Knowledge gaps in the construction of rural healthy homes: A research agenda for improved low-cost housing in hot-humid Africa

Seidlein, Lorenz von; Wood, Hannah; Brittain, Otis Sloan; Tusting, Lucy S.; Bednarz, Alexa; Mshamu, Salum; Kahabuka, Catherine; Deen, Jacqueline; Bell, David A.; Lindsay, Steve W.; Knudsen, Jakob

doi:10.1371/journal.pmed.1002909

Cited by 14 publications

(10 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Results of this review will hopefully encourage the development of mainstream policy discourse for the design of high-quality residential buildings to yield health benefits. It also resonates with the breath of interest of holistic sustainable development agenda to account for and remediate the incongruity of perpetuating substandard housing conditions and the attributable health inequities in resource-poor parts the world [ 14 ]. From a scientific, economic, and ethical perspective, appropriate housing interventions for implementation should be location and community-specific, effective, inclusive, acceptable, and affordable.…”

Section: Discussionmentioning

confidence: 99%

“…However, the widespread insecticide resistance has significantly compromised the effectiveness of such interventions [ 11 ], suggesting a need for additional approaches. In tandem with the global call for action to make human settlements inclusive, safe, resilient, and sustainable by 2030 [ 12 ], large-scale investments can have a positive impact on various health and wellbeing outcomes, including but not limited to chronic respiratory tract diseases, mental health conditions, and infectious diseases such as enteric diseases, respiratory infections, malaria, and dengue fever [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Kua

Lee

2021

PLoS ONE

View full text Add to dashboard Cite

Background Mosquito-borne diseases remain a significant public health problem in tropical regions. Housing improvements such as screening of doors and windows may be effective in reducing disease transmission, but the impact remains unclear. Objectives To examine whether housing interventions were effective in reducing mosquito densities in homes and the impact on the incidence of mosquito-borne diseases. Methods In this systematic review and meta-analysis, we searched 16 online databases, including NIH PubMed, CINAHL Complete, LILACS, Ovid MEDLINE, and Cochrane Central Register of Controlled Trials for randomized trials published from database inception to June 30, 2020. The primary outcome was the incidence of any mosquito-borne diseases. Secondary outcomes encompassed entomological indicators of the disease transmission. I2 values were used to explore heterogeneity between studies. A random-effects meta-analysis was used to assess the primary and secondary outcomes, with sub-group analyses for type of interventions on home environment, study settings (rural, urban, or mixed), and overall house type (traditional or modern housing), Results The literature search yielded 4,869 articles. After screening, 18 studies were included in the qualitative review, of which nine were included in the meta-analysis. The studies enrolled 7,200 households in Africa and South America, reporting on malaria or dengue only. The type of home environmental interventions included modification to ceilings and ribbons to close eaves, screening doors and windows with nets, insecticide-treated wall linings in homes, nettings over gables and eaves openings, mosquito trapping systems, metal-roofed houses with mosquito screening, gable windows and closed eaves, and prototype houses using southeast Asian designs. Pooled analysis depicted a lower risk of mosquito-borne diseases in the housing intervention group (OR = 0.68; 95% CI = 0.48 to 0.95; P = 0.03). Subgroup analysis depicted housing intervention reduced the risk of malaria in all settings (OR = 0.63; 95% CI = 0.39 to 1.01; P = 0.05). In urban environment, housing intervention was found to decrease the risk of both malaria and dengue infections (OR = 0.52; 95% CI = 0.27 to 0.99; P = 0.05).Meta-analysis of pooled odds ratio showed a significant benefit of improved housing in reducing indoor vector densities of both Aedes and Anopheles (OR = 0.35; 95% CI = 0.23 to 0.54; P<0.001). Conclusions Housing intervention could reduce transmission of malaria and dengue among people living in the homes. Future research should evaluate the protective effect of specific house features and housing improvements associated with urban development.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Kua

Lee

2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Moreover, an apparent ‘protective’ effect by presence of eaves gaps on dengue risk might be explained by the location of productive breeding sites. Indeed, if the majority of container habitats are located indoors, eaves gaps can represent exit routes for the vectors [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

Complex relationships between Aedes vectors, socio-economics and dengue transmission—Lessons learned from a case-control study in northeastern Thailand

et al. 2020

View full text Add to dashboard Cite

Background/Objectives Dengue fever is an important public health concern in most tropical and subtropical countries, and its prevention and control rest on vector surveillance and control. However, many aspects of dengue epidemiology remain unclear; in particular, the relationship between Aedes vector abundance and dengue transmission risk. This study aims to identify entomological and immunological indices capable of discriminating between dengue case and control (non-case) houses, based on the assessment of candidate indices, as well as individual and household characteristics, as potential risk factors for acquiring dengue infection. Methods This prospective, hospital-based, case-control study was conducted in northeastern Thailand between June 2016 and August 2019. Immature and adult stage Aedes were collected at the houses of case and control patients, recruited from district hospitals, and at patients’ neighboring houses. Blood samples were tested by RDT and PCR to detect dengue cases, and were processed with the Nterm-34 kDa salivary peptide to measure the human immune response to Aedes bites. Socioeconomic status, and other individual and household characteristics were analyzed as potential risk factors for dengue. Results Study findings showed complex relationships between entomological indices and dengue risk. The presence of DENV-infected Aed es at the patient house was associated with 4.2-fold higher odds of dengue. On the other hand, Aedes presence (irrespective of infectious status) in the patient’s house was negatively associated with dengue. In addition, the human immune response to Aedes bites, was higher in control than in case patients and Aedes adult abundance and immature indices were higher in control than in case houses at the household and the neighboring level. Multivariable analysis showed that children aged 10–14 years old and those aged 15–25 years old had respectively 4.5-fold and 2.9-fold higher odds of dengue infection than those older than 25 years. Conclusion DENV infection in female Aedes at the house level was positively associated with dengue infection, while adult Aedes presence in the household was negatively associated. This study highlights the potential benefit of monitoring dengue viruses in Aedes vectors. Our findings suggest that monitoring the presence of DENV-infected Aedes mosquitoes could be a better indicator of dengue risk than the traditional immature entomological indices.

show abstract

“…The form and concentration of these emissions is shaped by the number and age of the people in the house, indoor and outdoor climates, as well as the materials used for house construction and the house design. Computer simulations of airflow, based on these variables could be used to better model how attractive odours leak out of houses and thereby draw mosquitoes indoors (Figure 3) (von Seidlein et al 2019). This approach should be combined with studies on the 3-dimensional flight of mosquitoes to improve our understanding of mosquito house entry.…”

Section: Basic Research On Vectors and The Built Environmentmentioning

confidence: 99%

“…(Coogle 1928) We can surely do better than that? Developments in building materials and new designs offer exciting, creative and effective opportunities for excluding mosquitoes and incorporating housing concepts which can improve health and well-being in general (von Seidlein et al 2019). Recent research has tested new ventilated doors (Figure 4) (Jawara et al 2018) and new types of screened houses (von Seidlein et al 2017), made from lightweight materials with a low thermal mass to help keep the house cool at night so that people are more likely to sleep under an insecticide-treated net (Pulford et al 2011).…”

Section: New Tools and Approachesmentioning

confidence: 99%

Research agenda for preventing mosquito-transmitted diseases through improving the built environment in sub-Saharan Africa

Shenton

Addissie

Alabaster³

et al. 2019

Cities & Health

Self Cite

View full text Add to dashboard Cite

Mosquito-transmitted diseases are a major threat to health in sub-Saharan Africa, but could be reduced through modifications to the built environment. Here we report findings from a major workshop held to identify the research gaps in this area, namely: (1) evidence of the health benefits to changes to the built environment, (2) understanding how mosquitoes enter buildings, (3) novel methods for reducing mosquito-house entry, (4) sustainable approaches for reducing mosquito habitats, (5) case studies of micro-financing for healthy homes and (6) methods for increasing scale-up. Multidisciplinary research is essential to build out mosquito-transmitted diseases, and not build them in.

show abstract

Knowledge gaps in the construction of rural healthy homes: A research agenda for improved low-cost housing in hot-humid Africa

Abstract: Lorenz von Seidlein and colleagues discuss improving house designs in rural Africa to benefit health.

Cited by 14 publications

References 20 publications

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Complex relationships between Aedes vectors, socio-economics and dengue transmission—Lessons learned from a case-control study in northeastern Thailand

Research agenda for preventing mosquito-transmitted diseases through improving the built environment in sub-Saharan Africa

Contact Info

Product

Resources

About