)* Malawi Madziabango 18•93 Madanitsa et al (2016)* Malawi Madziabango 18•93 19 studies excluded (20 069 participants) Cohee et al (2014) Malawi Blantyre 23•67 Nkhoma et al (2017) Malawi Mangochi district 27•87 Williams et al (2016)* Williams et al (2016)* Fried et al (2018) Williams et al (2016)* Adam et al (2005) 45 studies with IPD included in analysis 54 099 total participants 48 869 participants with data 5230 participants without data † Mali Bamako Mali Kita Mali Ouelessebougou Mali San Sudan New Halfa 5•18 23 ‡ studies with aggregate data included in analysis § 31•14 14 665 total participants 49•62 11 683 participants included in analysis 50•86 2982 participants excluded from analysis † 0•71 Kakuru et al (2016)* Uganda Tororo 13•03 Briggs et al (2019) Uganda Busia district 45•93 Chico et al (2017)* Zambia Nchelenge 37•51 Subtotal (I 2 =97•148%, p<0•0001) Asia and the Americas Bardaji et al (2017) Brazil Manaus Vasquez et al (2018)* Colombia Pregnancy Apartado, Turbo, El Bagre Delivery Delivery Pregnancy Delivery Delivery Gavina et al (2018)* Colombia Puerto Libertador (maternal (placental (maternal (placental Vasquez et al (2020)* Colombia Tumaco blood) blood) blood) blood) Bardaji et al (2017) Vasquez et al (2018)* Vasquez et al (2020) Vasquez et al (2018)* Included studies Colombia Total participants Colombia Included participants Colombia Colombia 28 36 504 Tieralta Tumaco 25 708 Quibdo Quibdo 32 33 922 21 976 29 3 2 141 1 8 609 10 8288 6622 14 5802 4504 13 3977 3035 Bardaji et al (2017) Excluded participants Guatamala 10 796 Fray Bartolome 11 946 13 532 1666 1298 942 Elbadry et al (2017) Haiti South Haiti Elbadry et al (2017) Haiti Middle and north Haiti Bardaji et al (2017) India Bikaner Singh et al (2015) India Rajnandgaon Singh et al (2015) India Bastar Ahmed et al (2014)* Indonesia Jayapura and Sumba Ahmed et al (2019) Indonesia Sumba Pava et al (2016) Indonesia Timika Ahmed et al (2019) Indonesia Timika Stanisic et al (2015)* Papua New Guinea Alexishafen Bardaji et al (2017) Papua New Guinea Madang Unger et al (2015)* Papua New Guinea Madang Unger et al (2015)* Papua New Guinea Mugil Unger et al (2015)* Papua New Guinea Alexishafen-U Unger et al (2015)* Papua New Guinea Yagaum Subtotal (I 2 =96•725%, p<0•0001) Overall Heterogeneity between groups: I 2 =97•695%, p<0•0001.