Things mosquitoes like: biting people, mud huts and thatched roofs.
Things mosquitoes don’t like: screens, bed nets and closed eves.
Where you live affects your risk for malaria. A new analysis shows that the “where” is even more specific than geography. The kind of house you live is makes a difference, too.
Living in homes with screened doors and windows, closed eaves and ceilings may help keep mosquitoes out and reduce the likelihood of malaria infection by nearly half. A meta-analysis of 90 studies conducted in Africa, Asia and South America determined that modern housing may be the cause for people to be as much as 65 percent less likely to have malaria with a fever.
Insecticide-treated bednets are already a well-proven way to slow down infections for the disease that kills roughly 600,000 people each year. The research, published in Malaria Journal, indicates that housing may need to become a part of the conversation.
“Our study suggests housing could be an important tool in tackling malaria. This is a welcome finding at a time when we are facing increasing resistance to our most effective insecticides and drugs,” said lead author Lucy Tusting of the London School of Hygiene & Tropical Medicine. “Housing improvements were traditionally an important pillar of public health, but they remain underexploited in malaria control.”
The findings alone are not groundbreaking. For years, studies have shown the connection between housing and malaria rates. Evidence dates back as far as 2000. But research into the importance of ceilings, closed eves and household screening date back to the 19th century.
Despite all the research and evidence, it was not all that strong. There seemed to be a bunch of papers out there connecting reduced malaria incidence with better housing, but it was not definitive. The meta analysis conducted by Tusting and her colleagues essentially addresses some of the lingering concerns.
“Despite low quality evidence, the direction and consistency of effects indicate that housing is an important risk factor for malaria,” said the paper. “The relative consistency of the size and direction of effect across studies and settings indicates some protection by modern housing, compared to traditional homes, in urban and rural settings in Africa, Asia and South America.”
What we are left with is the knowledge that getting people into better homes can improve their health. What remains unknown is which of the improvements matter most or need to be prioritized.
“We now need to pinpoint which housing features can reduce mosquito entry in different settings, to incorporate these into local housing designs and to assess the impact on malaria in large-scale field trials,” said Tusting.
And then there is the pesky fact that housing still only offers some protection. Mosquitoes are most active during dusk and dawn. Living in improved homes and sleeping under bed-nets are a good way to stay safe, but that assumes people are not outside during the high-mosquito times of the day. That poses its own challenge.