Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study
Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and ev...
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| Autor*in: |
John C Rek, MBChB [verfasserIn] Victor Alegana, PhD [verfasserIn] Emmanuel Arinaitwe, MBChB [verfasserIn] Ewan Cameron, PhD [verfasserIn] Moses R Kamya, ProfPhD [verfasserIn] Agaba Katureebe, MBChB [verfasserIn] Steve W Lindsay, ProfPhD [verfasserIn] Maxwell Kilama, BA [verfasserIn] Sarah G Staedke, PhD [verfasserIn] Jim Todd, MSc [verfasserIn] Grant Dorsey, ProfPhD [verfasserIn] Lucy S Tusting, PhD [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Übergeordnetes Werk: |
In: The Lancet Planetary Health - Elsevier, 2018, 2(2018), 2, Seite e83-e94 |
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| Übergeordnetes Werk: |
volume:2 ; year:2018 ; number:2 ; pages:e83-e94 |
| Links: |
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| DOI / URN: |
10.1016/S2542-5196(18)30010-X |
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| Katalog-ID: |
DOAJ074154532 |
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| 520 | |a Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. | ||
| 653 | 0 | |a Environmental sciences | |
| 700 | 0 | |a Victor Alegana, PhD |e verfasserin |4 aut | |
| 700 | 0 | |a Emmanuel Arinaitwe, MBChB |e verfasserin |4 aut | |
| 700 | 0 | |a Ewan Cameron, PhD |e verfasserin |4 aut | |
| 700 | 0 | |a Moses R Kamya, ProfPhD |e verfasserin |4 aut | |
| 700 | 0 | |a Agaba Katureebe, MBChB |e verfasserin |4 aut | |
| 700 | 0 | |a Steve W Lindsay, ProfPhD |e verfasserin |4 aut | |
| 700 | 0 | |a Maxwell Kilama, BA |e verfasserin |4 aut | |
| 700 | 0 | |a Sarah G Staedke, PhD |e verfasserin |4 aut | |
| 700 | 0 | |a Jim Todd, MSc |e verfasserin |4 aut | |
| 700 | 0 | |a Grant Dorsey, ProfPhD |e verfasserin |4 aut | |
| 700 | 0 | |a Lucy S Tusting, PhD |e verfasserin |4 aut | |
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10.1016/S2542-5196(18)30010-X doi (DE-627)DOAJ074154532 (DE-599)DOAJ3687a55c03c74168b1bc0c2be29bd349 DE-627 ger DE-627 rakwb eng GE1-350 John C Rek, MBChB verfasserin aut Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. Environmental sciences Victor Alegana, PhD verfasserin aut Emmanuel Arinaitwe, MBChB verfasserin aut Ewan Cameron, PhD verfasserin aut Moses R Kamya, ProfPhD verfasserin aut Agaba Katureebe, MBChB verfasserin aut Steve W Lindsay, ProfPhD verfasserin aut Maxwell Kilama, BA verfasserin aut Sarah G Staedke, PhD verfasserin aut Jim Todd, MSc verfasserin aut Grant Dorsey, ProfPhD verfasserin aut Lucy S Tusting, PhD verfasserin aut In The Lancet Planetary Health Elsevier, 2018 2(2018), 2, Seite e83-e94 (DE-627)895241757 (DE-600)2902154-6 25425196 nnns volume:2 year:2018 number:2 pages:e83-e94 https://doi.org/10.1016/S2542-5196(18)30010-X kostenfrei https://doaj.org/article/3687a55c03c74168b1bc0c2be29bd349 kostenfrei http://www.sciencedirect.com/science/article/pii/S254251961830010X kostenfrei https://doaj.org/toc/2542-5196 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2018 2 e83-e94 |
| spelling |
10.1016/S2542-5196(18)30010-X doi (DE-627)DOAJ074154532 (DE-599)DOAJ3687a55c03c74168b1bc0c2be29bd349 DE-627 ger DE-627 rakwb eng GE1-350 John C Rek, MBChB verfasserin aut Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. Environmental sciences Victor Alegana, PhD verfasserin aut Emmanuel Arinaitwe, MBChB verfasserin aut Ewan Cameron, PhD verfasserin aut Moses R Kamya, ProfPhD verfasserin aut Agaba Katureebe, MBChB verfasserin aut Steve W Lindsay, ProfPhD verfasserin aut Maxwell Kilama, BA verfasserin aut Sarah G Staedke, PhD verfasserin aut Jim Todd, MSc verfasserin aut Grant Dorsey, ProfPhD verfasserin aut Lucy S Tusting, PhD verfasserin aut In The Lancet Planetary Health Elsevier, 2018 2(2018), 2, Seite e83-e94 (DE-627)895241757 (DE-600)2902154-6 25425196 nnns volume:2 year:2018 number:2 pages:e83-e94 https://doi.org/10.1016/S2542-5196(18)30010-X kostenfrei https://doaj.org/article/3687a55c03c74168b1bc0c2be29bd349 kostenfrei http://www.sciencedirect.com/science/article/pii/S254251961830010X kostenfrei https://doaj.org/toc/2542-5196 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2018 2 e83-e94 |
| allfields_unstemmed |
10.1016/S2542-5196(18)30010-X doi (DE-627)DOAJ074154532 (DE-599)DOAJ3687a55c03c74168b1bc0c2be29bd349 DE-627 ger DE-627 rakwb eng GE1-350 John C Rek, MBChB verfasserin aut Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. Environmental sciences Victor Alegana, PhD verfasserin aut Emmanuel Arinaitwe, MBChB verfasserin aut Ewan Cameron, PhD verfasserin aut Moses R Kamya, ProfPhD verfasserin aut Agaba Katureebe, MBChB verfasserin aut Steve W Lindsay, ProfPhD verfasserin aut Maxwell Kilama, BA verfasserin aut Sarah G Staedke, PhD verfasserin aut Jim Todd, MSc verfasserin aut Grant Dorsey, ProfPhD verfasserin aut Lucy S Tusting, PhD verfasserin aut In The Lancet Planetary Health Elsevier, 2018 2(2018), 2, Seite e83-e94 (DE-627)895241757 (DE-600)2902154-6 25425196 nnns volume:2 year:2018 number:2 pages:e83-e94 https://doi.org/10.1016/S2542-5196(18)30010-X kostenfrei https://doaj.org/article/3687a55c03c74168b1bc0c2be29bd349 kostenfrei http://www.sciencedirect.com/science/article/pii/S254251961830010X kostenfrei https://doaj.org/toc/2542-5196 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2018 2 e83-e94 |
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10.1016/S2542-5196(18)30010-X doi (DE-627)DOAJ074154532 (DE-599)DOAJ3687a55c03c74168b1bc0c2be29bd349 DE-627 ger DE-627 rakwb eng GE1-350 John C Rek, MBChB verfasserin aut Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. Environmental sciences Victor Alegana, PhD verfasserin aut Emmanuel Arinaitwe, MBChB verfasserin aut Ewan Cameron, PhD verfasserin aut Moses R Kamya, ProfPhD verfasserin aut Agaba Katureebe, MBChB verfasserin aut Steve W Lindsay, ProfPhD verfasserin aut Maxwell Kilama, BA verfasserin aut Sarah G Staedke, PhD verfasserin aut Jim Todd, MSc verfasserin aut Grant Dorsey, ProfPhD verfasserin aut Lucy S Tusting, PhD verfasserin aut In The Lancet Planetary Health Elsevier, 2018 2(2018), 2, Seite e83-e94 (DE-627)895241757 (DE-600)2902154-6 25425196 nnns volume:2 year:2018 number:2 pages:e83-e94 https://doi.org/10.1016/S2542-5196(18)30010-X kostenfrei https://doaj.org/article/3687a55c03c74168b1bc0c2be29bd349 kostenfrei http://www.sciencedirect.com/science/article/pii/S254251961830010X kostenfrei https://doaj.org/toc/2542-5196 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2018 2 e83-e94 |
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10.1016/S2542-5196(18)30010-X doi (DE-627)DOAJ074154532 (DE-599)DOAJ3687a55c03c74168b1bc0c2be29bd349 DE-627 ger DE-627 rakwb eng GE1-350 John C Rek, MBChB verfasserin aut Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. Environmental sciences Victor Alegana, PhD verfasserin aut Emmanuel Arinaitwe, MBChB verfasserin aut Ewan Cameron, PhD verfasserin aut Moses R Kamya, ProfPhD verfasserin aut Agaba Katureebe, MBChB verfasserin aut Steve W Lindsay, ProfPhD verfasserin aut Maxwell Kilama, BA verfasserin aut Sarah G Staedke, PhD verfasserin aut Jim Todd, MSc verfasserin aut Grant Dorsey, ProfPhD verfasserin aut Lucy S Tusting, PhD verfasserin aut In The Lancet Planetary Health Elsevier, 2018 2(2018), 2, Seite e83-e94 (DE-627)895241757 (DE-600)2902154-6 25425196 nnns volume:2 year:2018 number:2 pages:e83-e94 https://doi.org/10.1016/S2542-5196(18)30010-X kostenfrei https://doaj.org/article/3687a55c03c74168b1bc0c2be29bd349 kostenfrei http://www.sciencedirect.com/science/article/pii/S254251961830010X kostenfrei https://doaj.org/toc/2542-5196 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2018 2 e83-e94 |
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John C Rek, MBChB @@aut@@ Victor Alegana, PhD @@aut@@ Emmanuel Arinaitwe, MBChB @@aut@@ Ewan Cameron, PhD @@aut@@ Moses R Kamya, ProfPhD @@aut@@ Agaba Katureebe, MBChB @@aut@@ Steve W Lindsay, ProfPhD @@aut@@ Maxwell Kilama, BA @@aut@@ Sarah G Staedke, PhD @@aut@@ Jim Todd, MSc @@aut@@ Grant Dorsey, ProfPhD @@aut@@ Lucy S Tusting, PhD @@aut@@ |
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Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. 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Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. 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John C Rek, MBChB |
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John C Rek, MBChB misc GE1-350 misc Environmental sciences Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
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GE1-350 Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
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Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
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John C Rek, MBChB Victor Alegana, PhD Emmanuel Arinaitwe, MBChB Ewan Cameron, PhD Moses R Kamya, ProfPhD Agaba Katureebe, MBChB Steve W Lindsay, ProfPhD Maxwell Kilama, BA Sarah G Staedke, PhD Jim Todd, MSc Grant Dorsey, ProfPhD Lucy S Tusting, PhD |
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rapid improvements to rural ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
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Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
| abstract |
Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. |
| abstractGer |
Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. |
| abstract_unstemmed |
Summary: Background: Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. Funding: US National Institutes of Health, Bill & Melinda Gates Foundation, and Medical Research Council UK. |
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Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study |
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Victor Alegana, PhD Emmanuel Arinaitwe, MBChB Ewan Cameron, PhD Moses R Kamya, ProfPhD Agaba Katureebe, MBChB Steve W Lindsay, ProfPhD Maxwell Kilama, BA Sarah G Staedke, PhD Jim Todd, MSc Grant Dorsey, ProfPhD Lucy S Tusting, PhD |
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Victor Alegana, PhD Emmanuel Arinaitwe, MBChB Ewan Cameron, PhD Moses R Kamya, ProfPhD Agaba Katureebe, MBChB Steve W Lindsay, ProfPhD Maxwell Kilama, BA Sarah G Staedke, PhD Jim Todd, MSc Grant Dorsey, ProfPhD Lucy S Tusting, PhD |
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10.1016/S2542-5196(18)30010-X |
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2024-07-03T21:38:11.430Z |
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Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods: This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a cohort of children and adults with temporal changes in malaria test positivity rate from health facility surveillance. All children aged 6 months to 10 years (n=384) living in 107 households in Nagongera sub-country, Tororo, Uganda, were given long-lasting insecticide-treated nets and followed between Aug 19, 2011, and June 30, 2017. Repeat rounds of indoor residual spraying of insecticide were initiated on Dec 5, 2014. Socioeconomic data were collected at two timepoints (Sept 25–Oct 9, 2013 and June 21–July 11, 2016) and houses were classified as modern (cement, wood, or metal walls, tiled or metal roof, and closed eaves) or traditional (all other homes). Associations between house design and three outcomes were evaluated before and after the introduction of indoor residual spraying: human biting rate estimated monthly in each household using US Centers for Disease Control and Prevention light traps; parasite prevalence measured routinely by microscopy every 3 months before indoor residual spraying and monthly after indoor residual spraying; and malaria incidence measured by passive surveillance. Findings: The implementation of indoor residual spraying was associated with significant declines in human biting rate (33·5 vs 2·7 Anopheles per house per night after indoor residual spraying, p<0·0001), parasite prevalence (32·0% vs 14·0%, p<0·0001), and malaria incidence (3·0 vs 0·5 episodes per person-year at risk, p<0·0001). The prevalence of modern housing increased from 23·4% in 2013 to 45·4% in 2016 (p=0·001). Compared with traditional houses, modern houses were associated with a 48% reduction in human biting rate before indoor residual spraying (adjusted incidence rate ratio [aIRR] 0·52, 95% CI 0·36–0·73, p=0·0002), and a 73% reduction after indoor residual spraying (aIRR 0·27, 0·17–0·42, p<0·0001). Before indoor residual spraying, there was no association between house type and parasite prevalence, but after indoor residual spraying there was a 57% reduction in the odds of parasitaemia in modern houses compared with traditional houses, controlling for age, sex, and socioeconomic position (adjusted odds ratio 0·43, 95% CI 0·24–0·77, p=0·004). House type was not associated with malaria incidence before or after indoor residual spraying. Interpretation: House design improved rapidly in rural Uganda and was associated with additional reductions in mosquito density and parasite prevalence following the introduction of indoor residual spraying. Changes to house design in endemic Africa, including closing eaves and the replacement of traditional building materials, might help further the gains achieved with more widely accepted malaria control interventions. 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