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Changing home designs and materials to make homes cooler and harder for mosquitoes to enter could reduce malaria transmission in sub-Saharan Africa, according to a new study in The Lancet Planetary Health.

Study researchers found 96% fewer mosquitoes in a Southeast Asian style two storey house built with permeable local bamboo walls and screened windows compared to a traditional mud or wattle-daub African home built on the ground with poor ventilation.

“New house designs could become an important health intervention in the fight against malaria in Africa,” said Dr Lorenz von Seidlein, study author and Head of Targeted Malaria Elimination at the Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand.

“Between 80-100% of malaria transmission there occurs indoors at night, yet people often don’t sleep under insecticide-treated bednets because they are uncomfortably hot. We think there is an unprecedented opportunity to fight malaria transmission in hot, humid Sub-Saharan Africa by designing homes that keep the cool in and mosquitoes out,” said Dr von Seidlein.

Funded by the Ruth W Jensens Foundation, Denmark, and the Hanako Foundation, Singapore, the study built six prototype houses based on a Southeast Asian design in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared them with modified and unmodified traditional, sub-Saharan African houses.

The prototype houses were designed by Prof Jakob Knudsen of the University of Copenhagen School of Architecture (KADK) and owner of Ingvartsen, a practice in Copenhagen. In June 2015, long-time Shoklo Malaria Research Unit (SMRU) staff member Mr. Tip Ruechaitrakul, two Karen colleagues and a local Tanzanian craftsman built a typical two storey Thai-Karen house that was included the study and found to have the best climate comfort index of all study houses.

Researchers found that while both Southeast Asia style single and two storey buildings provided a cooler indoor climate than traditional housing, two-storey buildings provided the biggest reduction in mosquito densities, with 96% fewer mosquitoes than in a traditional African home.

“Our next step is a randomised trial to prove (or disprove) whether the findings hold in a substantial number of African houses and villages. We are looking for funding for a household randomised cohort trial where 110 households receive a novel design home and are compared with a cohort of residents living in 440 traditional, rural African homes,” said Dr von Seidlein.

Study reference (an error-free, updated version should be available 4 Sept 2017)

Affordable house designs to improve health in rural Africa: a field study in northeastern Tanzania. von Seidlein L, Ikonomidis K, Mshamu S, Nkya TE, Mukaka M, Pell C, Lindsay SW, Deen JL, Kisinza WN, Knudsen JB. The Lancet Planetary Health, vol 1, No. 5, e188-e199, Aug 2017. DOI: http://dx.doi.org/10.1016/S2542-5196(17)30078-5. http://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30078-5/fulltext

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