Assessing the health benefits of development interventions

Tusting, Lucy S.; Cairncross, Sandy; Ludolph, Ramona; Velayudhan, Raman; Wilson, Anne L.; Lindsay, Steve W.

doi:10.1136/bmjgh-2021-005169

Cited by 13 publications

(20 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…arabiensis dominates transmission. Being community-led and delivered, as well as a human right, housing improvements offer the advantage of a 'development' intervention that benefits a range of health and social needs [3]. Our study suggests that the health co-benefits of housing improvements include prevention of gastrointestinal illness, but future research is needed to determine causality and protective mechanisms.…”

Section: Discussionmentioning

confidence: 89%

“…Pneumonia, diarrhoea and malaria persist as the leading causes of mortality beyond the neonatal period, contributing 40% of the 2.7 million total deaths in children aged <5 years old across SSA in 2019 [2]. As SSA undergoes rapid urbanization, population growth and environmental changes, there is an urgent need to better understand the underlying social and environmental determinants of diseases that contribute significantly to morbidity and mortality [3].…”

Section: Introductionmentioning

confidence: 99%

“…For example, housing improvements could avert an estimated 19 to 30 million of 213 million total annual malaria cases in SSA [8]. These improvements, however, cannot be fully leveraged without an understanding of effects across different health outcomes [3]. For example, sealing all openings in a house will keep out malaria vectors but will reduce air flow, potentially raising indoor temperature and discouraging use of insecticide-treated nets (ITNs) [10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

Musiime

Krezanoski

Smith

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

House construction is rapidly modernizing across Africa but the potential benefits for human health are poorly understood. We hypothesised that improvements to housing would be associated with reductions in malaria, acute respiratory infection (ARI) and gastrointestinal illness in an area of low malaria endemicity in Uganda. Data were analysed from a cohort study of male and female child and adult residents (n = 531) of 80 randomly-selected households in Nagongera sub-county, followed for 24 months (October 4, 2017 to October 31, 2019). Houses were classified as modern (brick walls, metal roof and closed eaves) or traditional (all other homes). Light trap collections of mosquitoes were done every two weeks in all sleeping rooms. Every four weeks, we measured malaria infection (using microscopy and qPCR to detect malaria parasites), incidence of malaria, ARI and gastrointestinal illness. We collected 15,780 adult female Anopheles over 7,631 nights. We collected 13,277 blood samples of which 10.2% (1,347) were positive for malaria parasites. Over 958 person years we diagnosed 38 episodes of uncomplicated malaria (incidence 0.04 episodes per person-year at risk), 2,553 episodes of ARI (incidence 2.7 episodes per person-year) and 387 episodes of gastrointestinal illness (incidence 0.4 episodes per person-year). Modern houses were associated with a 53% lower human biting rate compared to traditional houses (adjusted incidence rate ratio [aIRR] 0.47, 95% confidence interval [CI] 0.32–0.67, p<0.001) and a 24% lower incidence of gastrointestinal illness (aIRR 0.76, 95% CI 0.59–0.98, p = 0.04) but no changes in malaria prevalence, malaria incidence nor ARI incidence. House improvements may reduce mosquito-biting rates and gastrointestinal illness among children and adults. For the health sector to leverage Africa’s housing modernization, research is urgently needed to identify the healthiest house designs and to assess their effectiveness across a range of epidemiological settings in sub-Saharan Africa.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

Musiime

Krezanoski

Smith

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

“…Housing modification for vector control has been re-introduced on the global agenda [46,47]. Leveraging housing improvement offers a key opportunity to boost malaria control by accessing public and private sector funding beyond the vertical donor funded mechanisms that currently support public health [48]. It has been estimated that homes for up to 2 billion people will need to be built by 2050 to accommodate the growing population in Africa, which is equivalent to building housing for 7000 people/hour for the next 30 years.…”

Section: Discussionmentioning

confidence: 99%

Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d’Ivoire: A geostatistical modelling study

Canelas

Thomsen

McDermott

et al. 2021

PLOS Glob Public Health

View full text Add to dashboard Cite

New malaria control tools and tailoring interventions to local contexts are needed to reduce the malaria burden and meet global goals. The housing modification, screening plus a targeted house-based insecticide delivery system called the In2Care® Eave Tubes, has been shown to reduce clinical malaria in a large cluster randomised controlled trial. However, the widescale suitability of this approach is unknown. We aimed to predict household suitability and define the most appropriate locations for ground-truthing where Screening + Eave Tubes (SET) could be implemented across Côte d’Ivoire. We classified DHS sampled households into suitable for SET based on the walls and roof materials. We fitted a Bayesian beta-binomial logistic model using the integrated nested Laplace approximation (INLA) to predict suitability of SET and to define priority locations for ground-truthing and to calculate the potential population coverage and costs. Based on currently available data on house type and malaria infection rate, 31% of the total population and 17.5% of the population in areas of high malaria transmission live in areas suitable for SET. The estimated cost of implementing SET in suitable high malaria transmission areas would be $46m ($13m –$108m). Ground-truthing and more studies should be conducted to evaluate the efficacy and feasibility of SET in these settings. The study provides an example of implementing strategies to reflect local socio-economic and epidemiological factors, and move beyond blanket, one-size-fits-all strategies.

show abstract

“…Designing appropriate methods and metrics for evaluating the impact of such housing improvements on health and on malaria speci cally is currently a matter for debate. Two recently conducted systematic reviews concluded that housing improvements may reduce malaria infection [4][5][6][7], resulting in the World Health Organisation recommending the use of untreated screening of homes [8].…”

Section: Introductionmentioning

confidence: 99%

House screening for malaria control: views and experiences of participants in the RooPfs trial.

Jones

Matta

Pinder

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: The housing stock of rural sub-Saharan Africa is changing rapidly. With millions of new homes required over the coming decades, there is an opportunity to protect residents by screening homes from malaria mosquitoes. This study, undertaken in the Upper River Region of The Gambia, explores local perceptions of what a good house should provide for its inhabitants and responses to living in a house that has been modified as part of a randomised control trial designed to assess whether improved housing provided additional protection against clinical malaria in children (the RooPfs trial).Methods: This descriptive, exploratory study was undertaken over 22 months using mixed-methods (informal conversations, observations, focus group discussions, photovoice, and a questionnaire survey) in a parallel convergent design. Analysis was conducted across the data sets using a framework approach. Following coding, the textual data were charted by a priori and emerging themes. These themes were compared with the quantitative survey results. The nature and range of views about housing and the RooPfs study modifications and the relationships among them were identified and described.Results: The data were derived from a total of 35 sets of observations and informal conversations in 10 villages, 12 discussions with the photovoice photographers, 26 focus group discussions (across 13 villages) and 391 completed questionnaires. The study participants described a ‘good house’ as one with a corrugate-metal roof, cement walls (preferably cement block, but mud block covered with cement plaster was also an acceptable and cheaper substitute) and well-fitting doors. These features align with local perceptions of a modern house that provides social status and protection from physical harms. The RooPfs modifications were largely appreciated, although poor workmanship caused concerns that houses had become insecure. However, the long-term trusting relationship with the implementing institution and the actions taken to rectify problems provided reassurance and enhanced acceptability.Conclusion: In developing housing to address population needs in Africa, attention should be paid to local perceptions of what is required to make a house secure for its inhabitants, as well as providing a healthy environment.

show abstract

Assessing the health benefits of development interventions

Cited by 13 publications

References 13 publications

House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d’Ivoire: A geostatistical modelling study

House screening for malaria control: views and experiences of participants in the RooPfs trial.

Contact Info

Product

Resources

About