Reduced Prevalence of Malaria Infection in Children Living in Houses with Window Screening or Closed Eaves on Bioko Island, Equatorial Guinea

Abstract

BackgroundPrevious studies demonstrated that fewer mosquitoes enter houses which are screened or have closed eaves. There is little evidence about the effect on malaria infection in humans that changes in house construction may have. This study examines the impact of protective housing improvements on malaria infection on Bioko Island.Methodology/Principal FindingsData from the annual malaria indicator surveys between 2009 and 2012 were used to assess trends in housing characteristics and their effect on RDT confirmed malaria infection in household members. Odds ratios were adjusted for socio-economic status of the household.22726 children between the ages of 2 and 14 years were tested for P. falciparum. Prevalence of infection in those living in houses with open eaves was 23.0% compared to 18.8% for those living in houses with closed eaves (OR = 0.81, 95% CI 0.67 - 0.98). The prevalence of infection for children in screened houses was 9.1% versus 20.1% for those living in unscreened houses (OR = 0.44, 95% CI 0.27 - 0.71). The proportion of houses with closed eaves increased from 66.0% in 2009 to 74.3% in 2012 (test for trend p = 0.01). The proportion of screened houses remained unchanged over time at 1.3%.Conclusion/SignificanceAs a malaria control intervention, house modification has the advantages that it is not affected by the growing threat of insecticide resistance; it protects all household members equally and at all times while indoors; and it offers protection against a number of vector borne diseases. The study provides evidence in support of efforts to regulate or encourage housing improvements which impede vector access into residences as part of an integrated vector control approach to complement existing measures which have been only partially successful in reducing malaria transmission in some parts of Bioko.

Plasmodium falciparum infection in febrile Congolese children: prevalence of clinical malaria 10 years after introduction of artemisinin‐combination therapies

“…Moreover in RoC, ACTs are easily accessible and affordable, as can be concluded from the fact that 31% of children presented to hospital after antimalarial self‐medication. A similar (6–13%) drop in malaria prevalence occurred in other endemic sub‐Saharan countries such as Gabon, Cameroon, Equatorial Guinea, Ghana, Burkina Faso, Kenya, Tanzania and Ethiopia . Children suffering from uncomplicated P. falciparum malaria in the study were treated according to the national treatment policy of RoC, where the recommended first‐line antimalarial is artemether–lumefantrine .…”

Poor Housing Construction Associated with Increased Malaria Incidence in a Cohort of Young Ugandan Children

“…An increase in the presence of household openings, such as windows and open eaves, has been associated with increases in mosquito entry into the home and parasite prevalence. [4][5][6][7] Poor-quality household construction materials have also been associated with increased mosquito entry, malaria incidence, and parasite prevalence. 4,5,[8][9][10][11] Several studies classify housing structures into quality groupings according to the composition of the construction materials have found poor house quality to be associated with greater presence of mosquitoes in the home and higher malaria incidence.…”

“…24 An interesting finding in this study was the association between an increase in the number of openings in the room where the study participant slept (presence of windows or eaves) and a lower incidence of malaria, which is contradictory to the findings from several other studies. [4][5][6]22,23,25 Indeed, conventional wisdom would suggest that more openings would lead to a higher mosquito density and an increased risk of malaria. In a randomized controlled trial from the Gambia, full or ceiling screening was associated with a reduction in vector density and childhood anemia, but had no effect on the prevalence of malaria infection.…”

Assessment of Novel Lehmann’s Funnel Entry Trap Prototypes Performance to Control Malaria Mosquito Populations

“…Since the establishment of a link between malaria and mosquito [11], house screening has been one of the rst experiments used as part of malaria vector control management [23]. Recent studies using house screen have found a reduced number of mosquitoes entering the house and a consequent protection of the households against mosquito bites compared to houses without screen [18,24,25]. In addition to the house screening, other studies demonstrated that well-built house with fewer entry points for mosquitoes or speci c modi cations of house design can help reducing malaria transmission by lowering human exposure to infectious bites [26,27].…”