London School of Hygiene: Housing improvements could reduce malaria cases by half in some settings, according to research published in Malaria Journal.. As mosquitoes become resistant to insecticides and malaria parasites
become resistant to drugs, researchers looked at how making changes to
houses might contribute to tackling the deadly disease. Researchers reviewed 90 studies in Africa, Asia and South America
comparing malaria cases in traditional houses (mud, stone, bamboo or
wood walls; thatched, mud or wood roofs; earth or wood floors) and
modern houses (closed eaves, ceilings, screened doors and windows).
They found residents of modern homes were 47% less likely to be
infected with malaria than those living in traditional houses, and
residents were 45-65% less likely to have clinical malaria (fever with
infection).
The study was led by the London School of Hygiene & Tropical
Medicine in partnership with Durham University and the University of
California, San Francisco.
Lead author Lucy Tusting
from the London School of Hygiene & Tropical Medicine, said:
“Housing improvements were traditionally an important pillar of public
health, but they remain underexploited in malaria control. Good housing
can block mosquitoes from entering homes and prevent them from
transmitting malaria to the people who live there.
“Our study suggests housing could be an important tool in tackling
malaria. This is a welcome finding at a time when we are facing
increasing resistance to our most effective insecticides and drugs. We
now need to pinpoint which housing features can reduce mosquito entry in
different settings, to incorporate these into local housing designs and
to assess the impact on malaria in large-scale field trials.”
Malaria, a life-threatening disease caused by parasites that are
transmitted to people through the bites of infected mosquitoes, causes
more than half a million deaths per year, mostly among African children.
The authors note that the effectiveness of improving housing will
vary depending on the location. While many mosquitoes enter homes to
bite humans at night, outdoor malaria-transmission is more common in
some places, meaning interventions centered on the home will have less
impact.
Co-author Professor Steve Lindsay from Durham University, added:
“Improved housing has huge potential to reduce malaria transmission
around the globe and to keep malaria at bay where we have eliminated it.
Since many of the world’s major vector borne diseases are transmitted
indoors, improved housing is likely to be protective against diseases
like dengue, leishmaniasis, Chagas disease and lymphatic filariasis.
“In many parts of the tropics development is occurring at an
unprecedented rate and the quality of housing is improving too. Across
much of sub-Saharan Africa thatched-roofed houses are being replaced by
metal-roofed housing. We need to ride this wave of house improvement and
develop new ways of protecting people against the insects that transmit
so many deadly and debilitating diseases. Good housing should line-up
alongside clean water and sanitation as major public health
interventions.”
While the studies eligible for inclusion in this new review were of
low quality, the authors say the consistency of the findings indicate
that housing is an important risk factor for malaria.
The study was funded by the Leverhulme Centre for Integrative
Research in Agriculture and Health; US National Institutes of Health;
the Bill & Melinda Gates Foundation; Novartis Foundation for
Sustainable Development; Medical Research Council and Department For
International Development.